Today on the show, I’m joined by Gina Nelson,  a licensed clinical social worker and creator of Combating Teen Anxiety–her proven 10-step method to reduce anxiety in teens.

Gina and I talk about how to catch your teen’s anxiety before it gets out of control.

  • How Gina got involved in working with teens and parents
  • The difference in anxiety in children and adults
  • Common causes of anxiety in teens
  • How does social media contribute to anxiety and distress in teens
  • How perfectionism affects children and teens
  • Things that parents do that are not helpful for their teen’s mental health
  •  Signs that a teen may need professional help with their anxiety

Related resources:

57. Parenting A Teen in Crisis with Aaron Huey


Carrie: Hope for Anxiety and OCD, episode 86. I’m your host, Carrie Bock. This month’s episodes are about anxiety, and next months are gonna be about OCD. So today on the show we have an interview with Gina Nelson on how to catch your teen’s anxiety before it gets out of control. Before we get into the interview, we want to give away a t-shirt. Drum roll please!

We give away t-shirts randomly to our email subscribers. Today’s winner is number 40, and that happens to be Sasha. So it doesn’t look like Sasha has been opening our emails, but hopefully when we email her personally and remind her that she’s on the email list and see what size T-shirt she wants, hopefully our emails will be capturing her attention a little bit more.

We’ll see. So Sasha, you have won a Hope for Anxiety, and OCD T-shirt. This is not a scam. It’s for real.

All right, let’s dive into the interview now.

Gina Nelson’s Background and Areas of Expertise

Carrie: Tell us a little bit about yourself.

Gina: Gina Nelson. I’ve been a licensed clinical social worker for 22 years now and practicing both California and in Idaho, native to California, and I’m certified in EMDR.

So I do a lot of work with anxiety and kind of some trauma work with people. And probably the majority of my practice is actually perfectionistic high achievement-driven adults and teens. And I’m also certified in the Daring Way, which is Brene Brown’s curriculum for the Daring Way which it’s all about shame, resilience, and working with parents and teens or adults and teens just on how to manage shame and deal with vulnerability and how that comes out in anxiety.

Discussion on Anxiety and Perfectionism

Carrie: Yes. There’s a lot of perfectionists out there.

Gina: Yes. I like to call myself a recovering one, but it’s one of those things I have to work on, on a regular basis as well and be mindful of.

Carrie: Yeah, absolutely. Tell us how you got involved in working with teens and parents.

Gina: Sure. I told you, I’m gonna give you my cliff version of it, but essentially, I mean, I was an anxious teen.

I grew up in a house with a mom who was pretty anxious, although the word anxiety was never used. And she was really good at kind of masking her perfectionism and things with alcohol, which was kind of her version of how to tame it because the idea of mental health wasn’t an acceptable topic in our house, and it was more probably of a shame trigger now looking back to even identify anxiety as a problem, if you will.

Carrie: Right.

Gina: And so I didn’t really know how to cope with that. And in fact, there was so much going on just in my own house and my own perfectionism and achievement-driven characteristics in school that actually about my sophomore year, I lost a chunk of hair in the back of my head, it was larger than a silver dollar and I kind of became this kind of like identified like, what’s wrong with you?

How come you can’t manage things? I kind of took on that sense of, wow, what’s wrong? And so, you know, it wasn’t until like my college years when I got out of that home and I started thinking, okay, I’m gonna manage this anxiety in a different way. And like many of my clients today, I became kind of more the perfectionistic, task-driven achievement goal seeker who just kept, I managed that anxiety in that way.

And when I worked as a social worker initially, the first 20 years I spent in hospitals working in trauma ICU with medical crisis, that my own anxiety in those settings was completely like it disappear. I used to call myself the calm in the storm, and I thought, this is so strange. Like I can sit around all this chaos and trauma and be with people when people are dying in a code.

