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 do not cause 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 meaningful conversations.
Common mental health conditions
Depression is the most common mental health condition among teens. Depression is characterized by prolonged hopelessness and/or sadness, a loss of interest in activities, and other impediments to daily functioning, such as eating and sleeping, for at least two weeks. Difficult or traumatic life events, genetics, and environmental factors can trigger depression.
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 emotional, including dread, distress, restlessness, and irritability; physical symptoms include 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.
3. Attention-deficit/hyperactivity disorder (ADHD)
Attention-deficit/hyperactivity disorder (ADHD) can result in academic and social stress due to difficulty focusing, organization, impulse control, and emotional regulation. Parents can support teens with ADHD through treatment, advocating for accommodations at school, and supporting teens in strengthening their social skills.
4. Eating disorders
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, are characterized by excessive concern about food, body weight, and body image. Physical symptoms include eating too little, overeating, 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.
5. Post-traumatic stress disorder (PTSD)
Teens who have experienced a traumatic event or trauma from physical, sexual, or verbal abuse can experience post-traumatic stress disorder (PTSD) and other impacts of processing trauma. Trauma can affect daily functioning and cause symptoms similar to depression and anxiety. Teens with trauma also can have trouble concentrating, poor short-term memory, and hypervigilance or flashbacks.
6. Suicidal ideation
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.
7. Substance abuse
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 misuse of alcohol, marijuana, prescription drugs, over-the-counter drugs, psychedelics, or other drugs.
What are the warning signs?
Sudden or significant changes in your teen’s behaviors, academic performance, or emotional responses could indicate 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):
- A 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, and 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
What do I say?
Whatever the circumstance, it’s important to first validate your teen’s experience, practice careful and genuine listening, show empathy, and normalize seeking help. Above all, ensure your teen knows that you are there for them unconditionally. The phrases below may help start and follow up on a conversation.
What to say if you think your teen may be experiencing mental health issues:
- Some of what you’ve shared with me makes me concerned about how you’re doing. How do you feel? Is there any way I can support you?
- I’m concerned about how you’re doing because you’ve been sharing some difficult emotions and seem to be having a hard time. How are you doing today? Is there a way I can support you?
- I’ve been noticing some changes in your behavior lately. [Share your observation of the warning signs, i.e., “You’ve been sleeping a lot and haven’t seen your friends during break.”] How are things going for you lately? Is there a way I can support you?
What to say if your teen tells you about an issue they are facing related to or impacting their mental health:
- Thank you so much for telling me about this. I know it’s not easy to talk about. Let’s work together to think through solutions and ways to support you.
- I’m so glad you shared this with me. It seems like you’re going through a hard time.
- I’m glad you brought this up. I am so sorry you are going through this. Let’s brainstorm what would be helpful. We will work together to find a solution.
How to follow up to learn more about your teen’s mental health:
- How are you feeling today?
- How often do you feel [insert difficult emotions shared]?
- When did you start feeling this way?
- Have you talked to others about this?
- How do you cope, or feel better, when feeling this way?
- Have you tried to get help in any way?
- How can I help you?
- What would make you feel better today?
What do I do next?
Teen mental health issues are common and treatable, and it’s critical to seek help for your teen if they are struggling. Resources like the National Alliance on Mental Illness website and the Jed Foundation’s Mental Health Resource Center are excellent places to start; your child’s pediatrician or school counselor may also be helpful.
Parents and other family members play a crucial role in helping their children navigate the challenges of adolescence — including mental health challenges — and setting them on the path to health and well-being into adulthood.
Kiran Bhai is a former school counselor and public health advocate. She oversees Making Caring Common’s K-12 and parenting programs, focusing on youth mental health and supporting youth by building empathy and care across differences. She lives in New Mexico, where she spends her time outside work hiking, baking, dancing, and spending quality time with her niece and nephew.
Alison Cashin is a writer, editor, and communications professional. As Making Caring Common’s Director of Communications, she translates research into accessible content for educators and families. She lives in Boston with her family.