Dealing with Anxiety in Teens and Young Adults: Visit to the Mountain Valley Treatment Center.
According to the National Association of School Psychologists, 1 in 11 teenagers today is diagnosed with anxiety severe enough to be considered a disorder; and girls develop anxiety disorders more frequently than boys. This is why we went to visit the Mountain Valley Treatment Center in Haverhill, NH. We wanted to use our combined knowledge of mental health, education, consulting, and evaluation to get a sense of this program and the services it provides. Located in a beautiful country site, with picturesque views of mountains and fields, the program made a strong impression on us. We were hosted by a skilled, highly credentialed team of outstanding specialists who spoke with passion about the work they do and the treatment model they have developed.
For many families, the relationship with the treatment team begins before the client steps foot in the program. The Mountain Valley team frequently travels around the country to meet clients in their homes to explain their services and to begin the process of educating potential clients and their families about disordered anxiety. Mountain Valley utilizes an evidenced treatment modality known as Exposure and Response Prevention (ERP) in which clients are gradually and thoughtfully exposed in a controlled and compassionate fashion to feared objects and situations, followed by a process of reflecting on the experience with their peers in support groups, in therapy sessions with members of the clinical team and in family therapy. The program relies heavily on the use of eight wellness modules: Farm to Table, Forest to Family, Equine Therapy, Mindfulness, Adventure, Fitness, Academics, and Art. The Mountain Valley team also offers comprehensive post-program support planning.
We asked the Clinical Director, Dr. Francis Moriarty to write a piece on anxiety for our blog to help families of struggling teens to better understand this issue. Please, feel free to comment or ask questions.
Anxiety is universal. Everyone gets it. It is a normal, useful, and even critical emotion. It communicates to us through a sense of worry, fearfulness, and alert that danger is near or upon us. Yet sometimes anxiety becomes an exaggerated, unhealthy response.
Adolescence or the teen years are the scene of a constant barrage of pressures and uncertainties. Anxiety, for many, if not all, teens, is a constant companion lurking in the background. For some teens, anxiety becomes a chronic state of daily life, interfering with the ability to attend school, perform to their potential, and participate in the extracurriculars that they have loved in the past. Often times, through avoidance, connections with friends and peers are sacrificed, while at home, domestic calm can be shattered by silence, withdrawal and at times aggression. Sometimes anxiety is characterized by a general, yet pervasive, sense of uneasiness. At other times, the fear and anxiety take the form of panic or fear of specific things or situations.
What to look for: Anxiety disorders take different forms and can vary widely from teen to teen. The presence of an anxiety disorder might be observed first with a general sense of uneasiness. Also, there may be the presence of excessive fears and worries, feelings of inner restlessness, and a consistent presence of apprehension, worry and hyper-vigilance.
Social settings can become occasions for great dissonance. In these situations anxious teens may appear dependent, withdrawn, ill at ease, and extremely avoidant. They may become overtaken with concern over their ability to keep it together or experience hyper-vigilant preoccupation with their ability to interact effectively.
In addition to emotional and behavioral problems, anxiety disorders can also impact a teen’s sense of physical well being. Common issues include: muscle tension, nausea or stomach complaints, headaches, soreness in muscles and joints, fatigue and a sense of lethargy that they believe is disabling. Skin discoloration or blotching, sweating, hyperventilating, trembling and an exaggerated startle response may also be present.
Adolescence is a time of emotional turbulence and upheaval in the best of circumstances. When an anxiety disorder is emerging this turmoil can be exaggerated in many different ways.
An overwhelming sense of intense panic may arise without any noticeable cause. Previously benign situations may take on new energy becoming triggers for a full-blown panic attack, characterized by a sudden episode of intense anxiety accompanied by emotional and physical symptoms. Once an experience of this kind is endured a teen may find that they are living in fear that another such occurrence may arise and that they will be powerless to prevent it.