And I didn’t have anxiety in that. I was calm, but in my own home life, that wasn’t necessarily the case. And so it was starting to show up in that kind of frenetic energy that I remembered as a kid. And I thought, oh, this is not what I want from my kids. And I had to recognize that I had to start doing something to manage my own anxiety because it was kind of being reflected on their behaviors and within the home.

How Gina Got Involved in Working with Teens and Parents

And quite frankly, I think we all tried to swing the pendulum a different way from some of the stuff in our parent world. So I thought, okay, I’m not gonna be like this anxious person, but in turn, I actually had my own anxiety and I just was managing it differently. When I got certified in Brene’s work in 2017 and really, you know, had first read her work in 2013 with Darren Greatly, it really was the first time the word shame and the recognition of how I managed anxiety was normalized by somebody like me.

So it was, that was kind of the beginning of this journey. And so I thought when I opened my practice in 2017 and was pulling away from more than medical and doing more practice, of course, attracted people that were like me, right? I attracted a lot of corporate professionals and people who were trying to manage their anxiety or thought they were managing their anxiety until they couldn’t, and they also got teens that were in that same scenario.

And when I started working with the teens. There was just such this aha of,” “Oh my gosh!” These adults who are in their forties and fifties are now coming to terms with it. What if we could catch these teens in their high school years or their middle school years when all the shame stuff is happening and all these issues?

And so it kind of was this, sense of these kids were coming from perfectionistic parents. A lot of ’em were, at least the ones in my practice were high achievement kids. And they had a lot of pressure on themselves. And so with that, I thought, okay, I’m gonna be working with them and with these adults, and we’re gonna see if we can kind of really change the trajectory of these teens course so that they don’t end up in their forties and fifties going, oh my gosh, I’ve spent all these years of my life trying to manage this anxiety and I’m not living in peace or accessing that real calm.

Carrie: Working from the family system approach, like you’re talking about with working from the parent side and the teen side is so helpful because you near round someone that’s anxious, you’re more likely to be anxious yourself. It’s like that energy is already in the room.

Gina: I call it that frenetic energy, right? That everybody is trying to balance that whoever that phonetically anxious person is and however that manifest for them, whether it’s anger or you know, screaming or just control whatever it is, everybody else in the environment is trying to adapt to that.

Similarities and Differences in Anxiety between Teens and Adults

Carrie: How does anxiety look similar and different in terms of, because a lot of times when we’re talking about mental health disorders, it’ll look different in kids and teens than it does in adults.

So what have you seen as far as how it usually presents in teenagers versus adults? I mean, I’m sure there’s some overlap in similarity, but some differences.

Gina: Yes. I mean, obviously, the similarities are that, from my perspective, not dealing with shame and not acknowledging kind of the shame that’s behind some of the emotions that lead to the thoughts and the perception of what’s happening in the environment is really kind of the cause for both teens and adults that everybody’s trying to run from the feelings they don’t wanna sit with them.

And the commonality I see with both teens and adults is just that they don’t know how to access that kind of parasympathetic or ventral vagal, if you will, in my polyvagal theory work. It’s just that sense of relaxation and sitting with the emotions. For the teens, of course, there’s a couple different things.

There’s the manifestation of what they’re seeing in their home with their parents. There’s a lot of high expectations that the teens that I’m seeing now, most of them are coming from parents who are highly successful, very busy, have them in an extraordinary amount of stimulation with all of the external extracurriculars, I should say, activities.

And so there’s so much pressure to perform, whether it’s athletic or it’s coming from the academic side. And so the kids are not talking about their feelings and there’s this kind of expectation, hi, you know, mom and dad are doing great. Look it. They do all of these things. They never sit. A lot of my teens will say, mom and dad never rest.

The Impact of Social Media on Teen Anxiety

They’re always busy. They’re always buzzing around doing something, and that’s what it looks like to be successful. So they’re taking on some of that same kind of energy, and then the other thing, of course, with teens right now, obviously, there’s such a different environment with access to social media and what’s out there.

