The Doctor is In

Q:My teenager is starting high school and has some anxiety about it. It started as fears about a new environment, which I assumed would come with the territory, but has progressed to her losing sleep and some change in her appetite. What are some tips for alleviating her anxiety, and at what point does it make sense to get in touch with a therapist for her?

I am so glad that you asked this question as it is timely, important and close to home for me as well.

Part of being a teenager is constantly navigating new environments, including new schools, new friends, and constant changes in the brain and body. I have two teenagers, so I am well aware of some of the issues you are dealing with, both as a physician and a parent.

My daughter is just about to start college, and believe me, this has not been a stress-free time in our house. A certain amount of anxiety is totally normal and to be expected, especially with your daughter starting high school. In fact, some degree of anxiety can be helpful for staying motivated, organized and prepared, and making people aware of danger and helping calculate risks.

But, unchecked anxiety may greatly impact your daughter’s quality of life. The fact that she is losing sleep and you are noticing changes in her appetite are both red flags that this may be more than a mild case of first-day jitters.

These signs and symptoms may also be an indication that she could be depressed as well as anxious. Other signs to look out for are lack of interest in things she used to find enjoyable, feelings of guilt or worthlessness, lower energy, or expressing any dark thoughts.

First, it is so important to have open lines of communication with your daughter. Being non-judgmental and just being there for her is vital during these trying times. Hopefully she can share her feelings and give you more information.

At this point, given what you have told me, it would be imperative to get her some professional help. Otherwise, there is a risk that these symptoms could get worse, she could do poorly in academic and social settings, or may even try self-medicating with alcohol or other substances.

In addition to seeing a therapist who may give her tools to help her, you can start by encouraging your daughter to increase her activity. Regular exercise is not just about physical health but can be a huge boost for mental health as well. Getting her heart rate up can boost the anti-anxiety chemicals in her brain similar to what prescription drugs can do.

Making sure she limits any caffeine intake and gets enough sleep will also help her. Meditation, mindfulness and deep breathing exercises are all good techniques to ameliorate feelings of anxiety and provide feeling more grounded.

Having her see a therapist is not a last resort. It is a good first step to getting her feeling better as soon as possible.

Interview the therapist and make sure your daughter feels comfortable, as the connection is key. There are prescription medications available to help more severe cases, but these should not be the first thing to reach for.

Taking the harder route with other therapies may provide a more successful and longer lasting outcome with fewer side effects than a quick fix. Good luck with your daughter.

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