Source: Harvard Graduate School of Education - EducationNOW

It’s noon on Sunday and your teenager—usually an early riser—hasn’t emerged from the dark cocoon of their bedroom. You crack open their door, tiptoe past musty mounds of last week’s laundry, and squint to see your child’s face. They’re still sleeping.

As a parent, it's natural to worry when your teen’s behavior changes, whether they’ve started sleeping more, seeing friends less, or are picking at their food when they used to have seconds. The good news is that most of the time, these types of changes in behavior are not cause for concern. Still, there’s ample reason for parents to be on the lookout for red flags. According to the Centers for Disease Control and Prevention, an alarming number of adolescents report poor mental health. Nationally, one in six children and adolescents ages six to 17 experiences a mental health disorder; 50% of all lifetime mental illnesses begin by age 14. Untreated, adolescent mental health issues can lead to physical, emotional, and mental health consequences into adulthood.

Because early detection and intervention can help significantly, it’s essential for parents and other family members to support teens by learning about common mental health conditions, understanding the signs that their teen might be experiencing a mental health issue, and familiarizing themselves with ways to begin a conversation with a teen who might be struggling. We assembled the information below to help parents and other family members understand possible red flags and begin these important conversations.

“Untreated, adolescent mental health issues can lead to physical, emotional, and mental health consequences into adulthood. ”

Common mental health conditions

Depression is the most common mental health condition among teens. Depression is characterized by prolonged feelings of hopelessness and/or sadness, a loss of interest in activities, and other impediments to daily functioning, such as eating and sleeping, for a period of at least two weeks. Depression can be triggered by a combination of things, including difficult or traumatic life events, genetics, and environmental factors.

Like depression, anxiety disorders are common during adolescence. Anxiety is characterized by excessive worry, stress, and fear that can impede day-to-day activities. Symptoms can be both emotional, including feelings of dread, distress, restlessness, and irritability and physical, including shortness of breath, racing heart, sweating, headaches, and stomachaches. Social anxiety and panic attacks are common in teens with anxiety, and teen anxiety can often lead to depression or substance use and abuse.

Attention-deficit/hyperactivity disorder (ADHD) can result in academic and social stress due to difficulty with focus, organization, impulse control, and emotional regulation. Parents can support teens with ADHD through treatment, by advocating for accommodations at school, and by supporting teens in strengthening their social skills.

Eating disorders are common in adolescents and adults and are typically more common in women than men. Eating disorders including anorexia nervosa, bulimia nervosa, and binge eating disorder and are characterized by excessive concern about food, body weight, and body image. Physical symptoms include eating too little, eating too much, or excessive vomiting; emotional symptoms include social withdrawal, low self-esteem, feelings of embarrassment or shame, and irritability. Without treatment, eating disorders can lead to severe medical issues.

Teens who have experienced a traumatic event or trauma from physical, sexual, or verbal abuse can experience posttraumatic stress disorder (PTSD) and other impacts of processing trauma. Trauma can affect daily functioning and cause symptoms that are similar to depression and anxiety. Teens with trauma also can have trouble concentrating, poor short-term memory, and hypervigilance or flashbacks.

Suicidal ideation, or thoughts of death by suicide, is common among adolescents, especially high school students. On average, 20% of high school students seriously consider suicide and 9% attempt suicide. In the U.S., historically marginalized populations are at higher risk of suicide. Black Americans, Indigenous populations, and youth who identify as LGBTQIA+ are considered high-risk groups. If you suspect that your child may be experiencing suicidal thoughts, especially if they seem to be suffering from extreme depression, seek help immediately. The Crisis Textline and the National Suicide Prevention Lifeline are both excellent resources.

Substance abuse is one of the many risk-taking behaviors that can begin in adolescence. Substance use is often linked with mental health disorders such as anxiety and depression and is used as an unhealthy coping behavior. Substance abuse can include a misuse of alcohol, marijuana, prescription drugs, over-the-counter drugs, psychedelics, or other drugs.

“Sudden or significant changes in your teen’s behaviors, academic performance, or emotional responses could be an indication that something more serious is going on.”

What are the warning signs?

Sudden or significant changes in your teen’s behaviors, academic performance, or emotional responses could be an indication that something more serious is going on. As outlined above, specific mental health issues present a variety of symptoms and warning signs. The list below highlights some common red flags (the National Alliance on Mental Illness offers a more comprehensive list here):

• Sudden drop in grades

• School avoidance

• Eating too much or too little

• Sleeping too much or too little

• Frequent physical complaints (headaches, stomach aches) 

• Social withdrawal (from friends, family, previous social connections) 

• Excessive worry or fear about daily activities 

• Frequent mood swings (including both “highs” and “lows”)

• Prolonged periods of irritability or anger

• Excessive sadness or lack of energy

• Ideas of self-harm or suicide 

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Posted by Kiran Bhai, Program Director, Schools and Parenting and Alison Cashin, Director of Communications