What Parents And Caregivers Need To Know About Teen Mental Health

How To Know When They Need Help

You're not alone if your teen child is struggling with anxiety, depression, or other mental health issues. Many teenagers are still having difficulties more than a year after the American Academy of Pediatrics (AAP) joined forces with other groups to declare a national emergency in juvenile mental health. You might still wonder if the symptoms are simply a result of the biological and social changes that all teens experience as they approach maturity, or if there is anything more going on. How do you as a parent or a caregiver know when to bring up mental health with your teen and their doctor?

Your teen may exhibit specific mental health symptoms that are exclusive to them. But as a parent or caregiver, you are well aware of what constitutes their "normal." It's common for teenagers to have mood swings. But when do a teen's mood fluctuations indicate a condition more closely related to mental illness? Teens are more likely than you might assume to experience mental illness. However, many forms of mental illness can be treated; it only requires a proper diagnosis.

Warning Signs Of Mental Illness In Teens Vary Depending On The Condition

Young people deal with a similar range of mental health issues as adults do. Although a drop in grades would typically be one of the warning signals for most teenagers, there are other symptoms as well. Withdrawal from school, friends, and activities that your child has previously loved participating in are examples of changes in social habits. Additionally, sadness, social phobias, and generalized anxiety all have particular symptoms.

8 Of the most common mental illnesses in teens are:

1. Attention-deficit/hyperactivity disorder (ADHD): a brain disorder that typically develops in childhood or early adolescence, attention-deficit/hyperactivity disorder makes concentrating and staying focused very difficult. Youth with ADHD tend to be more impulsive, and restless.

2. Conduct disorder: conduct disorder is a behavioral and emotional disorder that is only diagnosed in children and adolescents/teens. Conduct disorder is marked by extremely aggressive and destructive behavior toward other people, pets, or property. Because of this violent and disruptive behavior, many youths with conduct disorder struggle to follow rules and often avoid places where rules are enforced (i.e. skipping school, running away from home, etc.).

3. Anxiety Disorders: among the most common mental health problems affecting teens and adolescents, anxiety disorders cause significant distress and worry that interferes with everyday life. There are many different kinds of anxiety disorders including generalized anxiety disorder (GAD), social anxiety disorder, obsessive-compulsive disorder (OCD), phobias, panic disorder, and post-traumatic stress disorder (PTSD).

Signs Of Anxiety Disorders-

• Excessive worry about everyday matters
• Feeling restless, wound up, or on edge
• Becoming fatigued quickly
• Struggling with concentration
• Experiencing irritability
• Feeling muscle tension
• Struggling with sleep, difficulties falling asleep or staying asleep
• Feeling very anxious at the thought of being around others, and struggling to talk to other people
• Experiencing extreme self-consciousness and fear of humiliation, embarrassment, rejection, or offending people
• Worrying about being judged
• Feeling anxious days or even weeks ahead of a social event
• Avoiding places where other people will be
• Struggling to make and keep friends
• Blushing, sweating, or trembling around others
• Experiencing nausea around other people

4. Depression: a mood disorder that commonly shows up during the teenage years. Depression is more than just experiencing low mood every once in a while – depression is marked by persistent feelings of sadness and loss of interest in previously enjoyed activities. Here are 4 kinds of depression affecting adolescents and teens today:

1. Dysthymia – is considered a “low-grade” and persistent (chronic) form of depression in teens and adolescents. Dysthymia makes individuals more susceptible to other forms of depression/mood disorders.
2. Adjustment Disorder with Depressed Mood – typically a result of a major change or significant life event, adjustment disorder with depressed mood tends to be brief in nature, and if symptoms persist for longer than 6 months, the adolescent or teenager may be assigned a different diagnosis.
3. Bipolar Disorder – marked by periods of depression, followed by periods of mania or hypomania, bipolar can cause significant impairment in teens. Although bipolar is treatable (usually a combination of psychotherapy and medication), there is no identified cure.
4. Major Depressive Disorder (MDD) – this type of depression is the most serious and pervasive, with an estimated 8% of adolescents and teenagers meeting diagnostic criteria. Major depression typically impacts a child’s home, school, and social life.

