Your oxygen mask first: parent stress and the anxious teen

Westlake High School runs a week each September called Be Kind to Your Mind, built around suicide prevention and the everyday habits that protect a teenager's mental health. The counseling team asked me to give parents thirty minutes on a piece of that picture most of us would rather not look at: our own stress, and what it does to an anxious kid. This is the written version, for the parents who could not make a lunchtime Zoom and for anyone who wants the ideas in one place.

The airline instruction is a cliche because it is right. You put your own mask on first not because you matter more than your child but because a parent who has passed out cannot help anyone. The mental health version is less dramatic and more common: a parent running on empty responds to a teenager's anxiety in exactly the ways that keep it going.

What the research says about parent stress

Before private practice I spent years as a pediatric psychologist at Children's Wisconsin, much of it with families of children who had serious heart conditions. Some of the most striking findings in that field are about parents. When researchers measured a mother's stress during pregnancy and then followed the child, the mother's stress predicted the child's emotional adjustment at ages one through four better than the severity of the heart defect did. I watched it in clinic. A child waiting for a heart transplant could be coping better than a child with a minor murmur, and the difference was how the parents were doing.

That is not a verdict on anyone. Raising a child with a serious diagnosis is stressful through no fault of the parent. It is a finding about leverage. If the parent's state moves the child's outcome more than the diagnosis does, then the parent's state is the place to intervene, and the same logic holds in a house in Westlake with a sixteen-year-old who cannot sleep before a test.

The second finding comes from anxiety research specifically. Families of anxious children accommodate the anxiety at remarkable rates: in one large study, almost every parent reported doing it, and daily accommodation was common. And a randomized trial at the Yale Child Study Center found that treating only the parents, coaching them to stop accommodating and to respond to anxiety differently, worked as well as treating the child directly with cognitive behavioral therapy. The child never had to attend a session. The parents changed, and the anxiety fell.

How accommodation happens in a loving home

Accommodation is any change a family makes so that an anxious teen does not have to feel anxious. It never looks like a problem when it starts. You email the teacher because your tenth grader is too nervous to ask about the makeup test. You let your son skip the party because the thought of it made him sick to his stomach. You answer "are you sure it's going to be okay?" for the fifth time tonight because it seems cruel not to. You take the long way to school so you do not pass the intersection where the accident was. You sit in the car outside the orthodontist because she cannot go in without you.

Every one of those comes from love, and every one of them teaches the anxiety that avoidance works. The relief the teen feels is real, it is immediate, and it is the problem: anxiety that is relieved by escape grows, because the brain learns that the feared thing was in fact too dangerous to face. The most effective anxiety treatments we have are built on the opposite principle. Facing the feared thing, in planned steps, until the body's alarm quiets down. A family that accommodates is, without meaning to, running the treatment in reverse.

Here is where stress comes in. Accommodating is what tired parents do. It ends the argument, stops the tears, and gets everyone out the door. Holding the line, calmly, while your child is distressed, takes reserves. When the reserves are gone, you either give in or you snap, and both make the anxiety worse. The parent's stress level is not a side issue in a teenager's anxiety. It is the thing that decides whether the household can do the hard, boring, effective work.

Five things to do this week

Notice your own tells. Most parents have a stress signature: short answers, checking the phone, a tight jaw at dinner, the sigh before the sentence. Teenagers read those instantly and often assume they are the cause. Naming it out loud, "I've had a hard day, it's not about you," removes a source of anxiety you did not know you were adding.

Pick one accommodation and retire it. Not all of them, one. Choose the smallest, tell your teen in a calm moment what is changing and why, and then hold it with warmth. "This is hard, and you can do hard things. I'll be right here" is the whole script. Expect the anxiety to get louder for a few days before it gets quieter; that is the anxiety testing whether the old rule still applies.

Replace reassurance with confidence. Reassurance answers the anxious question; confidence answers the anxious child. The first is "yes, I'm sure it will be fine." The second is "I don't know how it will go, and I know you can handle it." The second is harder to say and works better.

Protect the three ordinary things. Sleep, movement, and time with people. For anxiety and depression in young people, regular physical activity holds up in the research alongside therapy and medication, and it is the one of the three a parent can model directly. A family walk after dinner is treatment.

Take your stress somewhere that is not your teen. Your spouse, a friend, another parent, your own therapist. Teenagers should see that adults have stress and do something about it. They should not be the something.

