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Stress in Teenagers

Contributor(s): Gene Beresin, MD, MA
12 minute read
A mother and daughter discuss coping with stress

Content warning: Suicide, gun violence


Ask any one of the millions of preteen and teenage students who headed back to school this month and they’ll confirm: The stresses of school in 2022 extend far beyond class schedules, homework, and a lack of time with friends. In fact, things are so stressful that the American Academy of Pediatrics, American Academy of Child and Adolescent Psychiatry, and Children’s Hospital Association have declared a national state of emergency in children’s mental health. This was echoed by the extensive 2021 U.S. Surgeon General’s report, Protecting Youth Mental Health.

“Preteens and teenagers are in a perfect storm,” explains Gene Beresin, MD, MA, a child and adolescent psychiatrist at Mass General Brigham. “They’re worried about viruses. They’re worried about new strains of COVID. They’re worried about polio. They’re worried about monkeypox virus. They are concerned another viral outbreak would result in another lockdown. They’re worried about climate change, about economics, and whether their families can afford things. They’re worried about mass shootings. Many are worried about the plight of underserved populations, such as kids of color, immigrants, and LGBTQ youth.”

Dr. Beresin is the executive director of the Clay Center for Young Healthy Minds at Massachusetts General Hospital. Dr. Beresin holds over 40 years of experience working with youth, with a particular focus on prevention, early intervention, and treatment for teens and young adults. In this article, Dr. Beresin discusses back-to-school stress, shares the best coping skills for teens and preteens to use in times of stress, and explores ways parents and guardians can help.

Why might adolescence be a stressful time for many teenagers?

Adolescence is an incredibly stressful time of life. In adolescence, children’s brains are maturing. They’re looking for (and developing) independence. Their relationships and social experiences begin to stand out against the backdrop of their lives. And all these changes cause them to consider, and care about, different issues in more complex ways.

“A school-aged child is more worried about being liked and fitting in,” explains Dr. Beresin. “An adolescent is struggling with questions like, ‘How do I fit in while being separate and autonomous and my own person?’ When you can see all the nuances like adolescents can in their developmental stage, you can get wrapped up in the weeds. They need precious time and experiences with peers, teachers, parents, caregivers, and others to sort out their identity and the role they play with others.”

According to Dr. Beresin, adolescents’ fears and anxieties about the state of the world, their families, and their lives are major contributors to the mental health conditions students face today. They commonly worry about the world they shall inherit. To complicate matters, the American school system overschedules and overburdens its students — and that makes things even worse. There is simply no down time to process all they are going through.

“Adolescents need 8 to 10 hours of sleep a night — they never get that. They must do community service, must play the violin. They must compete in athletics. They’re booked 24 hours a day, 7 days a week. And that overscheduling is a backdrop to all these other worries and concerns.”

Back-to-school time is an especially stressful time for teenagers. As Dr. Beresin explains, “For [most] young adults, the background of their life is mostly school, family, friends, and recreation. And their recreation is largely school based — or at least that’s the environment within which recreation occurs. So, most of their life is embedded in school.”

“School is so important because it’s not only where students learn, but also where they build friendships,” says Dr. Beresin. “It’s where they develop athletic skills, where they do extracurricular activities. They learn how to function in classroom settings. And it’s also the basis for how they develop a sense of inclusion, identity, autonomy… and it’s where they deal with how they’re treated. They also learn, sometimes the hard way, about resolving conflict that naturally occurs in their lives.”

I don’t have a single conversation with a young person where we don’t talk about worries about the planet, worries about the world they’re inheriting: viruses, climate change, economic downturn, marginalization, being shot or assaulted.
Gene Beresin, MD, MA
Child/Adolescent Psychiatrist
Mass General Brigham

What are common cognitive stressors for teens?

Teenagers face a lengthy list of stressors that includes:

School stressors

  • Pressure to do well in school
  • After-school and extracurricular activities
  • Demands for community service
  • Public health and safety concerns (such as school shootings)

Social stressors

  • Changes in platonic and romantic relationships
  • Bullying
  • For some, pressures to engage in use of substances and risky behavior
  • Pressure to change or control physical appearance
  • The need to continually focus on digital and social media

Family and home stressors

  • Family stress, such as conflict, illness, economic hardship, and/or divorce
  • Changes in familial relationships
  • Jobs and career decisions
  • A lack of unstructured/free time

Students are re-entering traditional schooling for the first time in years. And that brings its own set of stressors to the table.