Signs Of Depression-

• Feeling persistently sad, anxious, or empty
• Experiencing hopelessness or pessimism
• Struggling with irritability
• Feeling guilty, worthless, or helpless
• Losing interest in hobbies or activities that used to be enjoyable
• Struggling with fatigue or lack of energy
• Moving and/or talking more slowly than usual
• Feeling restless
• Struggling with concentration, memory, and/or decision-making
• Experiencing unexplained changes in appetite or weight
• Having thoughts of death or suicide
• Unexplained aches or pains that don’t go away when treated

5. Psychosis: a serious mental health condition often appearing in late adolescence or early adulthood. Psychosis involves a loss of contact with reality, which could mean hearing, and/or seeing things that are not there (visual/auditory hallucinations), or believing things that are not true (delusions). Warning signs can be difficult to spot, but if caught early, psychosis in adolescents and teenagers is treatable.

6. Eating disorders: are less common in young children, with the risk increasing with age. Although more common in females, eating disorders can affect teen males as well. Eating disorders are serious and potentially life-threatening. The most common eating disorders in teens and adolescents are:

Anorexia – characterized by significant weight loss and a distorted view of body shape and size, individuals with anorexia have an intense fear of gaining weight and restrict caloric intake in an effort to maintain and/or lose weight.

Bulimia – teens with bulimia engage in periods of binging (eating large quantities of food in a short period of time), followed by compensatory behaviors (i.e. – purging, over-exercising, laxative use) to avoid weight gain.

Binge-eating disorder – is marked by recurrent episodes of eating large quantities of food often to the point of physical discomfort), those who struggle with binge eating often experience intense feelings of guilt and/or shame following a binge. Binge-eating disorder is the most common eating disorder in the United States today.

7. Schizophrenia: this mental health disorder affects about 1% of the total population and typically shows up in adolescence or early adulthood (between the ages of 15 and 25). Schizophrenia can make it extremely difficult for young people (or anyone struggling with this mental health disorder) to think and speak in an organized way. It can also contribute to people losing touch with reality.

8. Substance Abuse Disorder: the adolescent and teenage years are a critical time of increased vulnerability to the effect(s) of alcohol and/or drugs. Because the brain is still developing, introducing drugs or alcohol can hugely affect the course of that development. Substance abuse disorder can contribute to the development of other mental health disorders, or in many cases, be the way a teen deals with the difficult symptoms of an already-existent mental health disorder.

Other Signs To Be On The Lookout For:

• A whole new set of friends you've never met before
• Refusing to talk about what's bothering them, even after you've made it as safe as possible to discuss hard issues openly
• Obsession with a certain goal, possibly with the belief that if they don't achieve it, their life will never be the same
• Signs of drug, alcohol, or other substance use
• Signs of self-harm such as cuts, burns, bruises, etc. that your teen tries to hide or can't explain fully and credibly
• Sexual activity or interest that seems new or more intense than before

A diagnosis can sometimes be made with just two weeks' worth of symptoms, even though the majority of these symptoms must typically be present for several weeks or months before an appropriate diagnosis can be made.

Are Drinking And Drugs Part Of The Problem?

Teenagers sometimes abuse drugs. It may interact with problems in the mind (and in most cases, make them worse).

An estimated 15% of high school students admit to using illicit substances like marijuana, cocaine, inhalants, heroin, meth, hallucinogens, or MDMA (also called ecstasy or molly). 14% of people claim to have abused prescription opioids. A little more than 30% admit to trying alcohol, and 14% admit to binge drinking. A startling 17% got into a car that was being driven by someone who had been drinking, putting them in danger on an entirely new level.