When to get help, and for whom

For the teen: when anxiety is shrinking their life. School, friendships, sleep, or activities they used to enjoy are suffering, it has gone on for more than a few weeks, or there are physical symptoms with no medical explanation, such as stomachaches and headaches on school mornings. Irritability counts; in teenagers it is often how anxiety and depression show up. Cognitive behavioral therapy with exposure is the treatment with the strongest evidence, and it works best when parents are coached alongside the teen. For moderate to severe anxiety, an SSRI alongside therapy is standard.

For the parent: when you recognize yourself in the accommodation section and cannot seem to stop, or when your own anxiety or mood has been low for weeks. A parent's treatment is often the fastest route to a calmer child, and there is no shame in a household where the adult goes first. That is what the oxygen mask means.

Because this page is part of a suicide prevention week, one more thing. Anxiety and depression travel together in teenagers, and a young person who feels hopeless, helpless, or like a burden needs a direct question and, if you are worried, an evaluation. I have written separately about how to talk to your teen about suicide and about what every parent should know about teen mental health, including the warning signs that matter most. Every Westlake campus has counselors and licensed school-based therapists, and 988 is there at any hour.

Common questions

Does my stress really affect my teenager's anxiety?

Yes, and more than most parents expect. In research on families of children with congenital heart disease, a mother's stress level predicted her child's emotional adjustment in the early years better than the severity of the heart condition did. Teenagers read their parents constantly, and a parent who is running on empty tends to respond to a teen's anxiety in ways that keep it going: rescuing, over-reassuring, or snapping. Taking care of your own stress is not selfish. It is one of the most effective things you can do for your child.

What does it mean to accommodate a teen's anxiety?

Accommodation is any change a family makes to keep an anxious teen from feeling anxious: writing the email to the teacher so they do not have to, letting them skip the party, answering "are you sure it will be okay" for the fifth time, driving the long way to avoid the thing. Every one of those comes from love, and every one teaches the anxiety that avoidance works. The most effective anxiety treatments for young people are built on the opposite: facing the feared thing in steps until the body stops sounding the alarm.

How do I stop reassuring my anxious teen without seeming cold?

Name what you are doing and why, once, when everyone is calm: "I've noticed that when I keep telling you it'll be fine, you feel better for a minute and then ask again. I'm going to try something different because I think it will help." Then, in the moment, replace reassurance with confidence in them: "This is hard, and you can do hard things. I'll be right here." Warmth stays; the answer to the anxious question goes.

What are the signs a teen's anxiety needs treatment rather than time?

Interference and duration. If anxiety is shrinking their life, meaning school, friendships, sleep, or activities they used to enjoy are suffering, or it has lasted more than a few weeks, it is worth an evaluation. Physical symptoms with no medical explanation, such as stomachaches and headaches on school mornings, count. So does irritability, which in teenagers is often how anxiety and depression show up.

What treatment works for teen anxiety?

Cognitive behavioral therapy with exposure has the strongest evidence, and it works best when parents are coached alongside the teen so that home stops accommodating the anxiety. For moderate to severe anxiety, an SSRI alongside therapy is standard. Regular physical activity belongs in every plan. If a teenager refuses therapy, medication plus exercise is a real plan; if a family will not consider medication, therapy plus exercise is a real plan.

What if I am the one who needs help?

Then get it, and let your teen see you do it. A parent who says "I'm stressed, so I'm going for a run" or "I talk to someone about this" is teaching the single most useful lesson in mental health: that you notice a feeling and do something about it. Little Dove sees parents and caregivers as well as kids and teens, and a parent's own treatment is often the fastest route to a calmer child.

Sources cited on this page

• Westlake High School Counselors' Corner. (2026, September 4). Be Kind to Your Mind Parent Speaker Series. Reflections newsletter, Eanes ISD ParentSquare. Read the post
• Lebowitz, E. R., Woolston, J., Bar-Haim, Y., et al. (2013). Family accommodation in pediatric anxiety disorders. Depression and Anxiety, 30(1), 47–54. doi:10.1002/da.21998
• Lebowitz, E. R., Marin, C., Martino, A., Shimshoni, Y., & Silverman, W. K. (2020). Parent-based treatment as efficacious as cognitive-behavioral therapy for childhood anxiety: A randomized noninferiority study of supportive parenting for anxious childhood emotions. Journal of the American Academy of Child and Adolescent Psychiatry, 59(3), 362–372. doi:10.1016/j.jaac.2019.02.014
• 988 Suicide and Crisis Lifeline: 988lifeline.org

This page is general information for parents and is not a substitute for an evaluation of your own child or yourself.