Weight loss during adolescence is rarely cause for alarm. Growth spurts, changing appetites, fluctuating routines for most families, these are accepted and known indicators of teenage transition also known as
the age of ‘stress and storm’. Breathlessness, too, is often brushed aside as fatigue or poor fitness. It is only when such symptoms interrupt daily life rather dangerously that they demand closer attention.
Globally, concerns about adolescent mental health have never been more urgent. A 2025 World Health Organization(WHO) report estimates that roughly 1 in 7 adolescents aged 10–19 experiences a mental disorder, with anxiety and depression among the leading causes of illness and disability in this age group. Mental health conditions account for about 15% of the total disease burden in adolescents worldwide, yet many remain undiagnosed and untreated. Half of all adult mental health disorders begin by age 14, underscoring how crucial early detection and support are during these formative years.
For Shaurya (name changed for anonymity), a 13-year-old Gurugram boy, that moment came unexpectedly, in the middle of a school day. Teachers noticed him struggling to breathe before he collapsed. He was taken to hospital, where routine tests ruled out respiratory and cardiac causes. What followed was not a diagnosis his family had anticipated. Doctors identified the episode as a severe anxiety attack, and a week later further evaluation revealed Generalised Anxiety Disorder (GAD), a condition more commonly diagnosed in adulthood than in early adolescence.
Dr. Astik Joshi, Child & Adolescent Psychiatrist told News18, “Anxiety disorders have been diagnosed in younger children over the last several years than was previously the case. Today, parents and clinicians can recognize children with anxiety at a much earlier age, for example, in elementary school. Recognizing anxiety in younger children can help overcome barriers in their environments and improve the quality of life for them, but this also indicates a growing number of stressors in their environments.”
In about 8 months leading up to Shaurya’s anxiety attack in school, the physical signs were there, though very easy to dismiss. Shaurya was eating less, often pushing food around his plate or skipping meals altogether. His appetite had narrowed, and he became increasingly selective about what he would eat, a behaviour the family attributed to adolescent fussiness and teenage mood swings. Gradually, his weight dropped, his body structure noticeably thinner. There were occasional complaints of fatigue and uneasiness, brushed off as weakness or poor stamina. None of it seemed urgent, until his body made it impossible to ignore.
The family although stunned did not take into account the events that may have led this teenage boy to experience such a shocking state. There had been no visible warning signs, no academic pressure, no behavioural issues at school. He was quiet, attentive, and by most measures, “coping, mature, sensible, reasonable”. What this case revealed was how easily childhood anxiety can hide behind normality.
“Constant activation of a child’s stress response due to long-term parental conflict and family financial strain, as well as illness or instability at home, will eventually have negative effects on the brain areas associated with emotional regulation. Ultimately, these effects result in adolescents becoming hypervigilant, more easily agitated, and at a higher risk to become anxious or worried about everything. These children will have developed expectations of danger or fear of trusting others and will continue to have persistent anxiety patterns as adults,” adds Dr Astik, who is also a Forensic Psychiatrist, Fortis Hospital Shalimar Bagh, New Delhi.
Shaurya lives with his parents and grandparents in a joint family setup. He is an only child of two service-class professions and grandson to a retired ‘daada-daadi’, deeply loved and well cared for. Yet the emotional environment around him was far from calm. Not just his parents but grandparents too shared a dysfunctional relationship with frequent arguments, fights and doors slamming, although no physical violence ever occurred but on most occasions meals were skipped and silence settled heavily across the household.
Dr Joshi explains, “Situational stress tends to be transient and identifiable through a triggering event. Stress can be alleviated when conditions surrounding the trigger change. In contrast, a clinical Anxiety Disorder will persist longer and is not directly related to the specific triggering event. Clinical Anxiety may also be disproportionate to the actual triggering event. Daily activities such as academics, school, sleep, friendship or any physical activity will be affected by clinical anxiety. Clinical symptoms will typically last for several weeks or months and include avoidance, physical complaints, and/or excessive reassurance-seeking by the individual experiencing the disorder.”
No one ever directed anger towards the child. He was not scolded, threatened or blamed. But children do not need to be the focus of conflict to feel its effects. They observe patterns, absorb tension and adapt quietly. Over time, the boy became hyper-aware of emotional shifts in the house. His body remained on alert, anticipating disruption even in moments of calm.
In many households across India, such dynamics are not considered harmful. Raised voices are dismissed as normal disagreements. Emotional volatility is seen as part of family life. Adults often assume that children are unaffected as long as they are not directly involved. Yet psychology tells us otherwise. Prolonged exposure to unresolved conflict can shape a child’s stress response, particularly when there is no space to process or express what they feel.
In this case, anxiety did not announce itself through panic or rebellion. It surfaced slowly, through weight loss, poor appetite and increasing physical discomfort. By the time it culminated in a collapse at school, the emotional burden had already been carried for years.
Dr Astik points out, “Repeated exposure to conflict results in children’s feelings of security becoming unstable. When children recognize that there is conflict in the home on a regular basis, their home environment becomes less predictable and secure, causing them to remain in a continual state of heightened awareness.”
“Chronic exposure to this stress may cause children to develop negative feelings about parents; expect caregivers to be tense and act in an unpredictable way; develop hyper-vigilance; are unable to sleep well, and will have a trust deficit when it comes to caregivers and parents.”
Once the diagnosis was clear, treatment extended beyond the child alone. Therapy helped him identify and articulate emotions he had long suppressed. He learned to recognise early signs of anxiety in his body before they escalated. Family counselling addressed the emotional climate of the home, encouraging adults to acknowledge how everyday interactions can affect a child’s sense of safety.
Warning Signs: Does Anxiety Look Different In Children?
Quiet and compliant, children with internalised anxiety may not appear to have anxiety, but they do. Dr Astik notes, “unlike externalised anxiety that leads to tantrums or aggression, children that experience internalised anxiety often appear to be diligent, conscientious, hardworking, and/or compliant. The behaviours manifested from a child with internalised anxiety can be excessive worry, social withdrawal, high levels of perfectionism, stomach aches, headaches, and sudden dips in self-confidence. Internalised anxiety is very overwhelming emotionally, but may be difficult to identify.”
This incident highlights a crucial reality, anxiety in children is often invisible. It does not always manifest as tears, tantrums or defiance. Sometimes, it appears as compliance, quietness and physical symptoms that are easy to rationalise away.


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