Signs of Alexithymia in Teens

Common Alexithymia Symptoms in Teens

Alexithymia symptoms may show up in a teen’s behavior, communication, and relationships. Symptoms can range from subtle day-to-day difficulties to more noticeable problems during conflict or stress. 

It’s important to note that one or two signs do not automatically mean that a teen has alexithymia. There are usually repeated patterns and significant impacts on a teen’s functioning. 

Difficulty Identifying Specific Feelings

One of the most common signs of alexithymia is difficulty identifying emotions. A teen may rely on broad descriptions like: 

• “I’m fine.” 
• “I don’t know.”
• “I feel off.” 

These responses are likely a reflection of genuine uncertainty rather than defiance or resistance. 

The teen may recognize that something has changed in their internal world without knowing what the change means. They may also confuse emotions that produce similar sensations, such as anxiety and excitement. 

The racing heart and restless energy of the two can feel nearly identical from the inside. A teen bracing for a test and a teen looking forward to a party may be describing the same physical state.

Difficulty Expressing Emotions

Some teens may feel that they are experiencing an emotional reaction but can’t easily explain it. They may become quiet or frustrated, or change the subject or have an emotional outburst when asked to describe what is happening. Difficulty expressing emotions can look like:

• Giving brief or vague answers.
• Finding it difficult to explain why they are upset.
• Describing what happened without discussing feelings.
• Using behavior instead of words to communicate distress.

A teen who cannot describe what is happening may yell, shut down, lash out, or walk away. This can lead parents to only notice or even punish the behavior without realizing that their child doesn’t have an accessible way to communicate how they are feeling.

Focusing on Facts Instead of Feelings

Teens with alexithymia can often describe events in a very factual and detailed way, while saying very little about their emotional experience. This is because concrete details tend to be easier to organize and communicate than internal feelings. 

For example, after an argument with a friend, a teen may be able to explain the exact sequence of messages and dynamics of those involved, but find it hard to explain how they felt during the argument.

Becoming Overwhelmed Without Recognizing the Buildup

Emotional awareness can help people notice stress before it reaches its peak. Alexithymia, though, has been associated with emotional regulation difficulties in teens.^[2][3] 

This means that a teen with alexithymia who struggles to recognize their emotions may not realize that a feeling like stress has been building. And once stress reaches its peak, their reaction may appear sudden because the warning signs went unnoticed. 

Afterward, the teen may be just as confused as everyone else. They may know they reacted strongly without understanding what triggered their response. 

This is sometimes the point at which a teen gets labeled as having a short temper, because the slow buildup to the outburst was invisible to them until it arrived.

Difficulty Recognizing Emotional Needs

A teen with alexithymia may have trouble recognizing what they need. Identifying a feeling can often help a teen understand what they need, but a teen with limited emotional awareness may struggle to determine if they need: 

• Reassurance.
• Space.
• Rest.
• Comfort.
• Support.

This may cause the teen to reject help because they are unsure what would be useful, and they may expect parents to understand their needs without being able to communicate them. This can then lead to misunderstandings or escalations. 

Difficulty Understanding the Emotions of Others

Some teens with alexithymia may find emotionally complex interactions confusing, which can lead others to assume that the teen is insensitive or does not care. In fact, the teen may care very much, but is unable to interpret or respond to emotional information.

This is why it’s important that alexithymia not be treated as proof that someone lacks empathy. Research involving youth with and without alexithymia found no overall difference in emotional empathy between teens.^[4]