mother and daughter

When It’s More Than Just Teen Angst

Kids can be kids, and sometimes their reactions and responses reflect that. And teenagers and preteens, in particular, are notorious for conflict with parents and family members as they learn to navigate hormones, a bigger desire for independence, and increased responsibilities at school and home.

May 1-7 is Children’s Mental Health Awareness Week, with the intention to help parents and the public understand what mental health issues can look like for children, and better recognize when an issue is a routine rite of passage for an adolescent, and when it is more serious.

In fact, the Centers for Disease Control and Prevention say studies reveal that children aged 3 to 17 years identify as having a current diagnosis of the following:

  • Attention-deficit/hyperactivity disorder (ADHD) (6.8%)
  • Behavioral or conduct problems (3.5%)
  • Anxiety (3.0%)
  • Depression (2.1%)
  • Autism spectrum disorder (1.1%)

The CDC also says that among adolescents aged 12 to 17, 4.7 percent have partaken in illicit drug use in the past year, with 4.2 percent identified as having alcohol abuse disorder. “Suicide, which can result from the interaction of mental disorders and other factors, was the second leading cause of death among adolescents aged 12 to 17 years in 2010,” the CDC says.

“Research shows that half of all lifetime cases of mental illness begin by age 14,” the National Institutes of Mental Health says.

So how do you know when your child’s behavior needs more attention and help? And what should you do?

“It’s normal or natural for adolescents to seek what we call individuation—that learning to be independent,” says Ross Teemant, director of Texas Health Springwood Hospital and senior director of behavioral health outpatient services for Texas Health Resources. “They are reaching the age where the driving force is, ‘How can I be my own person?’”

So that eye-rolling, that insistence on being dropped off and not walked in someplace—all of it is fairly normal. “They get more embarrassed to be around parents,” Teemant explains. “They struggle to manage time—they may have problems managing time on the computer or the phone. These things are normal.

“In fact, in order for them to become adults that are compassionate and caring contributors to society, they need to know how to do that—and we need to let them learn how to do that. That’s normal.”

“And you will likely notice that they fight hard about family time or family activities, but they really do enjoy the family time—even though they push back at first,” Teemant continues.

But if your child begins avoiding peers and friends, or doesn’t want to participate in activities they once enjoyed, then it might be time to look deeper. “You might be concerned when the teen is not engaging in other activities with their friends,” he says. “If they do not want to participate with their friends, or if they feel chronically angry or sad; that’s worth looking into.”

And, of course, a whole new set of firsts will also inevitably bring new emotions and situations for adolescents. “It’s normal to go through ups and downs during boyfriend/girlfriend breakups, or to be upset about a score on a test,” Teemant says. “And the reactions can seem big because it’s generally true that in those adolescent years, those coping tools aren’t fully developed.”

“But if they go on longer than a day or two, maybe three, and really continue beyond that, it’s good to look deeper.”

Of course, other more serious incidents would require professional help. “Self-harm or self-risk puts things into a different category,” Teemant says. “Any thoughts about death or dying or not wanting to be alive, not eating or self-mutilation. Those things immediately need some kind of attention.”

Concerning symptoms, Teemant says, include decreased enjoyment in being with friends and family, skipping school, an increase in bad grades, memory changes, and changes to attention and energy levels.

“Other symptoms include feeling hopeless, being sad for a longer period of time, feeling anxious, aggression, or crying spells,” he adds. “And not taking care of themselves, and any increase [in] or movement to substance abuse or drugs.”

And Teemant adds that talking to your children even after they leave for college is also important. “It is true that the late teens and early 20s are when we usually see the onset of more severe mental illnesses,” he says.

If you are concerned, NIMH recommends reaching out to your child’s primary care doctor as a first step.

“Ask questions and learn everything you can about the behavior or symptoms that worry you. If your child is in school ask the teacher if your child has been showing worrisome changes in behavior,” the agency says. “Share this with your child’s doctor or health care provider. Ask if your child needs further evaluation by a specialist with experience in child behavioral problems. Specialists may include psychiatrists, psychologists, social workers, psychiatric nurses, and behavioral therapists. Educators may also help evaluate your child.”

So how do you support your child if they are diagnosed with a mental illness? In short, Teemant says, keep talking.

“Seeking professional support and getting connected with treatment is important,” he says. “Maintaining open communication is important. Let your child know that you love them and care about them, and that you’re going to care for them in the best way you know how.”

Often, Teemant says, the stigma attached to mental illness causes parents to shy away from advocating for their child when needed. “With a food allergy, a parent will do everything they can to support the

ir child. They’ll make sure everyone at the school knows what to do,” he says. “But when their child has depression, for instance, are they as willing to go to principals and teachers and talk about it?

“Parents being as involved with the diagnosis as they would with any medical diagnosis is important,” Teemant adds. And most of all, “just being there for the child, letting them know nothing has changed in regard to how you love them. Stay in the role of parent, and don’t hide the symptoms away. Address them.”

And while all this sounds overwhelming, Teemant says there are support groups filled with fellow parents going through the same things that can give advice, or just a hearing, empathetic ear. “Every community has support groups based on diagnoses,” he explains. “There are also a lot of resources online that offer educational support or online peer support, too.”

“And lots of foundations offer research dollars and support groups as well,” he continues. “Most of your treatment centers—if your child needs more intensive care for a while—have family support groups where parents can go in and almost normalize what’s going on with their teen with other parents dealing with the same things.”

The biggest tip, Teemant says, in knowing when something is more amiss than the usual travails of growing up, is communication. “It’s really important to know your kids. If you have that relationship with them, they’re more likely to come to you and talk about things,” he says.

“Overall, don’t be afraid to act on the feelings you have as a parent with your kids,” he adds. “Have straightforward, difficult conversations about their feelings. Start young. Talk about real issues. Talk about puberty and what they can expect. Talk about how to respond to peer pressure.”

“We sometimes forget what it was like when we were a teen. We remember being a teen, but we don’t remember how we treated our parents,” Teemant reassures. “If we can try to remember those feelings, and keep the lines of communication open, we can help them navigate adolescence—and know when they might need more help.”

If you or someone you know is struggling with depression or other mental health issues, visit Texas Health Behavioral Health or call the helpline at 682-236-6023, which is available 24/7.

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