Understanding Teen Anxiety and Depression: Signs, Screening, and Support
Adolescence is a time of rapid growth, emotional development, and increased stress. For some teens, these challenges become overwhelming and develop into anxiety or depressive disorders that interfere with daily functioning, academic performance, and relationships. Early recognition of symptoms, appropriate screening, and timely intervention are essential.
Teen Anxiety and Depression Through the DSM-5-TR Lens
Mental health diagnoses are guided by the DSM-5-TR (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision), which outlines specific criteria used by licensed clinicians.
Anxiety Disorders in Teens (DSM-5-TR Overview)
Anxiety disorders are defined by excessive fear, worry, or avoidance behaviors that are persistent and developmentally inappropriate. In the case of Generalized Anxiety Disorder (GAD), symptoms must be present for at least six months and may include:
Excessive worry that is difficult to control
Restlessness or feeling on edge
Fatigue
Difficulty concentrating
Irritability
Muscle tension
Sleep disturbance
These symptoms must cause clinically significant distress or impairment and not be attributable to substances or another medical condition.
Depressive Disorders in Teens (DSM-5-TR Overview)
Depressive disorders are characterized by a persistent low mood or loss of interest or pleasure in most activities for at least two weeks. For Major Depressive Disorder, five or more symptoms must be present, including at least one core symptom:
Depressed or irritable mood
Loss of interest or pleasure
Changes in appetite or weight
Sleep disturbances
Fatigue or low energy
Feelings of worthlessness or excessive guilt
Difficulty concentrating
Recurrent thoughts of death or suicide
Symptoms must represent a change from previous functioning and cause meaningful impairment.
Screening Tools for Teens
Validated screening tools are often used to help identify the presence and severity of symptoms. These tools are not diagnostic, but they help guide clinical decision-making.
PHQ-9 (Patient Health Questionnaire-9)
The PHQ-9 is a widely used 9-item self-report screening tool for depression. It measures the frequency of depressive symptoms over the previous two weeks and includes an item related to suicidal thoughts, which requires immediate clinical follow-up if endorsed.
🔗 PHQ-9 Overview and Access:
https://www.phqscreeners.com/select-screener/36
🔗 PHQ-9 for Adolescents (Teen Use Guide):
https://phq-9.org/blog/phq-9-for-adolescents-teen-depression-screening-guide/
GAD-7 (Generalized Anxiety Disorder-7)
The GAD-7 is a brief 7-item screening tool used to assess anxiety severity. It evaluates how frequently anxiety symptoms have occurred over the past two weeks and is commonly used in outpatient, school, and medical settings.
🔗 GAD-7 Screener:
https://www.phqscreeners.com/select-screener/41
When a Higher Level of Care Should Be Considered
There are situations in which outpatient therapy alone may not be sufficient. A higher level of care may be clinically indicated when:
Suicidal ideation with intent or plan is present
Self-harm behaviors are occurring or escalating
There is a rapid decline in functioning (school refusal, isolation, inability to complete daily tasks)
Aggressive behavior or threats toward others are reported
Symptoms are not improving or are worsening despite outpatient treatment
Severe mood instability, psychosis, or unsafe impulsivity is observed
In these situations, immediate evaluation through emergency services or a psychiatric hospital is recommended.
Behavioral Health Hospitals Nearby
The following facilities provide inpatient or intensive psychiatric services for adolescents and teens when a higher level of care is needed:
Cypress Creek Hospital
Inpatient and outpatient psychiatric services for adolescents and adults.
🔗 https://www.cypresscreekhospital.com
UTHealth Houston Harris County Psychiatric Center
A psychiatric hospital providing crisis stabilization and inpatient mental health services.
🔗 https://hcpc.uth.edu
Behavioral Hospital of Bellaire
Offers inpatient behavioral health treatment for adolescents and adults.
🔗 https://www.behavioralhospitalofbellaire.com
Woodland Springs Behavioral Health Hospital (Conroe)
Provides specialized adolescent and teen behavioral health programs, including inpatient care.
🔗 https://www.woodlandspringshealth.com/child-adolescent
Teen Privacy, Confidentiality, and Family Involvement
Therapy for teens is conducted with a strong emphasis on confidentiality and trust. A private therapeutic space is provided so that teens can speak openly and honestly. Information shared in sessions is not routinely disclosed to parents.
However, confidentiality is ethically and legally limited when there is a risk of harm to the teen or others. In those situations, caregivers are contacted to ensure safety.
Family sessions are incorporated as clinically appropriate, recognizing that family involvement can support long-term healing. At the same time, privacy is respected as a cornerstone of effective teen therapy.
Take the Next Step Toward Support
If your teen is showing signs of anxiety, depression, emotional withdrawal, or behavioral changes that are concerning, professional support may be helpful.
Inner Acceptance Therapy offers compassionate, evidence-based care for teens and families.
📧 Email: Contact us through email at info@inneractnow.com
📞 Phone: Call or text us at 832-543-3002 to discuss your concerns and schedule an appointment
Support is available, and help can begin with one conversation.
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