Is It Teenage Angst or Something More Serious?
Parenting an adolescent—just like being a teenager—has its peaks and its valleys. And while hormonal changes and emotional turmoil are to be expected, the current state of the world is having a massive impact on the mental health of young people. This has led to a tricky conundrum for parents of teens because it is more difficult than ever to decipher between what is typical developmental angst and what could be a sign of something more serious.
“In the teenage years, your body goes through more dramatic changes than at any other time in your whole life,” says John Mayer, PhD, a licensed clinical psychologist and author of Family Fit: Find Your Balance in Life. “We often forget that kids are walking around like a bag of chemicals shaken up.” That’s undeniably unpleasant—and can significantly alter a child’s mood. But these changes are completely expected, says Ariana Hoet, PhD, a pediatric psychologist at Nationwide Children’s Hospital and the clinical director of On Our Sleeves, a movement advocating for children’s mental health support.
“Part of destigmatizing mental health is acknowledging that we all feel emotions and that those are normal,” Hoet says. “Teens are finding their identity, navigating social relationships, worrying about school and their future, all while their brain is still in development and their bodies are going through hormonal changes.” Along with that, they’re beginning to want independence but are in that fuzzy space between kid and adult, says Melissa Santos, PhD, associate professor of pediatrics at the University of Connecticut School of Medicine and division chief of pediatric psychology at Connecticut Children’s Medical Center.
At the onset of the pandemic, remote school rocked the very foundation of adolescents’ lives. It also halted crucial development. “School is an epicenter of identity development and personality interests,” Mayer says. “What we’ve lost in this pandemic is critical life skills and developmental journeys that we need to go through during these teenage years.” Missing out on that can cause a slew of problems—like lower confidence and self-esteem, loss of identity, developmental delay, and immaturity. Mayer says these things can fuel mental illness.
The stress is even higher for people of color and those living in poverty. Santos points to Black youth currently having higher rates of depression and anxiety and Black girls having the highest rates of attempted suicide. “They’re being disproportionately impacted by mental health, Covid, and racism—it creates this perfect storm,” she says. “Children who reported experiencing racism also reported negative mental health outcomes and difficulty with school and social relationships,” adds Hoet. “Unfortunately, these children are often misdiagnosed and have less access to treatment.”
Hoet also points to early data that shows a rise in depression, anxiety, and eating disorders during the pandemic—with LGBTQ+ and female teenagers more highly at risk for these conditions.
Interestingly, rates of youth mental illness were steadily rising before the pandemic. “According to the CDC, between 2009 and 2019 there was an increase in sadness, hopelessness, and thoughts of suicide in children,” Hoet says. Many children with mental health disorders were not receiving treatment. “It’s important to realize we had a mental health crisis prior to Covid—all Covid did was amplify it,” Santos says. “It highlighted all the problems we have with mental health treatment and access to care.”
The thought of teenage mental illness is a source of anxiety for many parents and caretakers—with many saying they don’t know how to address it. Checking in with your child about their mental health doesn’t have to be scary. And not every teenage outburst is reason for concern. “We all have a continuum of what our sadness, nervousness, and anger is like,” Santos says. “With mental health, just like physical health, we have good and bad days.” In other words, your kid telling you they want to be alone doesn’t necessarily mean they are depressed.
Instead, be on the lookout for long-lasting personality changes. “When it comes to a mental health disorder, we look for persistent patterns that cause impairment,” says Hoet. This can manifest as behavioral shifts that happen every day for over two weeks. “You know your child the best,” Santos says. If they’ve done a complete 180 from how they used to be, it could be more than just hormones. If they are no longer interacting with their friends, their sleep is off, you’re concerned about self-harm—those are signs of something significant. Mayer also says that a more serious problem will show up in many areas of your child’s life—school, home, extracurriculars, friends’ houses, etc.—rather than just one place.
Along with emotional disturbances, mental health disorders can come with physical symptoms. “When they have a lot bottled up inside, your child may report tummy aches and headaches,” Santos says. If something like this is happening and you’ve crossed off any medical reasons for it occurring, consider the timing of the symptoms. For example, your teen may get nauseous every day before school—that could be an amplified Sunday scaries.
Some specific signs of mental health struggles in teens include:
Irritability, worry, sadness
Withdrawal from their usual activities and a lack of interest in most things
Difficulty focusing or finding motivation, especially causing a drop in grades
Changes in sleep and appetite
Getting into trouble or conflict with friends and family
A decline in taking care of their hygiene or cleanliness
Headaches, stomachaches, vomiting
If these symptoms are reading like a checklist of your child’s current status, don’t panic. “The first step is having a conversation with the child,” says Hoet. “By talking to them, you can assess and problem-solve together on next steps.” If you aren't sure what that next step should be, speaking with your child's pediatrician can help—they can help you assess and point you in the direction of mental health providers.
Another place to find resources is Hoet’s program, OnOurSleeves.org, which offers guides and strategies for those discussions. “We want to encourage adults to build the habit of talking to children so that when difficult conversations come up, such as being worried about their mental health, the conversation can feel a lot easier,” she says. The more we talk to kids about the importance of brushing your teeth, green vegetables, and being able to label your feelings, the more this gets incorporated as everyday language, which is what sets up a family for success, Santos adds.
Talking the talk is great, but you should also walk to the walk when it comes to taking care of your own mental health. “Your kids watch you and model what you do,” Santos says. “There’s nothing more powerful than for a child to see a parent or caregiver have a bad day and problem-solve.” Show them the things that help you feel better when you are anxious or feeling sad—maybe it's taking a walk outside or watching your favorite comedic movie.
“If there’s anything good that is coming out of this pandemic, it’s that we are talking about kids’ mental health a lot more,” Santos says. And where there's more awareness, there's a real opportunity to get ahead of mental health issues before they become truly problematic.
If you are having thoughts of suicide or are concerned that someone you know may be having those thoughts, in the United States call the National Suicide Prevention Lifeline at 800-273-8255 (TALK), call 911, go to the emergency room, or go to speakingofsuicide.com/resources for a list of additional resources. Go here for resources outside the United States.
You Might Also Like
