Best Coping Skills for Teens With Anxiety

1. Name it and rate it from 0 to 10

Best for: Getting a little distance from the feeling

When anxiety hits, say what it is and give it a number: "This is anxiety, about a 7." Naming it separates you from the feeling, and the number lets you notice that it moves. Over a week of ratings, many teens discover that their anxiety peaks and falls on its own, which is exactly what it feels like it will never do.

2. Slow your breathing, then stay

Best for: Bringing the body down enough to think

Breathing slowly and a bit more gently than usual, with a longer out-breath, can take the edge off a racing heart and dizziness. The NIMH fact sheet for teens, "I'm So Stressed Out!", lists deep breathing alongside visualization and mindfulness apps as ways to cope.

The key is what you do next. Use the breathing to stay in the class, the conversation or the car, not to get out of it. Breathing as a ticket to leave teaches your brain the situation was dangerous.

3. Schedule a "worry time"

Best for: Teens who worry all day or at bedtime

Pick a 15-minute slot each afternoon (not right before bed). When a worry shows up at other times, jot it down and tell yourself you will deal with it at worry time. When the slot arrives, go through the list; many items will already feel smaller. This CBT technique does not ask you to stop worrying, just to postpone it, which is a lot more doable.

4. Build a fear ladder and climb one rung

Best for: Avoidance that is shrinking your life

List situations you avoid, from mildly uncomfortable to very scary, and rate each one. Start with a rung around 3 or 4 and practice it repeatedly until it feels manageable, then move up. For social anxiety, that might go from asking a store employee a question, to answering one question in class, to texting a friend to hang out.

This is a self-guided version of exposure, the core of CBT for anxiety. Researchers such as Michelle Craske describe exposure as working by building new learning that the feared outcome does not happen, or that you can cope when it does. A therapist can help you set up the ladder so it is neither too easy nor overwhelming.

5. Test the prediction

Best for: Catastrophic "what if" thinking

Before a scary thing, write down exactly what you expect: "If I speak in class, people will laugh and I will freeze." Afterward, write what actually happened. Your brain updates faster from evidence you collected yourself than from anyone telling you it will be fine.

6. Drop one safety behavior at a time

Best for: Teens who "cope" by over-preparing, checking or escaping

Safety behaviors are the small things you do to feel safer: rehearsing every sentence, sitting by the door, only going places with one specific friend, checking your phone to avoid eye contact. Research on anxiety treatment links safety behaviors to keeping anxiety going, because they prevent you from learning you would have been fine without them. Pick one and try going without it.

7. Limit reassurance seeking

Best for: Asking "Are you sure it's okay?" over and over

Asking a parent or friend for reassurance feels good for a minute, and then the doubt comes back and you need to ask again. Try asking once, then practicing sitting with the uncertainty. Tell the people you usually ask so they can support you by answering once kindly instead of repeating it.

8. Protect your sleep

Best for: Anxiety that is worse when you are tired

The CDC lists 8 to 10 hours of sleep a night as the recommended amount for teens ages 13 to 17. Tired brains read more things as threats. A consistent wake time, even on weekends, and a phone that charges outside your bedroom are two of the simplest changes.

9. Cut back on caffeine and energy drinks

Best for: Jitters, a racing heart and poor sleep

Caffeine produces the same body sensations anxiety does: a fast heart, shakiness, restlessness. NIMH's fact sheet for teens recommends limiting caffeine. If you drink energy drinks, cutting back gradually can reduce headaches while you adjust.

10. Move your body

Best for: Burning off restless energy

NIMH's fact sheet for teens includes regular exercise and regular, healthy meals among its coping suggestions. A bike ride, a run, a climbing gym session or a walk with the dog all count. Exercise also gives you practice feeling a fast heartbeat without it meaning danger.

11. Talk to someone, then do something together

Best for: Teens who pull away when anxious

Reaching out to friends or family who help you cope is on NIMH's list too. The strongest version is not only talking about the worry but doing something with that person: getting food, playing a game, going somewhere you might otherwise skip.

12. Keep a short journal

Best for: Spotting patterns and triggers

Two or three lines a day is enough: what happened, how anxious you were from 0 to 10, and what you did about it. After a couple of weeks you will usually see patterns, like Sunday nights, a certain class, or days you skipped breakfast, and that is useful to bring to a therapist.