Even if you don't notice any indications of mental health problems, substance use is a problem all on its own that you should definitely talk about with your teen. However, finding it coupled with mental health problems is cause for more worry. Drugs and alcohol are frequently utilized as coping mechanisms for uncomfortable emotions or situations. This may indicate that you need to deal with some serious emotional anguish.

What If My Teen Is Having Thoughts Of Suicide?

Suicidal ideas or behavior should never be disregarded. You can reach the 988 Suicide & Crisis Lifeline by phone or by texting "TALK" to 741741. You can determine the most effective ways to safeguard your child with the aid of trained lifeline personnel.

Getting help is crucial even if your teen is not in crisis but is contemplating suicide. Make a quick call to your child's pediatrician or mental health professional to learn about available services and plan for the best possible care and support.

There is a range of options for treating mental illness in teens, including:

• Identifying stressors, such as not getting enough sleep, skipping meals, or generally lacking a day-to-day routine—and remedying them
• Counseling, which is often paired with medications
• Prescribing psychiatric medications like selective serotonin reuptake inhibitors (SSRIs), which are commonly used, very safe, and highly effective for depression, anxiety, and social phobias

Physicians Define “Mental Illness” Differently Than Most Of Us Do

To evaluate whether a patient is suffering from a mental disorder, doctors look at a number of individual factors. They typically look for a depressed mood or a lack of interest in hobbies or recreational activities to identify a patient with severe depressive illness. Teenagers, however, may exhibit these symptoms as shifts in their academic performance, a lack of interest in their companions, or an out-of-character irritation. In the event that at least one of those symptoms is present, further criteria are looked into.

In addition, five of the following seven symptoms must be present in order to make a diagnosis:

• changes in sleep
• new onset of guilt
• changes in energy level
• changes in concentration or task completion
• changes in appetite
• changes in motivation
• thoughts of suicide

A person may be diagnosed with severe depressive disorder if they have displayed five of these symptoms almost daily for at least two weeks. It's probably not a cause for concern if your teen occasionally gets angry or stays out late as this is common teen behavior. On the other hand, it's usually a good idea to go to your doctor if such feelings linger and there are additional uncommon symptoms.

A Teen’s Primary Care Doctor Can Make The Diagnosis And Can Provide Support

You need to first visit the family doctor or pediatrician for your teen. Due to their experience with your teen's medical history, a diagnosis may be made more quickly and simply. Your teen's health is important to your pediatrician, who has also assisted many other parents and caregivers with their mental health issues. Additionally, your pediatrician should be aware of local services you can use to assist your adolescent both now and throughout the healing period.

Pediatricians can discuss available treatments, including potential helpful drugs. They can also suggest mental health professionals who can assess your teen for you. By doing this, your child's pediatrician will be a part of a care team that can assist you in developing a treatment plan as well as a crisis plan that details what you will do if your child's condition worsens.

The doctor could inquire the following during the initial consultation to check for mental illness:

• What are the symptoms the teen is displaying?
• What are the parents worried about?
• Does the teen have any concerns?

The doctor can typically suggest a psychologist or psychiatrist if they feel uncomfortable making a diagnosis on their own.

Mental Illness In Teens Is More Common Than People Think—But Also Very Treatable

Mental illness can be managed. However, because they are in denial, parents frequently wait until problems have been ongoing for several months before bringing the child in. The majority of parents think, "It can't be what's happening to my child."

It's advisable to start a talk with your teen about the issue if they look stressed or if there has been a dramatic shift in their conduct. It might not necessarily indicate a psychiatric condition like depression or anxiety, but it could still be a symptom that they are experiencing stress from anything in their life.