I think everybody really wants to belong and to connect. But for teens right now, that sense of connection and belonging is such a struggle, and covid, just exacerbated that for so many of them when they were more isolated and alone. Working with my teens, a lot of ’em will say things like Snapchat is a real problem for them because they might say, maybe invite a friend to go do something, and their friend says no, or they get rejected, and then they’ll see, they’ll track them because I guess you know, they can track on these apps and so then they’ll say, oh, their friend actually was with these other friends.

Then the story that they make up is, I’m being rejected. They don’t like me. There’s something wrong with me. And so it just kind of is festering in that space. So I think there’s a lot of that extra stimulation and exposure for kids. And I guess the other thing that I do see, it’s not the most common, but it’s certainly something I’ve seen quite a bit, is that parents who haven’t dealt with their own shame, If their teen becomes anxious or their teen actually gets vulnerable enough or brave enough to actually express what’s happening.

If a parent turns that and becomes more the victim in that and says things like, oh, I know I’m just a horrible parent, or I can’t do anything right for you, and then they become more of the identified patient, if you will, in the family, then the team now feels like I can’t express myself. Beacause now I’ve gotta take care of mom, or now I’ve gotta take care of dad because they can’t handle what I’m saying.

Carrie: A bit about the social media. You said you talked about being able to see what. Your friends are doing at different points or pictures being posted online or on Snapchat that wasn’t going on. When you and I were a teenager, we didn’t know what our friends were doing.

They could probably lie to us, and unless somebody else told us and ratted them out, we wouldn’t have known. But now also there’s this heavy sense of comparison that social media brings up like, oh, look at that person in my class that maybe has more than me or that person that’s, they’re more successful, they’re doing better in school, whatever the case is.

How do you see those types of things play out in terms of causing a lot of like worry and distress?

Gina: I would say they’re probably the top issue that I see with teens. I mean, we can talk about family stuff, but what’s happening in their current environment, in that social environment is their biggest pressure right now.

Yes, they are. That comparison that the not good enough is such a big piece, but it goes even deeper. I tell it’s like the onion, right? I mean, you understand that with emdr, but it’s like not good enough is here and then underneath that is I’m stupid, or I’m this, or I’m all bad or nobody likes me. I’m bad.

It just gets deeper. Something’s wrong with me. And so once they, a lot of these teens, they don’t know how to connect with their bodies. They don’t like when they say they’re anxious, I say, where do you feel that? And they can’t, A lot of ’em can’t even connect to that until we really do some body work to acknowledge that.

The sense of, don’t even know what’s going on in their body. They just use this term anxiety cuz it’s kind of the buzzword. Then with that, the thoughts just get really loud and they get to a place where they get so overwhelmed that they can’t even function. And so for some of those teens, you know now, now they’re at this space where they’re withdrawing.

The thoughts are getting really bad. I don’t fit in. I’m not good enough. I’m not this, I’m not that. And they just get stuck in this negative feedback loop. And so the social media just amplifies that depending on where they are and what story they tell themselves about what their friends really think, and the ability to go back and actually have a conversation with their friends is really hard.

Even as I’m teaching them some of these skills, that doesn’t mean the people that they’re trying to implement those skills with have any ability to hold space for that. I think that they practice skills and come out and try to be vulnerable with their friends and it doesn’t go well, or at least their perception is that their friends think they’re even more different or they’re needy or there’s something else happening, and so that just causes them to be less able to express themselves or less wanting, I guess, to really express themselves.

High Achieving Families and Running from Anxiety

Carrie: That makes a lot of sense. And I think what you’re talking about in terms of these high achieving families, where the parents are very successful and they’re very driven in their careers, and then there’s this expectation that the kids will be successful, that they’ll be taking the advanced placement classes, which require a lot more work, and then they’re involved in a sport which meets several nights a week for practice, and you have games on the weekends.

There’s not a lot. Margin in people’s lives if you’re constantly like going, going, going. And in a sense, that’s also like a way to run from the anxiety, right?

