GET HELP

Does Your Teen HAVE DIFFICULTY TALKING ABOUT Feelings? Here’s Why

Meagan Burkhart
November 26, 2025
Authored by: Meagan Burkhart,
Edited by: Jemma Strain, B.S. Psychology
CALL (866) 901-4047
INSURANCE VERIFICATION

Adolescence is a time of new and increasing stressors. Teenagers today face academic stress, peer pressure, family conflicts, and major life transitions that can make them more susceptible to mental health issues.1 One area of particular study is emotional regulation, specifically the difficulty some teens have recognizing, managing, and expressing their emotions in an adaptive way (externally oriented thinking).1,2 

Alexithymia is a trait that can contribute to emotional expression issues in teens, as it involves difficulty identifying, describing, and accepting feelings.1 Understanding alexithymia in youth can help explain why teens bottle up emotions, struggle with communication, or shut down emotionally when overwhelmed.

If your teen finds recognizing and accepting their emotions to be a challenge, a mental health professional can provide support and guidance. This page can also help parents understand the emotional expression issues teens can face, as it explores:

  • What alexithymia in youth looks like
  • The importance of managing stress and emotions in teens
  • Causes of emotional expression issues in teens
  • Signs of mental health problems
  • Effective help for teens who shut down emotionally
Teenage girl sitting with hear resting on her hand experiencing difficulty talking about feelings

What Is Alexithymia in Youth?

Although alexithymia is not a clinical disorder, extensive research shows it is a significant risk factor for developing serious mental health problems in adolescence.1,2 

There are three main characteristics of alexithymia:1,2  

  1. Difficulty identifying feelings (DIF) 
  2. Difficulty describing feelings (DDF)
  3. Externally oriented thinking (EOT)

DIF often becomes noticeable in highly stressful situations, when teens are unable to differentiate between feelings of fear, anger, sadness, or anxiety.2 Instead, they experience an overall feeling of general distress. 

DDF means a teen cannot put words to their emotions, often leading to emotional shutdown and communication problems in teens.2 

EOT involves focusing on the external details of the world rather than acknowledging internal emotional states, which can contribute to why teens bottle up emotions.2 

Researchers have developed several models to describe how alexithymia impacts adolescents. One of the most useful is the attention-appraisal model, which belongs to a broader group of emotion regulation models.1,2 The attention-appraisal model focuses on how alexithymia impairs four specific stages of emotional processing:1,2

  1. Situation occurrence
  2. Attention to the stimulus
  3. Identification and understanding of the stimulus (appraisal)
  4. Response

Understanding how alexithymia interferes with these emotional processes is the first step in recognizing the signs in your child. This can then enable you to seek the right help and support for managing and hopefully resolving the underlying issues.

The Importance of Managing Stress and Emotions

Adolescence marks a pivotal time in the development of emotion regulation.3 Emotion regulation is the set of skills used to track, evaluate, and adjust emotional responses in order to achieve a goal.3 Research shows that strong emotion regulation has a number of positive outcomes in life, including healthier communication, more effective conflict resolution, and a higher degree of empathy.4 

Emotion regulation also helps teens manage stress and difficult feelings caused by academic challenges.4 By effectively managing stress and emotions, teens can remain focused and composed, which enables them to learn, problem-solve, and make important decisions.4 

Positive emotion regulation strategies are also linked to better mental health outcomes. These include a decreased risk of depression and anxiety disorders in teens.4 Conversely, poor emotion regulation strategies can lead to overwhelming distress and a sense of being emotionally out of control.4 These patterns help explain why emotional expression issues in teens, such as shutting down, withdrawing, or bottling up emotions, place some adolescents at higher risk for future mental health problems. 

Taken together, the research highlights why building emotion regulation skills is such a critical part of coping with stress and pressure during adolescence.