“Students are going back to school in this era of uncertainty, divisiveness, and polarity,” says Dr. Beresin. “And they’re worried: ‘Am I going to fit in? Will other kids like me? Will I be able to keep up with the work, or have I fallen too far behind? Am I still as good as I used to be in athletics and other activities?”

And it’s not only stress about academics, extracurriculars, and social standing that impact teens. Many of today’s students are also coping with fears about their lives and their families’ well-being.

Dr. Beresin says, “I don’t have a single conversation with a young person without talking about worries about the planet, worries about the world they’re inheriting, viruses, climate change, economic downturn, marginalization, being shot or assaulted.”

Many parents wonder about digital and social media as potential stressors for adolescents. According to Dr. Beresin, while these devices and apps certainly need better management techniques, they’re not solely responsible.

“We’re hostages to digital media,” Dr. Beresin says. “And we haven’t learned how to use it productively and sparingly. It’s complicated, and it complicates our lives. Does it cause more stress, anxiety, depression, and loneliness? Sure. But it’s just one of many factors that contribute to the back-to-school situation.”

How does stress affect teenagers?

Back-to-school stress can be overwhelming for teenagers. And they may not be able to recognize or articulate their needs.

Adolescents who are stressed out may show some of the following signs:

  • Moodiness and irritability
  • Increased anxiety and worries
  • Sometimes oppositional or defiant behavior or shutting down and isolating themselves
  • Trouble sleeping
  • Reduced interests in ones they previously had
  • Reduced energy or more tiredness than usual
  • Difficulty focusing and academic decline
  • Lack of motivation
  • Withdrawal from friends or favorite activities
  • Reduced or increased appetite
  • Headaches, stomach aches, jaw tightness, and/or teeth grinding

What are some good coping techniques for teens?

There’s no easy way to adjust the demands and stressors today’s preteens and teens face. But there are ways for teens and preteens to manage their emotions so the stress doesn’t become intolerable.

Dr. Beresin says preteens and teens can manage stress in several ways. “I believe students can, and should, be activists. I want them to look, with guidance from teachers, at their curriculum and extracurricular activities.”

He explains that activism is not only an excellent way for teens to establish identity and connect with a group, but it’s also a creative outlet, a positive form of rebellion, and a channel for abstract thinking. Most importantly, it’s a means to enact change in the system that is causing such severe mental health challenges.

But activism alone won’t help manage stress. “It’s no substitute for good sleep hygiene, exercise, diet, meditation—which every child should do—yoga, and use of cognitive behavioral therapy. And the same process of self-care should be practiced by parents.”

Additional coping skills include self-care, such as:

  • Setting boundaries
  • Choosing activities that reenergize or relax you
  • Changing your environment
  • Engaging in gentle activity
  • Yoga and/or meditation 

How can parents help?

Here’s how parents can help their children manage stress:

  • Control your own anxiety by taking care of yourself. You are in the best position to help if your mental state is calm.
  • Ask them what they are concerned about: What bothers you the most? What troubles you? Open-ended questions are always best as they can provide key information about how to address children’s issues.
  • Listen to, and validate, their feelings.
  • Have frequent conversations.
  • Encourage them to use creative arts to express themselves.
  • Talk with them about family narratives, and how we have gotten through hard times before. Let them know: We can manage this.
  • Watch media with them and use this to discuss important issues.
  • Support others in your community who may be struggling. Send them an upbeat note, a YouTube video, make them a meal. Giving to others always feels good — and better than receiving.

According to Dr. Beresin, “Parents and caregivers could advocate for more free time, for less demands, for less teaching to the test, for changing the school system and school policies, and looking at what works, for more socio-emotional learning. I think that’s more important as a life skill than the three Rs.”

There are several resources available to help parents and students seeking support for back-to-school stress and mental health. These include:

  • Massachusetts General Hospital’s Clay Center for Young Healthy Minds: A free, practical, online educational resource dedicated to promoting and supporting the mental, emotional, and behavioral well-being of children, teens, and young adults
  • Newton-Wellesley Hospital’s Resiliency Project: An innovative, community-based initiative designed to promote the mental health and well-being of adolescents
  • McLean Hospital’s website, which offers support for parents and caregivers of adolescents struggling with mental health
  • CASEL: The Collaborative for Academic, Social, and Emotional Learning resources
Eugene Beresin, MD, MA headshot


Child and Adolescent Psychiatrist