7 Science-backed Ways to Help Adolescents Struggling with Anxiety
According to the ADAA, anxiety disorders affect 31.9% of adolescents each year and have risen 25% since the start of COVID.[1] While there are many reasons why anxiety is on the rise, let’s take some time and delve into the science behind mitigating anxiety.
1. Flow
Help your teen take the wind out of their anxiety’s sails by encouraging them to engage in an activity that is conducive to flow. Take it from Charles Limb, a neuroscientist at Johns Hopkins who conducted an experiment on flow states in 2008. While using fMRIs to examine the brains of jazz musicians while improvising, Limb discovered that the dorsolateral prefrontal cortex (the area of the brain known for self-monitoring) was deactivated.[2] This is the region of the brain where our inner critic (the mighty voice of doubt / the arbiter of our planned actions) resides. Thus, when the dorsolateral prefrontal cortex goes quiet, so does your teen’s inner critic.[3] The good news is that teens don’t need to be jazz masters to experience such bliss. Flow comes in all shapes and sizes. Teenagers can achieve it while engaging in almost any pursuit, so long as they pursue a worthy, yet reasonable challenge, and fully commit their attention.[4] This could be as simple as having your teen roll up their sleeves and help you cook a new dish, tackle some gardening, tidy up the house, etc. Perhaps they would be more inclined to pursue a solo activity like riding a bike, going for a walk, skateboarding, or learning a new dance. The more we can help young people tune into flow, the more we can help them turn off their dorsolateral prefrontal peanut gallery.
2. Opposite Action
Let’s say (hypothetically) that your teenager is feeling anxious about socializing this weekend. The anxiety compounds and they begin justifying another night alone in their room rather than doing something social. Try helping them punch back with opposite-action. This DBT skill encourages a person to do the opposite of what they might normally do under the given circumstances.[5] For instance, if you see your teenager slipping into a pattern of isolation, help them flip the script and encourage them to hang out with a friend. This is easier said than done. Trust me, I know. But the point of this exercise isn’t supposed to be easy. In fact, they might loathe every single second of doing it, but the truth is that they will be cutting off the oxygen supply to their anxiety. They will strengthen a positive impulse, which may someday become a reflex, and better yet, a habit. Personally, when my young adult clients are feeling anxious, I like to encourage them to take a trip with me to the gym. It helps them to clear their mind, but best of all, it gives them the satisfaction of having punched back at their anxiety. In many ways, throwing that punch is more satisfying than the workout itself. The more we can help young people hone this reflex, the more they can learn to mitigate anxiety and foster resilience.
3. Thought Flagging
Nothing breeds intrusive thoughts quite like anxious thinking.[6] And the more teens push their intrusive thoughts away, the more they seem to appear. Left unchecked, these thoughts can wreak havoc on your teen’s focus, motivation, self-esteem, outlook, and disposition. But we don’t have to sit idly by and watch these unruly thoughts get away with it. Instead, we can encourage teens to mark them, label them, and study their patterns. This tool is known as thought flagging. Eventually, the goal is to become so familiar with these thoughts that we can identify them before they take hold of us. And the better we get at identifying these thoughts, the better chance we have to work on creating separation and detachment from them.
4. Thought Acceptance
Though flagging is the first step, but what happens after our teens have become experts at spotting their anxious thought? The next step is acceptance. This doesn’t mean encouraging your teenager to greet these thoughts with a warm smile and a hardy handshake; it means encouraging them to acknowledge their presence and accept them the way they might accept a tacky holiday gift from a quirky Aunt (Thanks, but no thanks). No strings attached. Help them to try and recognize these thoughts for what they are (cortisol disguising itself as cognition). Please note that this is not a pseudo-mindfulness platitude. According to Daniel Wegner (the social psychologist who discovered the ironic processes theory of thought suppression), our brains actively “check in” on the thoughts that we push away.[7] So, it’s not enough to merely flag a troubling thought because we still run the risk of pushing it away. And the extra attention we give a thought by trying to suppress it basically tells our brains: ‘Hey! This thought is super important. Please haunt me with it all day.” Thus, the sooner teenagers learn to flag their anxious thoughts, the sooner they can accept them, and the sooner they can accept them, the sooner they will finally have some peace of mind. The opposite of anxiety is not calmness, it is acceptance.
5. Paradoxical Intention
Teenagers can empower themselves by undermining their fears. It sounds strange, but this is the core of paradoxical intention, a tool used in Logotherapy to help people overcome fear and anxiety.[8] Let’s say (hypothetically) that your teenager has a stressful class presentation coming up. It needs to be their best work yet and it’s giving them a ton of anxiety. Using paradoxical intention, they would take a break from trying to make the presentation “perfect” and instead explore what might happen if things didn’t go perfectly according to plan. Encourage them to take a break and imagine themselves getting up in front of their classmates and bursting out into song. Would the world actually end? It might sound strange at first, but this technique works by undermining your performance anxiety to “be perfect,” which, in turn, gives you a chance to be great. This is subversive thinking at its best. If you are familiar with the Harry Potter franchise, a great example of paradoxical intention can be seen when Harry and his classmates learn to conquer their fears by literally turning that which they fear most into something laughable, such as a massive spider on roller skates.[9] Help your teenager subvert their expectations the right way and suddenly they will be able to escape the trap of perfection and step into greatness.