What Are the Causes of Emotional Expression Issues in Teens

Many factors influence emotion regulation in adolescents, including biological, psychological, social, and environmental elements.4 Below, we will explain several key contributors to emotional expression issues in teens: hormonal changes,2,5 personality traits,2,6 family and peer relationships,4,7,8 and exposure to adverse childhood experiences.4

Biological Factors

During puberty, the brain undergoes significant hormonal and structural changes.5 For female adolescents, specifically, fluctuations in ovarian hormones during puberty are linked to changes in the balance of different brain processes. There have been several studies looking at these structural changes in the brain and how they relate to depression and social anxiety symptoms, among other emotional expression issues in teens.5

Psychological Factors

Personality traits can also play a major role in shaping how teens express and regulate emotions. The “Big Five” personality model identifies five broad traits:6

  1. Extraversion
  2. Agreeableness
  3. Conscientiousness
  4. Neuroticism
  5. Openness/intellect 

Based on this model, researchers have mapped these personality traits to different levels of emotional processing.6 For example, extraversion is associated with positive emotionality.6 On the other hand, neuroticism is associated with negative emotionality, which may present as fear, anger, discomfort, and sadness.6 Finally, effortful control, linked to conscientiousness, supports better control over emotions and helps teens focus enough to notice subtle internal emotional changes.6 Therefore, these differences in personality traits can shape how adolescents experience and express their emotions.

Social Factors

Family relationships and peer relationships can also significantly influence emotional expression in adolescents.7,8 One important concept is “flexibility”, which is an important concept when looking at how parent-child relationships affect emotion regulation.7 Two forms of flexibility are especially relevant:

1. Dynamic Flexibility 

This has been studied extensively over the years and refers to the moment-to-moment emotional shifts during interactions between a parent and child. 

2. Reactive Flexibility

This has been the subject of more recent studies and refers to adjusting emotional responses based on different contexts. For example, a teen may respond differently when interacting with a parent compared to a friend.7 

Dynamic flexibility and reactive flexibility are especially relevant when studying parent-child relationships. For example, parents who are more rigid during conflicts with their child show low dynamic and reactive flexibility. This can make it harder for both teens and their parents to return to a positive emotional state after disagreements.7 Ultimately, this can contribute to emotional expression issues in teens and may increase conflict avoidance or emotional shutdown in family situations. 

Peer relationships can also shape emotional development in teens. For example, negative experiences with peers, such as rejection, exclusion, and bullying, are often linked to emotional dysregulation, rumination, and low emotional awareness.8 

Three key psychological models can explain these effects:

1. Cognitive Control of Emotion Model

This proposes that when an adolescent is exposed to negative events in their peer groups, they can become overwhelmed, and this hinders their ability to use adaptive coping skills in the future. For instance, being bullied or rejected by peers can result in limited emotional responses later on in life.8 

2. Social Information Processing Model 

This model proposes that teens who struggle to read social cues may interpret neutral interactions as threatening. This can then increase emotional dysregulation and the risk of peer victimization, perpetuating the cycle.8 

3. Social Learning Theory 

This focuses on low levels of self-efficacy, which are negative feelings about yourself and how you can handle stressful situations. According to the theory, this is a predictor of emotion dysregulation, as teens with lower self-efficacy may be more negatively affected by adverse peer situations.8

In conclusion, it is the combination of biological, psychological, and social factors that negatively impact emotion regulation strategies in adolescence. It is important to understand how these can lead to more serious mental health problems, which is discussed in the next section.

What Are the Signs of Mental Health Problems in Teens?

Recent studies show that alexithymia in adolescence is linked to depressive disorders, anxiety disorders, and eating disorders.9 Because of this, it is important for parents to understand the early signs of hidden mental health problems so they can access support as soon as difficulties appear. 

