Focus Area 8: Mental Health Basics
4. Mental Health Disorders Prevalent Among Youth

Anxiety Disorders

Everyone experiences anxiety from time to time but chronic anxiety is much more serious. An anxiety disorder is a condition in which you experience frequent, powerful bouts of anxiety that interfere with your normal day to day activity. Anxiety is the most common mental health concern in the United States. Roughly 1 in 4 youth will experience anxiety pervasive enough to be diagnosable.

There are many different types of anxiety disorders and the symptoms are varied. It is beyond the scope of this module to address them all, but as a youth worker there are certain things about anxiety you need to know.

Regardless of the stressor that is causing anxiety for a young person, you need to determine if it is interfering with their overall functioning. Stress is normal, so it is typical for the young people you work with to feel it. However, unmanaged stress can lead to anxiety and have a negative impact on healthy development.

The difference between anxiety and fear

While fear and anxiety overlap, there are differences:

  • “Fear is the emotional response to the real or perceived imminent threat, whereas anxiety is the anticipation of future threat,” according to the DSM-5 definition.
  • Fear generally elicits a fight or flight response to an immediate threat, whereas anxiety sparks a vigilant or avoidant response to possible future threat.

The difference between anxiety and nervousness

Severity and impeding normal or desired behavior is what differentiates nervousness, anticipation, or excitement from anxiety. An example to show the difference would be test-taking or interviewing. Most people get nervous for tests or interviews:

  • People without anxiety tend to address those nerves through preparation, “powering through,” deep breaths, etc. They continue to engage in those types of activities despite the nerves.
  • People who suffer from anxiety will be more likely to avoid activities that cause excessive “nerves.” They may have a panic attack as a result of the anticipation, which will likely affect their performance in the activity. This impacts their social, occupational, and emotional life and may limit what they are able to accomplish. It pushes nervousness into the realm of anxiety disorder.


Risk factors are situations that trigger stress and cause anxiety in youth. Examples can be social situations that make youth feel uncomfortable, pressure to perform situations like tests, or family turmoil like divorce. Symptoms are the outcomes of these stressors. The National Alliance on Mental Illness (NAMI) provides the following list of symptoms associated with anxiety disorders:

Emotional Symptoms:

  • Feelings of apprehension or dread
  • Feeling tense and jumpy
  • Restlessness or irritability
  • Anticipating the worst and being watchful for signs of danger 

Physical Symptoms:

  • Pounding or racing heart and shortness of breath
  • Sweating, tremors, and twitches
  • Headaches, fatigue, and insomnia
  • Upset stomach, frequent urination, or diarrhea

As a youth worker, if you notice these symptoms of anxiety, it is imperative you consult with your supervisor for appropriate steps to take. Remember, consulting is a sign of a highly effective youth worker.

Now that you have a good handle on general risk factors and symptoms of anxiety, it's important to understand that not all symptoms look alike or are equally severe for every young person. There can be many factors and co-occurring conditions at play.

Jillian Nelson is a Community Resource and Policy Advocate with the Autism Society of Minnesota and an autistic adult. Her lived experience with autism gives her an understanding of anxiety from a unique perspective. She shares her lessons to help you expand your own understanding and better support young people experiencing anxiety.


Be Patient: Often youth who struggle with anxiety will be caught up in circumstances and be very “spun up” at times. It is helpful to be patient. Take the time to hear them out. It will help expel some of that energy! 

Encourage self-care and relaxation in general: Offering ideas that promote relaxation such as drawing or coloring, journaling, exercise (especially yoga) can help the youth to regulate their emotional state. 

Highlight activities that reduce stress for that youth in particular: We all have our own spaces and activities that make us feel good. Reminding the youth of any activities you know they enjoy can be helpful in the midst of feeling that things are chaotic. There’s no research indicating that skateboarding in particular relieves anxiety, but if you know that a youth feels calm and confident while skateboarding, encourage them to do so. 

Join them! Whenever you can, try to join in the activity that the youth enjoys and offer reflections as they calm down. Making observations like “Wow, you’re really focused on that mandala” or “I bet it takes a lot of energy to get that trick right” can pull them into the activity and out of the anxiety. 

Ask “what has worked before?”: This can remind youth that they have been through this situation or feeling before and have gotten through it. The question will help remind them that they have tools that can help them to regain control of their response to a situation. It also is an opportunity to remind them of suggestions or interventions offered by a therapist in the past that they might not have thought of otherwise (e.g. breathing techniques). 

Focus on process, not content: A youth battling anxiety might be very caught up in the details and the content of a situation (test questions, over- scheduling, the details of a conversation). As a support person, you can focus on the process and the emotions they are experiencing to help them move through the anxiety in a healthy and productive way. They are not likely to solve the crisis while in such a heightened state of arousal. Helping to bring them back to a calmer state will enable them to better use problem-solving skills to address the issue.

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