Anxiety: Symptoms and Struggles in Adolescents

I am not very clear about my condition?

Since childhood, I have frequently experienced shortness of breath, and I have to take deep breaths to feel like I'm getting enough air.
When I close my mouth and breathe only through my nose, it feels like I'm not breathing at all.
Before approaching someone, I often feel discomfort in my chest, which seems to be related to anxiety.
During presentations at school, reading aloud, or speaking in front of a crowd, my body starts to tremble, my face feels very hot, my speech becomes incoherent, and I experience dizziness and a sense of pressure in my ears.

Starting in the second year of junior high, these symptoms have become more frequent, even occurring without having to go on stage.
Now that I'm in the third year, the pressure has increased, and my body feels even worse; I often have stomach discomfort.
This situation does not happen at home; it usually starts when I am at school or outside.
However, I cannot figure out why this is happening.
Sometimes I avoid going to class, but I feel that I shouldn't do that, which causes me a lot of distress.
When adults ask me why I feel this way, I can't articulate any reasons.
Everyone says I am very optimistic and helpful.
I do feel happy when I help others, but I tend to overthink things.
Recently, I have been feeling easily fatigued and unable to sleep at night, and I often feel dizzy for no apparent reason.
In the past, I would only feel dizzy upon getting up.
I suspect it might be anemia, but I'm not sure.
I often worry too much about various things, feeling that I need to plan for every situation, even if it may not arise for a long time.
I don't understand why I often feel this way.

Anny, 10~19 year old female. Ask Date: 2016/04/25

Dr. Ding Shuyan reply Psychiatry

Hello, you can check online to see if anxiety disorders and autonomic nervous system dysregulation resonate with your feelings.
These issues are quite common and manageable.
However, since they are related to personality and constitution, they may linger with us for a while, coming and going.
You can search for some muscle relaxation training and diaphragmatic breathing instructional videos on YouTube and practice along with them.
It takes some time to see results, and it's important to practice whenever you have a moment, even if it's just for a few seconds or minutes, to maintain that sense of familiarity.
You are still young, and many of your values are still forming.
Try to reflect on whether you have high expectations of yourself or if you tend to be a bit impatient.
If so, consider lowering your standards for the outcomes of your efforts, meaning do your best and leave the rest to fate.
In other words, we should still work hard, but not be overly attached to the results.
If these physical discomforts are troubling you, you can also consult a doctor, whether it's in psychosomatic medicine, psychiatry, or family medicine.
This is not a serious issue, so there's no need to be overly anxious.
It’s also best to let your parents know, so you’re not carrying this burden alone.
Wishing you all the best.
Sincerely, Dr.
Ding Shuo-Yan.

Reply Date: 2016/04/25

More Info

Understanding anxiety, especially in adolescents, is crucial as it can significantly impact their daily lives, academic performance, and overall well-being. The symptoms you've described—difficulty breathing, feelings of tightness in the chest, trembling, dizziness, and gastrointestinal discomfort—are common manifestations of anxiety disorders. These symptoms can be particularly pronounced in stressful situations, such as public speaking or social interactions, which can lead to avoidance behaviors, such as skipping classes.

From your account, it seems that your anxiety has been a persistent issue since childhood, intensifying during your transition to middle school. This pattern is not uncommon; many adolescents experience heightened anxiety due to academic pressures, social dynamics, and the general challenges of growing up. The physical symptoms you describe, such as feeling lightheaded or having a racing heart, can be attributed to the body's fight-or-flight response, which is activated during moments of perceived threat or stress.

It's important to recognize that anxiety can manifest differently in each individual. For some, it may present as social anxiety, where the fear of judgment or embarrassment in social situations leads to significant distress. For others, it may be generalized anxiety, characterized by excessive worry about various aspects of life, even those that may seem trivial. Your experience of feeling pressure to perform well academically, coupled with the fear of not meeting expectations, can exacerbate these feelings.

The fact that you feel more comfortable at home but experience discomfort at school suggests that your anxiety may be context-specific. This is a common experience for many students who feel safe in familiar environments but anxious in settings that require performance or social interaction. The pressure to maintain a positive image, as indicated by your description of being perceived as optimistic and helpful, can further complicate your emotional state. It’s essential to understand that it’s okay to feel anxious and that you don’t have to maintain a facade of being okay all the time.

Your concerns about fatigue and insomnia are also significant. Anxiety can lead to a cycle of poor sleep, which in turn can exacerbate feelings of anxiety and fatigue. The physical symptoms you’re experiencing, such as dizziness and gastrointestinal discomfort, could also be linked to anxiety. Stress can significantly affect the digestive system, leading to symptoms like stomachaches or nausea.

Given the complexity of your experiences, it would be beneficial to seek professional help. A mental health professional, such as a psychologist or psychiatrist, can provide a safe space to explore your feelings and develop coping strategies. They can help you understand the underlying causes of your anxiety and work with you to develop effective management techniques. Cognitive-behavioral therapy (CBT) is particularly effective for anxiety disorders, as it helps individuals identify and challenge negative thought patterns and behaviors.

When discussing your feelings with adults, it may help to express that you are experiencing significant anxiety that is impacting your daily life and academic performance. You might say something like, "I've been feeling really anxious lately, especially at school, and it's affecting my ability to focus and participate. I think it would help to talk to someone who can provide support." This approach can open the door for a constructive conversation about seeking help.

In conclusion, your experiences are valid, and seeking help is a strong and positive step. Anxiety is a common issue among adolescents, and with the right support and strategies, it can be managed effectively. Remember, you are not alone in this, and there are resources available to help you navigate these challenges.

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