Is it more than a phase? 10 signs to watch for in adolescents
At a glance
- Behavioral changes may signal mental health concerns, not just puberty-related shifts
- Watch for persistent patterns that occur over at least a two-week period
- Open communication and trusted adult connections are essential; call 988 in a crisis
Adolescence — which occurs between the ages of 10 and 19 — marks the shift from childhood to adulthood, bringing significant physical, emotional and social changes.
The brain is still developing, and hormones can cause natural fluctuations in mood and behavior. For a parent or caregiver, it can be challenging to know if a teen’s behavior is a passing phase related to puberty or a more concerning symptom of a mental health condition.
One in seven adolescents live with a mental health disorder, according to the World Health Organization (WHO). And 50 percent of all people who will have a mental health disorder in their lifetimes start to experience symptoms by age 14, reports Mental Health America.
With these statistics in mind, it’s important for parents and caregivers to recognize early warning signs.
The following are 10 signs that may indicate an adolescent is struggling with their mental health:
- Risk-taking behaviors, such as running away, reckless driving or unsafe sexual practices
- Repeated or increased use of drugs or alcohol
- Disordered eating or significant weight changes (weight loss or gain)
- Withdrawing or isolating from activities, sports, friends or family
- Sudden deterioration in academic performance that’s not normal
- Drastic changes in sleep habits (too much or too little)
- Severe mood swings or aggression
- Intense worries or sudden overwhelming fear
- Extreme difficulty concentrating
- Self-harm, suicidal ideation or gestures
These symptoms can occur across multiple conditions, including anxiety, depression, ADHD (attention-deficit/hyperactivity disorder), bipolar disorder and other mental health conditions, so it’s important to distinguish between a few “off” days and a pattern.
“We’re talking about young people who are going through puberty,” explains Jasmine Gregory, MSW, LICSW, professional development specialist with Mary Bridge Children’s Social Work department. “They might need to sleep more; they might have a bigger appetite at different times. Those types of symptoms are always going to fluctuate.”
What’s concerning is when these behaviors are a change from the child or teen’s baseline and continue consistently over at least a two-week period.
“This population is severely impacted by those initial signs and symptoms of mental illness,” Gregory says. “And how we care for them is extremely important as they’re navigating through those big changes.”
If adolescent mental health conditions are not addressed, effects may continue into adulthood, potentially impacting both physical and mental health and their adult life.
What to do if you notice signs of mental health challenges
If you’re seeing a concerning pattern, the first step is to start a conversation.
“Being open-minded in talking to your youth about how they’re feeling, what you’re noticing, and having that open dialogue is key,” Gregory says.
Adolescents tend to be more reserved or protective of their thoughts, their feelings and information.
“So when adults are able to show that it’s OK to talk about how we feel, that it’s OK to have bad days, that we are able to get through those difficult times, then kids can learn from that and model those behaviors, too,” she says.
Connecting and engaging with your teen doesn’t have to be a direct confrontation about their mental health.
“It could be as simple as, ‘Hey, let’s go get ice cream,’ or ‘Let’s do an activity together,’” Gregory recommends. “That type of connection could potentially open the door for them to feel more willing to engage.”
Sometimes it takes creativity to help a young person feel comfortable opening up.
“For one kid, it’s basketball. For another, it’s artwork,” she suggests. “How can we talk about the use of basketball or art as a part of mental health, building resilience and empowering yourself?”
If trusted adults can find that way in, it often makes it easier for adolescents to share what’s going on.
“Adolescence is just a hard time of life. My biggest recommendation is to always have the door open. If it’s not a severe or imminent risk, letting them know that you’re available, that you are open whenever they’re ready to talk, can go a long way.”
Allowing your child or teen to talk to other trusted adults about their symptoms or feelings can provide another avenue for communication, Gregory says.
“It is important that parents and caregivers support their youth in sharing with other trusted adults, like their doctor,” she adds.
For instance, many pediatricians begin conducting the Patient Health Questionnaire-9 (PHQ-9) with kids ages 10 to 12 during wellness visits. This nine-question screening tool assesses the presence and severity of depressive symptoms.
“The PHQ-9 is meant to identify and support young patients early because we know and recognize the data around the adolescent population having or living with a mental disorder,” Gregory explains.
If a need is identified, the provider can then help connect your child or teen to mental health services, counseling or medication, as appropriate.
What to do in a mental health crisis
If it’s a severe emergency, where medical attention is needed or your child’s behaviors are beyond what can be managed at home, call the national crisis line at 988 or go to the nearest emergency department.
“If a young person is expressing suicidality — talking about not wanting to be here, looking for ways or methods that they might try to end their life — that is obviously a sign to get support for them immediately,” Gregory says.
Kids’ Mental Health Washington is a resource for youths and families across the state. Many communities offer crisis services to help navigate these situations.
In Pierce County, for example, there are two youth mobile crisis teams that can go your home, your child’s school or anywhere in the community where the crisis might be occurring.
“These clinicians can help de-escalate the situation and help decide if the youth needs to go to the emergency department or if they can manage their symptoms at home in their own environment,” she explains.
Keep the door open
“Adolescence is just a hard time of life,” Gregory adds. “My biggest recommendation is to always have the door open. If it’s not a severe or imminent risk, letting them know that you’re available, that you are open whenever they’re ready to talk, can go a long way.”
If a child or teen is in immediate danger of taking suicidal action, call the 988 Suicide & Crisis Lifeline.
