Coping with Teen Disorders: Anxiety-Related Habits

I recently heard a generally healthy, seemingly well-adjusted adult mention that the stress of an over-booked holiday calendar caused her to revert to a childhood habit. “I like to joke that nail-biting is my smoking,” she told me. I didn’t laugh.

While it’s not nearly as unhealthy as smoking (hello, carcinogens?), nail-biting and other anxiety-related habits are real problems — not just because of their social unacceptability and potentially damaging results, but because of the thought patterns and resulting emotional distress that prompts them.

Sometimes these habits even become compulsions, or seemingly irresistible urges, prompted by obsessive thoughts (often labelled OCD — which, like many anxiety disorders, can sometimes be the result of physiological causes). The good news is that neither is necessary, and God offers all of us a better alternative.

What To Look For

Nail-biting (a.k.a onychophagia) is only one of the habits linked to anxiety; other body-focused repetitive behaviors (BFRBs) include hair-pulling (a.k.a. trichotillomania) and skin-picking (a.k.a. excoriation). These behaviors often begin as “nervous habits,” prompted by the need to relieve stress, but can often become compulsive behaviors prompted by mere opportunity during times of rest, even when stressful situations or anxious thoughts are not prompting them.

In addition to observing your teen doing the behaviors, you may notice traumatized skin or bald spots as a result of the behaviors. (These physical issues can definitely become concerns, such as skin infections or nasal septal perforation.)

How To Help

Some physical problems and medications can cause feelings of anxiety, and uncertainty or prospective problems can increase a tendency toward anxious or “what if” thinking. While some people may be genetically predisposed to such tendencies, rehearsing anxious thoughts represents one of many problematic obsessive thinking patterns against which God warns us.

Sometimes referred to as “worry,” rehearsing what-if scenarios or even realistic future problems is absolutely futile (see Matthew 6:25-34). God wants us to unburden ourselves of our “cares” or anxiety-producing situations through prayer (Philippians, 4:6, 1 Peter 5:7). Other antidotes to anxious thoughts include meditating on God (Psalms 63:6), His Word (Psalm 1:2 and throughout Psalm 119), and His many gifts to us (Psalm 103:2).

Instead of focusing on impossible or even possible future problems, we can choose to focus on what is true and lovely and good (Philippians 4:8). As the Psalmist does, we can ask God to help us to honor Him with our words and actions as well as the thoughts that produce them (Psalm 19:14, Luke 6:45).

In addition to dealing with the heart issues related to anxiety, some habit-reversal training may be helpful, especially in responding to long-standing habits or compulsions. When anxious thoughts come, having both Scripture meditations and non-destructive activities for the hands will likely provide a helpful solution. Fidget toys may prove helpful, but in their absence, a string or key ring can meet the need. The point is to move in some way, and especially to find something for hands to do, as you try to focus your mind on more productive thoughts.