Gina: Absolutely. Again, that’s a learned behavior most likely by how the parents are managing their own anxiety. Stay busy, so I don’t have to sit again.

That is one of the things that I noticed the most is. All of my anxious clients really have a hard time sitting with relaxation, and so when even try to teach some basic things like deep breathing or connection to that parasympathetic, it’s so foreign and it’s so uncomfortable, and so they manage it by doing these other things.

In the work I do end daring way, we have this term of superpower versus kryptonite, and I like that analogy because I think for a lot of anxious people, especially the parents of my anxious teens, they might not be having panic attacks. They might not be having some of the classic symptoms that people might caught or they might not be having some of the, the same symptoms that people who are really struggling with anxiety have, so they don’t see anxiety as necessary. They kinda see anxiety as a motivator, I guess, is kind of what I hear from them. And so they see it as a little anxiety, just keeps me being successful.

It kind of becomes my superpower that I can do all these things. I can manage everything and I can be like the perfect mom, the perfect wife, the perfect employee, all of those things. And if they get validation from that, it just kind of reinforces that bar of, okay, what’s next? But the kryptonite part of it is what’s the impact of that?

What’s the impact of managing and thinking that you’ve got it all together and managing all those things when you can’t rest, when your nervous system stays in that fight and flight all the time, and those around you are experiencing that frenetic energy. So learning to be able to go, okay, how is this useful for me?

And then what’s the kryptonite? What’s the part that I need to be watchful or mindful of so that I can recognize it’s not all good? And some of it also causes problems in my social life or how I perceive myself in relation to other people.

Strategies for Managing Teen Anxiety

Carrie: Yeah, sometimes we call those survival skills. Those things that helped us get through difficult situations, helped us survive.

They also can cause problems at the same time in our life, or like you had talked about before, the things that you used to do that worked. Now all of a sudden they don’t work. I think that this is really helpful in terms of talking about clients who have been through complex trauma. A lot of times those are clients that I end up seeing.

It doesn’t feel safe to relax, so then when you try to get to that like relaxed state, this part of self comes up. That’s like uhoh danger, danger, like this is not okay. So it takes time to really be able to work through, through some of those things. Let’s talk about, I know that you see parents that really love their children that wanna help their children, and so what are some things that the parents do that are really well-meaning and good intention, but they just aren’t necessarily helpful for their teen that’s struggling with anxiety?

Gina: I think we live in a kind of fix it society, and so I think for a lot of parents, they just want to give them the how to like do this, do that. Just go be more social when they’ve got social anxiety. You just need to be exposed to more social settings and you’ll get more comfortable. What the parents are missing is just being able to sit with the emotion with the kids and like talk about where do they feel this, and what are they experiencing.

What are the thoughts that are coming up in this moment, and can we just sit there and just support them versus trying to fix it. And again, I think parents, we all want to help our kids, but it’s that sense of we have to help them by modeling how to sit with it. And so parents who can’t sit with their own discomfort or can’t even tolerate their teen’s anxiety are gonna be.

Struggling more to be able to sit and model that behavior for them of what does relaxation look like? What does it mean to look at something other than just achievement or productivity as your measure of success? What are some of those other things that we need to bring in to calm our nervous system?

Carrie: What are some signs that a teen may need professional help with their anxiety?

Gina: I think it’s showing up in a lot of different ways, but certainly the negative self-talk, if teens are really judgemental of themselves, if their parents are noticing that they put so much pressure on themselves to perform and to achieve, like for instance, I’ll work with teens if they don’t get a hundred per cent.

Then that’s not good enough. They could get 98, but it’s still not good enough and they beat themselves up and they use shame language like, “I’m so stupid. I can’t believe I made that mistake.” Those are kids that I would be more cautious about just from that kind of high perfectionistic side, but certainly, the social withdrawal kids that have decided that they’re not good enough or they don’t fit in, and the depression side is kind of coming in with those real negative thoughts.