Pressures Teens Face

Experts in child and adolescent mental health have expressed concern about the enormous pressures that kids and teens are under, particularly in the present and during the COVID-19 pandemic. However, teen stress is not solely caused by the lasting impacts of school closings and other COVID-related pressures. Additionally, a lot of young individuals deal with:

• The overwhelming pressure to achieve good grades in school or gain admission to elite colleges and universities
• The need to be superstars in sports, the performing arts, or other extracurriculars
• Tough schedules that don't allow enough time for rest, relaxation, and unstructured fun
• Bullying (whether in person, via social media, or both)
• Persistent fears about climate change, global conflict, and other weighty issues
• Discrimination based on race, gender, sexual orientation, weight, religion, disability or other factors
• Problems related to poverty or lack of money for safe, stable housing and enough nutritious food.

If you’re concerned that your teen might be struggling with a mental illness, schedule an appointment with their primary care physician.

What Role Does Social Media Play?

Online platforms like Instagram, Snapchat, TikTok, and others are popular among young people. According to one survey, more than 60% of youths (aged 13 to 18) regularly use social media and utilize various platforms.

The effects of social media on human health, particularly in children and teenagers, are still being studied. Social media usage in a constructive way can promote positive connections. However, some young people might be more at risk for adverse outcomes. You may learn more about social media's effects on children's mental health by reading "Social Media & Your Child's Mental Health: What the Research Says."

How Can I Open Conversations With My Child?

Here are a few things to think about as you start the conversation about your teen's mental health. This should ideally be a series of continuous discussions and "check-ins" that you have with your teenager. This can aid in promoting your teen's mental health and provide you with a solid basis for times when your kid may be experiencing greater difficulties and require more problem-focused care.

Here Are Some Things To Consider:

Make it safe for your teen to discuss tough issues with you. Kids often avoid talking about touchy subjects, especially if they expect to be judged, lectured, or punished. If you haven't already made this clear, affirm that your teen can tell you anything. Emphasize that these conversations will take place in a judgment-free zone. Explain that you want to understand what they're going through and provide loving support.

Resolve to listen more than you speak. Nothing will send your teen running the other way faster than failing to see and hear them fully. You will need to manage your own fears during the conversation so you can avoid autobiographical listening. This happens when you filter everything through your own life lens instead of listening for deep understanding.

Consider ways to avoid putting your teen on the defensive. Naturally, you can't be sure how they will react when you ask about their mental health. But fair, factual statements are usually best. Instead of saying, "You've been acting really strange these past few weeks," you could start with an example: "I noticed you haven’t come down to dinner lately and you don't seem hungry at other times. I wondered if something in your life is making it hard for you to enjoy the stuff you usually love, like my broccoli casserole."

Accept some silence. Your child might not know what to say at first, especially if they've been trying to hide how they're feeling or manage things on their own. People having mental health struggles often feel shame and fear on top of everything else. This can make it hard to open up to anyone (even someone they trust). Explain that even though you're worried, you can wait for them to think about what they'd like you to know. If they don't come back to you on their own, try restarting the conversation in a few days.

Realize that mental health stigma still exists. Despite much progress, some people still believe that having a mental health condition means someone is broken, untrustworthy, or potentially violent. In fact, many don't seek mental health treatment because they're afraid of what others will think of them.

Mental health is a key part of human health. Parents and teens do not need to feel ashamed or fearful in seeking treatment. It's no different from getting care for a broken bone, a serious infection, or any other major health concern.

Try not to blame yourself for your child's struggles. Life is hard, and kids are doing the best they can to manage the pressures they face (just as you are, too). Show compassion for yourself and your child as you move forward.

Even if you have a history of mental health issues yourself, you are not the root cause of your child's difficulties. Showing love, trust, and respect for yourself and your teen is the healthiest way to ensure you both find the resources you need.

Take The Proactive Approach To Promote Mental Health

Remember that maintaining mental health involves more than just addressing issues. It is crucial to encourage resilient thinking and behavior in daily, proactive ways. Help your teen find time for self-care and wholesome routines even if they are doing well overall.

Spend quality time together as a family. Mental health can benefit from protective, "building" activities and relationships. We all experience both good and bad days. The same logic applies to days when we feel better than usual. Promoting mental health should be one of our daily objectives; it should be on our radar.

And as always take care and be well.

Mindful!