Depression in Teens

There are several signs of hidden depression in teens that appear consistently across research. Early symptoms often include loneliness, fatigue, depressed mood, and anhedonia.10 These symptoms are common in adolescents diagnosed with depression, but how they present can differ based on the child’s gender.10 Specifically, teenage girls are more likely to experience loneliness, while adolescent boys are more likely to report physical symptoms of depression, such as blunted affect and fatigue.10 

Another more serious symptom of depression in teens is suicidal ideation.10 Because emotion regulation issues and alexithymia are so closely tied to depression, looking out for these signs in your child can help you get them the right adolescent counseling programs early.1

Anxiety Disorders During Adolescence

As explained above, alexithymia in youth is also associated with an increased risk of anxiety disorders in adolescence.1 For example, symptoms of both alexithymia and social anxiety are the need for social approval, fear of public speaking, emotional suppression, experiential avoidance, and poor emotional awareness.11 As the symptoms overlap, teen social anxiety help may therefore also help with teen alexithymia. 

Low self-awareness is another symptom that is often seen with both social anxiety disorder and poor emotion regulation.11 Emotion regulation deficits are similarly connected to generalized anxiety disorder, meaning teens may have trouble managing internal stressors even in everyday situations.12 Parents should pay careful attention to these anxiety-related signs, especially if they notice increased avoidance, emotional bottling, or communication problems at home. 

Teenage Eating Disorders

Research shows that alexithymia is a significant risk factor for the development of eating disorders in adolescence, including anorexia nervosa, bulimia nervosa, and binge-eating disorder.1,13 Teens with these disorders consistently report higher levels of alexithymia than their peers.13 

At the core of this relationship is emotion dysregulation. However, research shows that for some teens, it isn’t only negative emotions that can cause problems. Overly intense positive emotions, such as feeling a sense of achievement or relief after engaging in certain behaviors, can often contribute to ongoing eating disorder symptoms.13 

In anorexia, this can lead to riskier behaviors. For example, a teen might feel a powerful dysregulated “reward” response after checking their weight or frequently using laxatives, which makes them more likely to repeat the behavior.13 If this continues, restricting food to control their weight or body shape can create a cycle where the temporary positive feelings reinforce the unhealthy behavior, making it harder for the teen to stop.13

Because alexithymia is associated with multiple mental health disorders in adolescents, it is essential for parents to understand these signs. This allows them to seek help for teens who shut down emotionally or struggle to communicate what they feel. 

Emotional Regulation Therapy for Teens

One effective form of emotion regulation therapy for alexithymia is dialectical behavior therapy (DBT).14 DBT involves four core modules, but the two most important for teens who find it difficult to talk about their feelings are emotion regulation and mindfulness.14 These modules teach adolescents to recognize links between triggering events, physical sensations, thoughts, urges, and behaviors.14 Because of this, DBT is particularly effective in treating teens who bottle up emotions or struggle with emotional awareness.14

Another treatment approach that focuses on emotion regulation is acceptance and commitment therapy (ACT).15 ACT combines acceptance and mindfulness practices with elements of traditional cognitive therapy.15 It is an effective form of treatment for social anxiety disorder and can also help address nonsuicidal self-injury (NSSI), which is thought to be a direct result of emotion dysregulation.15 Some of the main goals of ACT are improving psychological flexibility, accepting thoughts and feelings, reducing avoidant behaviors, and increasing actions that are in line with a person’s core values.15

Together, DBT and ACT provide structured ways for adolescents to practice coping with feelings. By learning more about the options available, parents and caregivers can reduce the mental health stigma in teens and ensure every child gets the help they need.

Teenage girl with parents and sister outside smiling after support with difficulty talking about feelings

MissionPrep: Resources for Adolescent Counseling Programs

If you have been searching for “therapy for teens near me”, Mission Prep is here to help. We are committed to helping parents gain access to adolescent counseling programs, emotional support, and family therapy for teenagers. We have outpatient therapy options as well as more intensive residential mental health programs for adolescents managing more serious mental health issues. 

If your teen is showing signs of alexithymia or poor emotion regulation, contact us today. Our team can listen to your situation and come up with a plan to get your child the help they deserve.

