A Therapist's Guide to Helping Teens Manage Anxiety

Anxiety is one of the most common struggles I see in teens—and one of the most misunderstood. As a therapist who primarily works with adolescents, I’ve learned that anxiety doesn’t always look like constant worry or panic attacks. Sometimes it looks like irritability, perfectionism, shutdowns, aches and pains, or a sudden refusal to go to school.

In this post, I hope to provide insight into how to support teens who are dealing with anxiety—whether you're a parent, loved one, educator, or clinician.

Understand What Anxiety Really Is

Anxiety is the body’s natural response to perceived danger. It activates our fight-or-flight system—even when there’s no real threat. For teens, anxiety can be triggered by social situations, academic pressure, family dynamics, or simply the chaos of adolescence.

Anxiety is not a character flaw, weakness, or lack of motivation. It’s a signal that the nervous system is overwhelmed.

💡 Therapist Tip: Try shifting the question from “What’s wrong with you?” to “What part of me is responding to this?" Though it may seem simple, this powerful reframe helps your brain to recognize that the feeling of anxiety is trying to tell you something. Emotions are information, and it is okay to lean into them and explore what they are trying to tell us.

Validate Before You Fix

Many well-meaning adults try to offer advice too quickly:

• "You're overthinking it!"

• "What are you so worried about? It's going to be fine."

• "Don't stress. Just breathe."

Though they may be well-intentioned, these phrases can leave teens feeling dismissed. What they often need first is validation—acknowledgement that their experience makes sense and that they’re not alone.

💡 Therapist Tip: To validate someone, listen to their experience and acknowledge what they are feeling without judgement or minimization of their feelings. For example...

• “It sounds like that was incredibly overwhelming.”

• “I can see why your brain went there.”

• “It makes sense that you feel this way. We can work through this together.”

  
  

Validation lowers emotional defenses, and teens are more likely to engage in coping strategies once they feel heard and understood.

Talk About Anxiety Openly

One of the most powerful things adults can do is normalize conversations about anxiety. When we talk about anxiety like it’s something that’s common and treatable (because it is), we reduce shame.

Encourage teens to:

• Name their anxiety (“This is just my anxious brain talking.”)

• Externalize it (“Even though I am having this thought, that does not make it true. I am not my thoughts.”)

• Notice patterns without judgment (“I tend to feel more anxious on Sunday nights—what might help?”)

  
  

💡 Therapist Tip: In therapy, we often personify anxiety to make it less intimidating. Giving it a name like “the Worry Voice” or “Inner Critic” helps teens push back against it instead of becoming overwhelmed by it.

Teach the Basics of Nervous System Regulation

Teens often need help connecting what they’re feeling to what’s happening in their bodies. Teaching them how anxiety shows up physically (racing heart, stomachaches, shaky hands, blanking out) gives them more language and control.

Some strategies I often use in therapy include:

• Box breathing (inhale for 4 (seconds), hold for 4, exhale for 4, hold for 4)

• Progressive muscle relaxation

• Cold water or ice for sensory grounding

• Movement—like walking or stretching—before trying to focus

  
  

💡 Therapist Tip: These aren’t just “tricks”—they’re nervous system regulation tools that teens can use in real time to help shift their emotional state and ground them in the present moment. Figuring out what strategies work best for each person can take time and some trial and error. Encourage teens to try various strategies in different situations and note how they respond to each.

Don’t Wait for Crisis to Start the Conversation

So many parents reach out for help when things have already hit a breaking point. That’s completely understandable—but there’s so much value in supporting teens before anxiety becomes unmanageable.

If you notice changes in sleep, appetite, motivation, or emotional outbursts—it may be time to check in. Asking “How’s your anxiety been lately?” can be more helpful than “What’s wrong?” because it gives teens a familiar framework. You can also share examples from your own life to help teens feel less alone in their experience (i.e., "I've noticed that when I am feeling more anxious and overwhelmed, I struggle to fall asleep at night.")

Final Thoughts

Teen anxiety is real, treatable, and incredibly common. What teens need most is support that feels safe, nonjudgmental, and practical. Whether it’s through therapy, school accommodations, or tools at home, anxiety can absolutely improve—and so can a teen’s confidence in handling it.

If you're a parent, educator, or therapist looking to support the teens in your life, I hope this guide gives you a place to start. And if you're a teen reading this: know that you're not alone, and help is always within reach.

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