Research indicates that school avoidance in middle school or junior-high has increased dramatically over recent years. Inordinate worry about performance or social pressure is at the heart of this rising level of truancy. A cycle of anxiety, physical complaints, and school avoidance is thus created and maintained. The pattern becomes exacerbated by increasing frequency and severity of physical complaints followed by visits to health care providers who most often are at a loss to provide concrete medical explanations for the complaints. The longer this pattern is perpetuated the more the fear rises and the harder it becomes to return to school. This leads to a greater sense of isolation and fear resulting in a greater entrenchment of avoidance.
Much of the research has suggested that a predisposition towards shyness and anxiety is prewired from birth. Additionally, if one or both parents have a tendency towards anxiety, there’s a good chance that their child will also have anxious tendencies. The environment, albeit often very loving and supportive, communicated in a family system comprising one or more anxious parents, may compound the child’s natural sensitive inclination. This is fertile ground for the generation of a cycle of increasing uneasiness. By the time this child reaches adolescence, his characteristic way of functioning in the world is consistently informed by a well-developed sense of anxiety. This maladaptive functioning is often supported by the entire family system through a process known as family accommodation. Family accommodation refers to ways in which family members accommodate their child’s symptoms. This can take many forms including providing reassurance, assisting or participating in the avoidance of feared objects or situations, taking over their child’s duties, and changing or modifying family routines. Family accommodation serves to reinforce a child’s anxious response and in so doing increases symptom severity and adversely impacts treatment.
Some teens with anxiety disorders can also become depressed or develop problems with eating. Evidence also suggests that persistent anxiety may lead to suicidal feelings or self-destructive behaviors. These symptoms should not be minimized and require immediate attention and treatment. Sometimes an anxious teen might self-medicate or self-soothe with the use of alcohol and drugs.
It is important to remember that the disturbance and disruption caused by the presence of an anxiety disorder can be effectively managed with education and treatment. A teen can learn skills to minimize the debilitating impact of anxiety and find the competence, skill and energy to face life with hope and confidence.
Parenting Troubled Teen 
This article can help recognize the symptoms of anxiety, but it does not provide any useful information about dealing with the symptoms.
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Laurie, thank you for your feedback. We are planning to post on resources on how to deal with anxiety in the nearest future. Meanwhile,here is the book that this program suggests to parents: “Anxious Kids, Anxious Parents: 7 Ways to Stop the Worry Cycle and Raise Courageous and Independent Children” by Wilson and Lyons. It has some good tips on changing the family dynamics and helping to deal with anxiety issues.
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My daughter just turned 19 and has suffered from anxiety for most of her life. It has gotten to the point that it is debilitating and she doesn’t have any friends or a job. She spends most of her days alone in her room. She sees a counselor every other week and takes an anxiety medication but I want to find real help for her. Your treatment center sounds like something that would really help her but we live in Washington Sate about 30 minutes east of Seattle. Do you know of any treatment centers like yours that are closer to us?
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Krista- As the parent of a teen who spent the better part of a year in bed due to debilitating social anxiety, I can relate to how you must be feeling. For me, it was a scary and frustrating time. For my son, it was a long, slow road to recovery. It took much more than weekly or bi-weekly visits with a counselor to get him on track. We would be more than happy at Changing Tide Associates to look into programs in you area. I would also recommend that you give the folks at Mountain Valley Treatment Center a call. They work with families across the country.
By the way, my formerly stuck-in-bed son is about to begin his first year in college, traveling from our home in New England to the Puget Sound area – your neck of the woods. Pretty exciting given what we’ve all been through!
Kathleen
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To kmcaleer2014: Thank you for your response. I appreciate that you have shared your story of success with your son and his journey with me. I just wanted to elaborate that we have done much more than weekly and biweekly visits to a counselor. She has been under the care of a Psychiatrist since she was 12 (many different ones, until we found the right one about 3 years ago). She has also been through a 12 week outpatient treatment program. But, as you pointed out, it is a long slow road to recovery and I feel like we have stalled in her recovery process so I am in search of other ways to help her.