They’re withdrawing and they’re not engaging or they’re not feeling invited or connected. And I think parents really need to be mindful of some of that. There is separation in teens where they don’t wanna be around the family, but we also have to pay attention to what are they looking at? What are their thoughts? What are the emotions?

Addressing Stigma and Seeking Help for Teen Anxiety

Because if they’re really bad, negative thoughts, you know, we wanna be paying attention to suicidality and we wanna, what is it that, what, how dark is it for them? And what are those thoughts so that parents are actually being able to connect more and go, okay, this is not your typical anxiety. This is something that we need some additional help with. Or maybe it’s not so significant, but the parent recognizes they can’t offer their team what their teen needs and their teen just needs a safe place to talk about whatever’s happening, even if it’s what’s happening in the home. So if your teen is expressing, I want some help, or they’re trying to be vulnerable and expressing these things, I think that parents need to be mindful of all of that, that sometimes their own shame triggers get in the way of, oh gosh, you know, we don’t have mental health in our family, or there’s religious or cultural dynamics that play a role that says we don’t talk about anxiety, everybody just suck it up and handle it. I want parents to be more mindful of some of these signs and be able to help their teen just kind of talk about it a little bit more or write about it. And that’s where kind of this communication journal will, I hope be effective for parents and teens so that even if you can’t verbally sit in front of each other and talk, it’s a cute version for them to be able to have some prompts and actually.

Talk about where they feel things in their body and what is upsetting them so that parents can have a better understanding of what’s happening.

Carrie: Yeah. Tell us a little bit about that.

Gina: Well, one of the things that I noticed so much with teens is that they really struggle to articulate how they feel or what’s happening, and I think in today’s world, the buzzword anxiety is like the safe word to say.

Everybody’s got anxiety. Okay, what does that mean? Where do you feel that in your body? What does that look like? What are the symptoms? How do you stop it? How do you learn to control it? For a lot of teens, just the bodywork of understanding what that actually feels like. And being able to label it as something other than anxiety can be helpful because maybe it’s, they’re saying I’m anxious, but really there’s some grief.

They’re disappointed or they’re expressing it as anger, but it’s really something deeper underneath that, like the grief or disappointment that they can’t really articulate. So the goal of the journal is that it gives some prompts and it lets the teen with things like “I” message and proper communication identify from a body chart where they feel that in their body.

Why is that important? What are the thoughts or the story that they’re making up as a result of these feelings? Then they can communicate that to a parent. And then the parent gets the kind of the same props on the other side of the journal, and they can respond back and say, I feel this way, and I feel it in my body too.

And the parents are learning to communicate the same way as the teen, but it’s a safer way, I think, for the teens to really express more of what’s going on for them and to help the parents get a better grasp. Without just saying I’m anxious, I’m anxious. I don’t know about you, but a lot of my teens will say I’m anxious.

And tell me about that. I don’t know. I’m anxious. I don’t know. Those are like the two.

Carrie: Goes together. That’s interesting. Like what you’re talking about, about anxiety is a buzzword and it’s almost like it’s been accepted as normal and Okay. And like, yes, of course, we talk on the show about reducing shame.

And yes, it’s okay to struggle with things, but what I’m saying is we shouldn’t be running around with chickens with our heads cut off all over the place. Like that in a sense is not healthy for us like we were meant to rest. We were meant to be able to pause and take breaks and have margin in our lives to not be constantly on the go.

And so because we’ve normalized that piece. It’s almost like we’ve normalized the anxiety that comes with that rushing around piece.

Gina: Absolutely. In fact, some of my teens will even tell me, they look at their parents and their parents’ careers and how hard they work and they’re like, I don’t want any part of that.

Like what they do. I don’t want any part of that because that doesn’t look like joy. That doesn’t look like fun. I don’t know. We’ll see a big shift with, certainly the millennials have taught us something different about work-life balance and they’re looking for something different. My generation for sure was with the corporate scene.

Carrie: Tell us about how people can find and get in touch with you.

