About half of the teens diagnosed with depression are also diagnosed with an anxiety disorder. It is not uncommon for people to feel anxious or depressed at times. These feelings are normal reactions to life’s stressors. But some teens experience these feelings daily or almost daily for no apparent reason. In some cases, such feelings last for more than two weeks and when the feelings interfere with daily activities and going to school, it makes it difficult to carry on with normal, everyday functioning. These teens may have an anxiety disorder, depression, or both.

Depression and anxiety disorders are different, however adolescents with depression often experience symptoms similar to those of an anxiety disorder, such as nervousness, irritability, and problems sleeping and concentrating. But each disorder has its own causes and its own emotional and behavioral symptoms. Right now, there is no evidence one disorder causes the other, but there is clear evidence that many people suffer from both disorders.

Depression affects the way a teen thinks, feels, behaves, and functions. They feel discouraged, sad, hopeless, unmotivated, or disinterested in life in general. Children whose parents have depression are at a greater risk of being depressed. While depression affects all ages and both genders, studies show that girls are more likely to develop depression during adolescence. Research also shows that depression is a risk factor for suicide.


  • Loss of energy
  • Low self-esteem
  • Depressed or irritable mood
  • Difficulty sleeping or concentrating
  • Change in grades, getting into trouble at school, or refusing to go to school
  • Change in eating habits
  • Feeling angry or irritable
  • Mood swings
  • Feeling worthless or restless
  • Frequent sadness or crying
  • Withdrawing from friends and activities
  • Thoughts of death or suicide

If symptoms last for more than two weeks and interfere with regular daily activities and family and school life, your child may have a depressive disorder.

There are two types of depression: Major depression lasts at least two weeks and may occur more than once throughout your child’s life. Your child may experience major depression after a traumatic event such as the death of a relative or friend. Dysthymia is a less severe but chronic form of depression that lasts for at least two years.

Anxiety is a normal part of childhood, and every child goes through phases that are temporary and usually harmless. But children who suffer from a real anxiety disorder experience fear, nervousness, and shyness, and they start to avoid places and activities.

Anxiety disorders affect one in eight adolescents. Research shows that untreated children with anxiety disorders are at higher risk to perform poorly in school, miss out on important social experiences, and engage in substance abuse. It is important to note that anxiety disorders also often co-occur with other disorders such as depression, eating disorders, and attention-deficit/hyperactivity disorder (ADHD).


In general: They exhibit excessive fears and worries, feelings of inner restlessness, and a tendency to be excessively wary and vigilant. Even in the absence of an actual threat, some teenagers describe feelings of continual nervousness, restlessness, or extreme stress.

In a social setting: Anxious teenagers may appear dependent, withdrawn, or uneasy. They seem either overly restrained or overly emotional. They may be preoccupied with worries about losing control or unrealistic concerns about social competence.

Physical symptoms: They may complain about muscle tension and cramps, stomachaches, headaches, pain in the limbs and back, fatigue, or discomforts associated with pubertal changes. They may blotch, flush, sweat, hyperventilate, tremble, and startle easily.


Depression and anxiety disorders can often be treated the same way and at the same time. In many cases, therapy can be tailored to an individual so that it works to reduce the symptoms of both disorders.

Like anxiety disorders, depression can be treated with cognitive-behavioral therapy and antidepressants.

Treatment of anxiety disorders will likely focus on reducing the symptoms of anxiety, relieving distress, preventing complications associated with the disorder, and minimizing the effects on the teen’s social, school, and developmental progress. If the problem manifests in school avoidance, the initial goal will be to get the youngster back to school as soon as possible.


In many cases, cognitive-behavioral psychotherapy techniques are the most effective in addressing adolescent anxiety disorders. This approach helps the teenager examine his anxiety, anticipate situations in which it is likely to occur, and understand its effects. This can also help a youngster recognize the exaggerated nature of his fears and develop a corrective approach to the problem. Moreover, cognitive-behavioral therapy tends to be specific to the anxiety problem, and the teen actively participates, which usually enhances the youngster’s understanding. The learn to replace negative and unproductive thought patterns with more realistic and useful ones. Treatment often involves facing one’s fears as part of the pathway to recovery. Interpersonal therapy and problem-solving therapy are also effective.


When symptoms are severe, a combination of therapy and antidepressant medication may be used. Symptoms of depression and anxiety disorders often occur together, and research shows that both respond to treatment with selective serotonin reuptake inhibitor (SSRI) and serotonin norepinephrine reuptake inhibitor (SNRI) medications. Other medications may be used if an SSRI or SNRI does not provide adequate improvement.

Holistic wilderness therapy or outdoor therapeutic programs like Pacific Quest are very beneficial in treating teens with anxiety and depression.

Joining a support group, family therapy, trying relaxation techniques, breathing exercises, regular exercise is also suggested as a plan of action.

If the teenager has engaged in suicidal or self-endangering behavior, is trying to self medicate through alcohol or drug use, or is seriously depressed, these problems should be addressed immediately.