Krista
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Krista- I apologize. Of course you have done MUCH more than simply bring your daughter to counseling. Like most caring parents dealing with an anxious child, I am sure you have accessed every possible resource to help your daughter. I suspect you have invested a lot of time, money and energy trying to move her toward recovery. I remember the hope I would feel when my son would make a little progress and my pain when he’d stall or lose ground. His one-step-forward and two-steps-back cycling happened over and over. It wasn’t until he entered a long-term program that could support his strengths while helping him to face his fears and insecurities that he was able to sustain real and lasting change.
This may or may not apply to you, but something I had to learn was to stop doing things for my son that he was capable of doing for himself. This was not easy for me as I was used to swooping in and fixing things. I thought I was helping him but in fact I was reinforcing his image of himself as disabled and unwell. I’m not sure I would have ever stopped doing this had it not been for the skills I learned and the insights I gained by doing my own therapeutic work. Talk about painful! In the end though, well worth it.
I am hopeful that your daughter will begin to move forward again and that she will learn the skills she needs to manage her anxiety. Please feel free to be in touch if you’d like to talk 413-579-8336.
Kathleen
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Kathleen,
Thanks again for your response. And, yes, we have been in a cycle of one-step forward, two-steps back. That is why I am feeling so helpless and frustrated and alone in this journey. I so appreciate your offer to talk. It means more than you know. My family (my mother and sisters) does not understand what I am going through with her because the anxiety comes from my husbands side of the family, and my husband just wants to pretend it isn’t as bad as it is or that it isn’t happening at all. I think he feels guilty because he suffers from anxiety and feels like it is his fault that she is the way that she is. I have told him a thousand times that no one blames him and that the important thing is to support her and to help her find the skills to move forward and learn how to live a fulfilling life with the anxiety and depression. But it just seems to be beyond his capabilities, so I am on my own in this.
I do see a counselor of my own, and she has told me the exact thing you just said…that I need to stop doing things for her. Its just so difficult because she is so depressed and I get worried that she will get worse if I stop helping her. She has no friends at all anymore. She is completely isolated. She only goes out of the house about three times a week. She has two volunteer positions, 1 at PAWS working in the Wildlife center for 5 hours once a week, 1 at Purrfect Pals, a no kill cat shelter that she goes to for 2 hours once a week and then she goes to her counselor every other week (sometimes once a week, depending on how she is doing). She is 19 and she hasn’t gotten her drivers license yet, so I still have to drive her everywhere. I have tried to talk to her counselor and her psychiatrist about the fact that I think she needs more intensive care to help her get out of this slump she is in but they say that she doesn’t “Meet the criteria” for more care. Which I gather means that the insurance company won’t pay unless she is suicidal.
Our country and its health insurance system is so messed up! Insurance companies should not be making decisions about the care that patients need! Doctors should be making the decisions about the care that patients need!
Anyway, this is getting very long. I am a nurse and I work the evening shift from 3pm to 11:30pm tonight so I have to get going. I will give you a call on one of my days off when I have more time to talk. I would really appreciate being able to talk to someone who understands what I am going through and could give me some real advice. : )
Thank you!
Krista
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Kathleen,
I forgot to say, congratulations to your son on his accomplishment! You must be so thrilled that he is going to college! He will love it here! It doesn’t rain as much as everyone says and it is absolutely beautiful when the sun shines : )
Krista
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Krista-
So sad. I’m sorry this is so hard for you and your family. It sounds like your hunch regarding “meeting criteria” is correct – insurance may not cover the cost of care for your daughter. Have you looked into the specifics of your plan? Sometimes, with strong advocacy and savvy navigating, people are able to get some services covered. In our case, insurance did pay for some of the treatment but the bulk was paid out-of-pocket by us. It was a significant burden, but given the results, something I would do again in a heartbeat.
Kathleen
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