As parents, we are always looking out for our children’s health and well-being. When they’re little, we child-proof our homes. When they get older, we make sure they wear a bike helmet and wash their hands regularly. But while scraped knees and stomach bugs are easy to spot, signs our adolescents and teens are struggling with their mental health can be harder to notice, especially if we don’t know what we are looking for.
What Are The Stats?
According to a meta-analysis published in the Journal of the American Medical Association, 25.2% children and adolescents globally experienced elevated depression symptoms during the first year of the COVID-19 pandemic, and 20.5% experienced clinically elevated anxiety symptoms — up from pre-pandemic numbers of 11.6% and 12.9%, respectively. And even prior to COVID-19 in 2019, the Centers for Disease Control and Prevention (CDC) reported that more than one third of high school students had experienced persistent feelings of sadness or hopelessness — both of which can sometimes be symptoms in other common mental health disorders in adolescents, which include:
- Mood disorders, such as depression
- Anxiety disorders
- Eating disorders
- Conduct disorders
- Substance use disorders
They may also have other conditions, such as attention deficit hyperactivity disorder (ADHD), which has a high comorbidity rate with mental health conditions. Less commonly, psychotic disorders such as schizophrenia can develop (usually in late adolescence or early adulthood).
Why Does It Matter?
Of course, living with mental illness is a difficulty no one wants their children to experience – but there is more to it. Left untreated, mental illness in adolescents is associated with risks such as academic and educational difficulties, risk-taking behaviors such as substance use and unsafe sex practices, substance use, self-harm, and suicide.
What Should We Look For?
Teenagers are emotional and reactive by nature. They are testing boundaries, gaining independence and the responsibilities that come with that, going through major physical changes, and are often, well, moody. It can be hard to tell what is just teenage behavior and what is cause for concern.
The National Alliance on Mental Illness (NAMI) recommends some warning signs to look for, including:
- Worrying excessively or excessive fear/anxiety
- Feeling excessively sad or “down”
- Problems with thinking, concentrating, and/or learning
- A change in school performance such as a drop in grades, increased absences, or regular lateness
- Frequent disobedience or aggression
- Extreme mood changes (including uncontrollable “highs” or feelings of euphoria)
- Irritability or anger that is prolonged or strong
- Avoidance of friends and social activities
- Trouble understanding or relating to others
- Changes in sleep, including feeling tired or having low energy
- Changes in eating habits, including increased hunger or lack of appetite
- Difficulty perceiving reality, including delusions or hallucinations (sensory experiences and/or firm beliefs not based in reality)
- Lack of insight into themselves, such as being unable to perceive changes in their own feelings, behavior or personality
- Overuse or misuse of substances such as alcohol or drugs
- Physical health problems that don’t have an obvious cause, such as headaches, stomach aches, vague and ongoing “aches and pains”
- Thinking about suicide
- Difficulty navigating, handling, and completing daily activities, problems, and stress
- An intense fear of weight gain or concern with their appearance
Don’t discount your own instincts and intuition. If you notice changes in your child that concern you or that you are unsure how to interpret, even if they are not on this list, it’s worth looking into.
“If you are a parent who is worried about your child’s mental health, don’t hesitate to seek professional help,” says Leigh McInnis, LPC, Executive Director for Newport Healthcare Virginia. “Remember that it is always better to be concerned and more sensitive to a possible mental health issue than oblivious to it.”
How Can Parents Take Action?
Talking to your kids about mental health – both theirs and in general – is very important. McInnis offers some suggestions for how to have these conversations:
- It’s important to regularly check in with your teen, especially if you notice a change in their behavior, personality, or appearance. When doing so, try to talk less, listen more, and use open-ended questions which limit a teen’s ability to respond with one-word answers. Questions like “What three words best describe how you’re feeling right now?” or “What are the best thing and worst thing that happened to you this week?” are great segues into doing an emotional temperature check with your teen.
- While it is important to check in regarding your teen’s emotional well-being, try to balance these “check-ins” with casual and fun conversation. This helps to avoid overwhelming your teen and communicates that you want to spend quality time with them.
- When your child talks to you about their experience of suffering, try to maintain neutral verbal and nonverbal communication.
- Try not to personalize it if your teen seemingly rejects conversations with you. At Newport Healthcare, they emphasize the parent’s role to initiate connections with their child regardless of whether your child knows how to receive these connections in a healthy way. Whether a teen rejects the conversation or acknowledges their struggles, it may be time for professional help. If you feel that professional help is best, McInnis recommends involving your child in this discussion and allowing them to be a part of the process of choosing their treatment provider. They will be much more invested if they can have some control in the process.
In addition to talking to your kids, McInnis also recommends that parents maintain a good understanding of what your teen is doing online, with friends, and at school. Some parents may interpret this as invasive, but a parent’s role is to keep their child safe. Having tools for monitoring online behavior is absolutely reasonable given all we know about the impact of social media and other online activities on teen mental health.
One more important way to take action? Encourage your child to save several emergency numbers in their phone. This gives them the ability to get immediate help for themselves or for a friend. Here are a few important numbers to encourage your child to save:
- The phone number for a trusted friend or relative
- The non-emergency number for the local police department
- The Crisis Text Line: 741741
- The National Suicide Prevention Lifeline: 1-800-273-TALK (8255).
Where Can We Go For Help?
If you are concerned, a good place to start is your child’s healthcare provider, such as their family doctor or pediatrician. They can do an initial assessment, see if further referrals are necessary, and help put a treatment plan in place if warranted.
If your child does not have a primary healthcare provider, the National Institute of Mental Health (NIMH) has a list of resources to contact for help. Youth.gov also offers a comprehensive list of resources and suggests questions to ask when looking for a support or treatment provider.
Treatment will depend on factors such as your child’s condition and symptoms including severity, their general health, their age, their ability to access resources, and other considerations. It can involve medication if appropriate, and is likely to involve some form of psychotherapy (talk therapy) or other counseling. It can take place in a variety of settings, including regular visits with a mental health professional, outpatient care or in-patient care through a medical centre, treatment centers, and more. For example, McInnis explains that Newport Academy teen treatment program offers several levels of care for teens struggling with mental health issues:
- Outpatient Treatment: Bases the number of days and hours on the teen’s clinical needs as well as their personal goals and the goals of the family
- Intensive Outpatient Programs (IOPs): For teens who are beginning to meet vocational and educational goals and do not require all-day support as they continue their recovery. The IOP treatment program is three hours per day, Monday through Friday, and provides individual, family, and group therapy
- Partial Hospitalization Programs (PHPs): All-day, Monday through Friday, on-site treatment programs that include academics and 4 to 5 hours of clinical sessions per day. This is the highest level of outpatient care for teens who need daily support and structure in a therapeutic environment, while still living at home
- Residential Treatment Options: Programs offered across the nation which provide evidence-based clinical, experiential, and academic elements in a safe, supportive, home-like environment
While navigating the world of teen and adolescent mental health can be daunting, it helps to have an idea of what to look for and where to turn for support if you or your child need it. “Diagnosing and treating an issue early increases the success of treatment, decreases the frequency and severity of future issues, and reduces the trauma surrounding the situation,” says McInnis.
If you think your child may be struggling with mental health concerns, talk to a health care provider or mental health professional. Help is available.
Learn more about Newport Academy, a provider of teen and adolescent mental health service across the United States.
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