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Teen Mental Health

Erica Jex Gergely, PhD, LP and Angela Deal, LMSW

Being a teen today is not easy; their lives are more fast-paced, technology-driven, and convenience- oriented than ever before. Pressure can attack from many angles (e.g., academic performance, social approval, achievement in sports, and acceptance of body image) and causes daily living to be uncertain and unpredictable. For this reason, learning how to adjust to change and manage stress becomes important for keeping teens’ psychological well-being in balance. Additionally, because parents can become easily overwhelmed as they attempt to understand their teen’s emotions and behaviors, it is important to be familiar with what is typical versus atypical during adolescence. It is also important to know where you can turn to for help when you’re concerned.

Due to their outward behavior, teens are often considered “moody,” “dramatic,” and “egocentric,” which, at times, can become exasperating and tiresome for parents to keep up with. Internally, however, teens are experiencing a combination of raging hormones, continued brain growth, and a belief in invincibility that can lead to unstable emotions, sensitivity to body image, impulsivity, and risk-taking. These can all be typical for your teen to experience. Determining whether or not your child’s behavior has moved from typical to atypical is tricky, even for professionals. Generally speaking, when assessing for a mental health disorder, clinicians take a close look at how your teen is feeling and acting, identify how long symptoms have been present, and evaluate the extent to which those symptoms have an impact on their daily functioning. To help sort through typical and atypical symptoms further, it may be easier to consider them in the following three categories: physical, emotional, and behavioral.

Physical/Somatic Symptoms can include changes in appetite and sleep patterns and any physical complaints your child may be expressing (e.g., stomach aches, headaches). While teens commonly experience irregularity in their sleeping and eating habits, notable changes in these areas should be considered a ‘red flag’ that requires further inquiry. In addition, be on the lookout for ongoing and repetitive physical complaints. For example, before school your teen may start to complain of stomach aches on a regular basis or they may ask for medication to relieve headaches frequently. When these types of symptoms are observed, it may indicate additional problems. Parents are recommended to explore with their child whether or not underlying stressors may be contributing to these issues.

Emotional Symptoms can include sad affect lasting longer than a few weeks, an increase in worries or concerns, daily irritability, frequent anger outbursts, expressions of hopelessness/ helplessness, increased sensitivity, or erratic mood shifts. While teens typically display a roller coaster of emotions, the key is to look for a consistent and ongoing change in your child’s mood or affect. Learning to appropriately express a range of emotions is an essential part of human development; however, an inability to effectively manage intense emotions can be a symptom of more serious concerns such as mood or anxiety disorders. When parents’ attempts to lift their child’s spirits or relieve them of their worries are unsuccessful, it may be time to contact a mental health professional who can assist in understanding the causes for their emotions and help create a roadmap back to feeling like themselves. When a teen’s mood appears severe or triggers serious problem behaviors (e.g., self- harm, alcohol or drug use, thoughts of suicide, etc.), a mental health assessment is vital.

Behavioral Symptoms can include poor school performance, declining grades, lack of attendance, isolation from friends and family, increased tearfulness, avoidance of activities they once enjoyed, anger outbursts, or destruction of property. In more serious cases, teens can exhibit risky or impulsive behaviors such as cutting or other forms of self- harm, use of alcohol or other drugs, expressed thoughts about or intention for suicide, restriction or purging of food, excessive refusal to comply with rules or expectations, or aggressive behavior toward others. Parents are strongly encouraged to become familiar with what is normal behavior for their child, so deviations from normalcy are quickly recognized. Moreover, it is important to be aware of your teen’s behavior in all settings (e.g., home, school, work), as their conduct may differ across environments. If your teen is engaging in serious problematic behaviors (e.g., self- harm, alcohol or drug use, thoughts of suicide, etc.) or showing other symptoms of concern, it is essential to contact a mental health professional immediately.

What to expect when you contact a mental health professional:

Mental health professionals use different treatment approaches to help adolescents who are experiencing mental health concerns. Some treatment methods have more research evidence to support their effectiveness than others. For example, Cognitive-Behavioral Therapy (CBT), a general term for a classification of similar therapies, is based on scientific evidence and has been shown to be effective in treating a variety of adolescent mental health issues, including: Anxiety Disorders, Eating Disorders, ADHD, Autism, Bipolar Disorder, Depression, Post Traumatic Stress Disorder, and Substance Abuse. CBT emphasizes the important role that thinking plays in how we feel and how we act.

Mental Health Resources:

There are a number of adolescent mental health services available including the following:

•Individual Therapy: Regularly scheduled ‘talks’ between an adolescent and clinician that focus on current problems, experiences, thoughts, feelings, behaviors, and relationships. The therapist demonstrates empathy, understanding, and respect to foster a safe setting where adolescents receive emotional support, learn to identify and understand their thoughts and feelings, and examine their behavioral choices and the consequences of these choices.

• Family Therapy: A branch of therapy that works with families and the system of interactions between family members. Families are viewed as an interconnected force where the actions of each member affect the health or dysfunction of the family as a whole. Family therapists focus on relationship patterns and what goes on between family members, and assist in improving overall family functioning.

•Neuro-biofeedback: A process that enables individuals to learn how to change physiological activity for the purpose of improving health and performance. Precise instruments measuring physiological activity such as brainwaves, heart function, breathing, muscle activity, and skin temperature rapidly and accurately provide “feedback” that individuals use in conjunctions with changes in thinking, emotions, and behavior – to support desired changes.

• Medication Management: Prescription and ongoing review of medication(s) suitability and therapeutic effects following individualized psychiatric evaluation targeted at reducing biologically-based psychiatric symptoms and stabilizing overall functioning.

• ADHD Evaluations: Comprehensive medical, psychological, developmental and social information is gathered from the adolescent, their parent/ guardian, teacher, and other involved professionals through clinical inter- views, questionnaires, direct observations, and testing in order to make a diagnosis of ADHD.

Psychological Testing: A process of testing that uses a combination of techniques to help arrive at some hypotheses about a person and their behavior, personality and capabilities.

Suggestions for Coping Skills:

In addition to contacting a mental health professional, the following are strategies teens can use for staying healthy and managing stress:

• Problem Solving: Generate a list of solutions, consider their possible outcomes, choose, implement the best option then evaluate its effectiveness. Repeat as needed.

• Mindfulness Exercises: Do one thing at a time and focus your mind and body on just that one thing. Redirect yourself when needed. Abstain from judgment.

• Relaxation Techniques: Circular Breathing (sniff a flower [inhale], blow up a balloon [exhale], repeat 10x.

• Progressive Muscle Relaxation (systematically tensing and relaxing major muscle groups from head down to the toes).

• Walk, bike, swim, shoot hoops, play catch, jog, skateboard, take horseback riding lessons.

• Verbal Expression: Share experiences and seek support from trusted friends or adults, journal, write poetry, sing, write music.

• Taking an Organized Approach: Break down large overwhelming tasks into smaller pieces and tackle one step at a time. Manage your time wisely.

• Balanced Eating and Sleeping: Don’t overlook the importance of nutritious meals and a good night’s rest.

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