References

  1. Brett, J. D., Zarei, M., Preece, D. A., Becerra, R., Gross, J. J., & Mazidi, M. (2025). How alexithymia increases mental health symptoms in adolescence: Longitudinal evidence for the mediating role of emotion regulation. Affective Science, 1-10. https://doi.org/10.1007/s42761-025-00318-9 
  2. Luminet, O., & Nielson, K. A. (2025). Alexithymia: Toward an experimental, processual affective science with effective interventions. Annual Review of Psychology, 76(1), 741-769. https://doi.org/10.1146/annurev-psych-021424-030718 
  3. Silvers, J. A. (2022). Adolescence as a pivotal period for emotion regulation development. Current Opinion in Psychology, 44, 258-263. https://doi.org/10.1016/j.copsyc.2021.09.023 
  4. Yılmazer, E. (2024). Emotional Regulation in Adolescence: A Comprehensive Review. Nişantaşı Üniversitesi Sosyal Bilimler Dergisi, 12(2), 403-424. https://doi.org/10.52122/nisantasisbd.1457804
  5. Pfeifer, J. H., & Allen, N. B. (2021). Puberty initiates cascading relationships between neurodevelopmental, social, and internalizing processes across adolescence. Biological Psychiatry, 89(2), 99–108. https://doi.org/10.1016/j.biopsych.2020.09.002
  6. Galambos, N. L., & Costigan, C. L. (2003). Emotional and personality development in adolescence. In R. M. Lerner, M. A. Easterbrooks, & J. Mistry (Eds.), Handbook of psychology: Developmental psychology (Vol. 6, pp. 351–372). Wiley.
  7. Hollenstein, T., & Lanteigne, D. M. (2018). Emotion regulation dynamics in adolescence. In A. M. Gross (Ed.), Emotion regulation: Conceptual and practical issues (pp. 158–176). Routledge.
  8. Herd, T., & Kim-Spoon, J. (2021). A systematic review of associations between adverse peer experiences and emotion regulation in adolescence. Clinical Child and Family Psychology Review, 24(1), 141-163. https://doi.org/10.1007/s10567-020-00337-x 
  9. Yeung, S. R., Kiropoulos, L., Nguyen, C. P. Q., Liu, S., Widjaja, E. S., Dang, A. B., Fuller-Tyszkiewicz, M., & Krug, I. (2025). Is alexithymia a transdiagnostic factor across depressive, anxiety, and eating disorders in adults? A meta-analytic review. Clinical Psychology: Science and Practice. https://doi.org/10.1037/cps0000288 
  10. Liu, S., Ren, H., Li, Y., Liu, Y., Fu, S., & Han, Z. R. (2025). Gender difference in the onset of adolescent depressive symptoms: A cross-lagged panel network analysis. Research on Child and Adolescent Psychopathology, 53(1), 113-123. https://doi.org/10.1007/s10802-024-01235-4 
  11. Panayiotou, G., Leonidou, C., Constantinou, E., & Michaelides, M. P. (2020). Self-awareness in alexithymia and associations with social anxiety. Current Psychology, 39(5), 1600-1609. https://doi.org/10.1007/s12144-018-9855-1 
  12. Mennin, D. S., McLaughlin, K. A., & Flanagan, T. J. (2009). Emotion regulation deficits in generalized anxiety disorder, social anxiety disorder, and their co-occurrence. Journal of Anxiety Disorders, 23(7), 866-871. https://doi.org/10.1016/j.janxdis.2009.04.006
  13. Muir, X., Preece, D. A., & Becerra, R. (2024). Alexithymia and eating disorder symptoms: the mediating role of emotion regulation. Australian Psychologist, 59(2), 121-131. https://doi.org/10.1080/00050067.2023.2236280
  14. Salles, B.M., de Souza, W.M., dos Santos, V.A., & Mograbi, D.C. (2023). Effects of DBT-based interventions on alexithymia: a systematic review, Cognitive Behaviour Therapy, 52, 110-131. https://doi.org/10.1080/16506073.2022.2117734
  15. Yuan, J., Zheng, M., Liu, D., & Wang, L. (2024). Effect of acceptance and commitment therapy on emotion regulation in adolescent patients with nonsuicidal self-injury. Alpha Psychiatry, 25(1), 47. https://doi.org/10.5152/alphapsychiatry.2024.231324
Tagged ,