6. Reframing
Oscar Wilde hit the nail on the head when he said, “The optimist sees the donut, the pessimist sees the hole.” Perspective is everything, and the frame through which we perceive reality can always be adjusted. But there’s just one problem: anxiety breeds stubborn and fickle cognitive distortions that warp the very frame through which our perceptions flow. Some of these distortions are catastrophizing (assuming the worst), magnifying (exaggerating your negative qualities while minimizing your positive qualities), labeling (reducing oneself or someone else to a single label), etc.[10] The list goes on. However, when teenagers learn to take the time to actively reframe their thoughts, they can tune into cognitive clarity and give themselves an opportunity to refill all those half-empty cups they have lying around. But first, they must learn how to interrupt their distortions, challenge them, and then make a positive adjustment. For example, perhaps an upcoming standardized test has them in the throes of catastrophizing. The more they think about it, the more they convince themselves that they haven’t studied enough to perform as well as they need to. And the more they think about that, the more they convince themselves that they aren’t going to get into college. As hard as it may be, try encouraging them to reframe their perspective and think of all the ways in which they are intelligent. Take an even bigger step back and help them realize that they don’t have to study, they get to study. Reframing, in general, often comes back to the realization that we don’t have to do things; rather, we get to do things (I don’t have to go to school, I get to go to school, etc.). This subtle distinction, when applied correctly, can turn flip obligations from drudgery to opportunity.
7. Positive Self-Talk
Muhammed Ali wasn’t just the greatest boxer of all time; he was also the undisputed champion of positive self-talk. Now, I’m not saying that we all need to encourage teens to tell themselves that they can “tussle with alligators,” but it might not hurt to take a page out of Ali’s book. Truth be told, positive self-talk is about far more than hyping ourselves up; it is scientifically proven to enhance levels of self-esteem and boost our problem-solving capabilities.[11] But that’s just the tip of the iceberg. Positive thinking also results in enhanced mental functions such as creative thinking, cognitive flexibility, faster processing, and a widened attention span.[12] Also, people who regularly think positively are at least .001% more likely to levitate (the jury is still out on this one). All in all, self-directed language that expresses self-compassion, self-acceptance, and self-love is a powerful tool that we all have at our disposal. Here’s what it looks like in practice: encourage your teen to write some positive affirmations on post-it notes and place them near their desk. See what happens if they vocalize some of their past accomplishments at the start of breakfast. What if, during the drive to soccer practice, they take a minute to remember some of the positive things that other people have said about them over the years? How could they make more of a daily effort, in general, to speak to themselves the way they would speak to a best friend? Afterall, they can’t start being their own best friend until they start talking to themselves like one.
[1] Facts & Statistics: Anxiety and Depression Association of America, ADAA.” https://adaa.org/understanding anxiety/facts-statistics.
[2] This Is Your Brain on Jazz: Researchers Use MRI to Study Spontaneity, Creativity - 02/26/2008.”This Is Your Brain on Jazz: Researchers Use MRI to Study Spontaneity, Creativity - 02/26/2008, 26 Feb. 2008, www.hopkinsmedicine.org/news/media/releases/this_is_your_brain_on_jazz_researchers_use_mri_to_study_spontaneity_creativity.
[3]This Is Your Brain on Jazz: Researchers Use MRI to Study Spontaneity, Creativity - 02/26/2008.”This Is Your Brain on Jazz: Researchers Use MRI to Study Spontaneity, Creativity - 02/26/2008, 26 Feb. 2008, www.hopkinsmedicine.org/news/media/releases/this_is_your_brain_on_jazz_researchers_use_mri_to_study_spontaneity_creativity.
[4] Csikszentmihalyi, Mihaly. (1990). Flow: The Psychology of Optimal Experience.
[5] Shireen L. Rizvi, Marsha M. Linehan, The treatment of maladaptive shame in borderline personality disorder: A pilot study of “opposite action”, Cognitive and Behavioral Practice, Volume 12, Issue 4, 2005.
[6] Seif, Martin, and Sally Winston. “Unwanted Intrusive Thoughts | Anxiety and Depression Association of America, ADAA.” Unwanted Intrusive Thoughts | Anxiety and Depression Association of America, ADAA, 26 Apr. 2018, adaa.org/learn-from-us/from-the-experts/blog-posts/consumer/unwanted-intrusive-thoughts.
[7] Wegner DM, Schneider DJ, Carter SR 3rd, White TL. Paradoxical effects of thought suppression. J Pers Soc Psychol. 1987 Jul;53(1):5-13. doi: 10.1037//0022-3514.53.1.5. PMID: 3612492.
[8] Victor Frankl, Mans Search For Meaning, Logotherapy in a Nutshell
[9] Rowling, J. K., Harry Potter and the Prisoner of Azkaban. New York: Arthur A. Levine Books, 1999.
[10] Burns, D. D. (1989). The feeling good handbook. New York, NY: Morrow.
[11] Positive Self talk (Curry & Russ, 1985; Scheier & Carver, 1993).
[12] Goleman, D. Focus: The hidden driver of excellence. PP. 170. HarperCollins Publishers, 2013.