This New York Times Opinion piece by Richard A. Friedman, Director of the Psychopharmacology Clinic at the Weill Cornell Medical College, provides an informative look at the workings of the adolescent brain in cases of to anxiety. The article, Why Teenagers Act Crazy, explains that the part of the brain that processes fear, the amygdala, develops much faster than the prefrontal cortex, which is used in reasoning and executive control. Because of this, adolescents are quicker to take fright at a potentially threatening situation than a child or adult. Yet they lack an adult’s ability to reason through the problem and realize that it may not be as much of a threat as originally perceived. At the same time, the reward center of the adolescent brain develops at a faster rate, predisposing them to more potentially threatening situations.
The combined effect of precocious development of the fear and reward centers of the brain places adolescents at greater risk for anxiety. Ironically, one of the most prescribed treatments for anxiety – cognitive behavioral therapy (CBT) – may be less effective for adolescents because it relies on underdeveloped reasoning ability to “unlearn” fearful responses to safe but apparently threatening stimuli. Stimulants prescribed to treat ADHD also can enhance fear conditioning which contributes to anxiety.
Dr. Friedman concludes by pointing out that adolescents are uniquely vulnerable to anxiety and have a hard time learning to be unafraid of passing dangers. For most adolescents, anxiety is a normal part of their development – a phase that they will soon outgrow. But when anxiety takes over and adversely impacts functioning, it is important to look at the interplay of drugs and wiring of the brain, and to consider treatments in addition to CBT. I recently wrote about one promising treatment called “reconsolidation”, still in the early research stages, in my blog post of July 7, 2014: Experimental Treatment for the Emotional Pain of PTSD and Anxiety
There are many sides to mental health recovery. Jay’s blog takes The Family Side.
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