Gina: Yeah, so on Facebook, I’m at Authentic Gains, just altogether a lowercase. And then on Instagram, it’s at Authentic underscore gains. Boy, that’s my business name. And then again, one of the best ways for parents are really just looking for some really fast tools that can help them.

I wanna give a free gift of this mini course that I have out there, and so parents can go to, and by going to that website, it’ll take them to a prompt that will start to feed in the different modules for the free minicourse, for them to get some tools.

Gina Nelson’s Story of Hope

Carrie: Okay, great. At the end of every podcast, I like to ask our guests to share the Story of Hope, which is a time in which you received hope from God or another person.

Gina: Great question. This probably relates more to my anxiety as a parent, but one of the things that I recognized, we try to control as much as we can of our kids, and at some point we recognize that they grow up and we don’t have control over their lives anymore. Two weeks before my son’s 18th birthday, he had been toying with the idea that he wanted to join the army, which was not my expectation for him.

I had a plan for him to go play lacrosse and go to college and all of those. And I came home from work and there was a sergeant in his full attire in my kitchen having a conversation with my husband, myself, about my son’s desire to go into the Army. Anyway, it was really a rough conversation and after a bunch of ma’am and the sergeant turned to me and says, ma’am, he said, There’s two ways we can do this.

He said, you and your husband can sign him in tonight while he’s 17 or in two weeks, he’s gonna come back and sign himself in. And either way, he’s joining the army. And it was just this like, oh wow, I don’t have control over this and there’s nothing I can do. And I just remember being a woman of faith, I was just like, okay, God.

Like help me through this conversation. Like give me some strength. And I just remember looking at my son and still get emotional. He’s 24 now, but I just remember looking at him and saying, if you can shake this man’s hand and look him straight in the eyes and tell him you wanna be a member of the US Army. So I have got to deal with my anxiety to get rid of that and my fear of what might happen to you. And that just became kind of a God journey because within a few weeks of me just wrestling with that going, Ugh, I don’t like any part of this. And everybody of course loved it. They’re like, oh, he is going into the military. Congratulations. Thank you for his service. And I’m thinking, no, I’ve worked with vets.

I know the other side of this and I’m scared to death. And so I really just one day at church just kind of put my hands up and said, God, I can’t hold this anymore. You’ve gotta take this away from me. And it was like this rush of just peace and relaxation and I got behind him and three and a half years later, he was unscathed, untouched, never saw any combat, and is now on the GI Bill finishing a construction management degree.

Carrie: Great. That’s awesome.

Gina: God had to hold me through that.

Carrie: Yeah, that’s amazing. And how rare that kids that young nowadays know what they want to do it sounds like he was set on that path.

Gina: It was. But that’s, I think that moment, and so when I work with parents now, even the empty nest and watching their teens make choices or things that maybe weren’t their expectation, it’s really a matter of, Hey parents, you gotta do your work too.

Oh, we have to learn how to grieve our expectations to be able to allow them to fly and to individuate and do those things on their own.

Carrie: Yeah. Accepting things that are outside of your control is such a big piece in anxiety. Absolutely. Well, thank you for sharing that story with us and we’ll put the links, to your information in the show notes for people and where they can find the mini-course and the journal.

Gina: Yeah, very excited. Thank you so much for having me. I love the work that you’re doing and getting the message out there about anxiety for everybody, whether they’re parents or teens, or just people struggling.

Carrie: If you know a teen who is struggling with anxiety, I hope that this interview and the information shared was helpful to you to receive ongoing, supportive encouragement and updates about our show. You can always follow us on Facebook and Instagram.

Hope for Anxiety and OCD is a production of By The Well Counseling. Our show is hosted by me, Carrie Bock, a licensed professional counselor in Tennessee. Opinions given by our guests are their own and do not necessarily reflect of using myself or By the Well Counseling. Our original music is by Brandon Mangrum. Until next time, may you be comforted by God’s great love for you.