As parents, we are always on the lookout for the health and well-being of our children. When they are young, we protect our homes for the children. When they get older, we make sure they wear a bike helmet and wash their hands regularly. But while scratched knees and stomach aches are easy to spot, signs that our tweens and teens are struggling with their mental health can be hard to spot, especially if we don’t know what to look for.
What are the statistics?
According to a meta-analysis published in the Journal of the American Medical Association, globally 25.2% of children and adolescents experienced elevated depressive symptoms within the first year of the COVID-19 pandemic, and 20.5% experienced elevated clinical anxiety symptoms—higher than previously—pandemic numbers reached 11.6% and 12.9%, respectively. Even before COVID-19 in 2019, the Centers for Disease Control and Prevention (CDC) reported that more than a third of high school students experienced persistent feelings of sadness or hopelessness—both of which can sometimes be symptoms in other common mental health disorders in teens that Include:
- Mood disorders, such as depression
- anxiety disorders
- eating disorders
- behavior disorders
- Substance use disorders
They may also have other conditions, such as attention deficit hyperactivity disorder (ADHD), which has a high rate of comorbidity 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 have — but there’s more to it than that. Left untreated, mental illness in adolescents is associated with risks such as academic and educational difficulties, risk-taking behaviors such as drug use and unsafe sexual practices, substance abuse, self-harm, and suicide.
What should we look for?
Teens are emotional and reactive by nature. They test boundaries, gain independence and the responsibilities that come with it, undergo major physical changes, and are often fickle. It can be difficult to know just what is the behavior of a teenager and what is the cause of anxiety.
The National Alliance on Mental Illness (NAMI) recommends some warning signs to look out for, including:
- Excessive or excessive anxiety/fear
- Feeling excessively sad or “frustrated”
- Problems with thinking, concentration and/or learning
- A change in school performance such as lower grades, increased absenteeism, or regular tardiness
- Excessive disobedience or aggression
- severe mood changes (including uncontrollable “highs” or feelings of euphoria)
- Persistent or strong irritability or anger
- Avoid friends and social activities
- Problems understanding or relating to others
- Changes in sleep, including feeling tired or low energy
- Changes in eating habits, including increased hunger or decreased appetite
- Difficulty perceiving reality, including delusions or hallucinations (sensory experiences and/or deeply held beliefs that are not based on reality)
- Lack of insight into themselves, such as the inability to perceive changes in their feelings, behavior, or personality
- Excessive use or misuse of substances such as alcohol or drugs
- Physical health problems that have no apparent cause, such as headaches, stomach aches, and vague and persistent “aches and pains”
- suicidal ideation
- Difficulty moving, coping, and completing daily activities, problems, and stresses
- Intense fear of gaining weight or worrying about her appearance
Do not dismiss your instincts and intuition. If you notice changes in your child that worry you or aren’t sure how to explain them, even if they aren’t on this list, it’s worth looking into.
“If you’re a parent concerned about your child’s mental health, don’t hesitate to seek professional help,” says Leigh McInnis, LPC, executive director of Newport Healthcare Virginia. “Remember that it is always better to be concerned and more sensitive to a potential mental health problem than to be unaware.”
How can parents take action?
Talking to your children about mental health – both for them and in general – is very important. McInnis offers some suggestions on how to have these conversations:
- It’s important to check in regularly with your teen, especially if you notice a change in his or her behavior, personality, or appearance. When doing this, try to talk less, listen more, and use open-ended questions that limit the teen’s ability to respond with one-word answers. Questions like, “What are the three best words to describe how you feel right now?” or “What was the best and worst thing that happened to you this week?” These are great clips to take an emotional temperature check with your teen.
- While it’s important to check in regarding your teen’s emotional well-being, try to balance these “check-ins” with casual, fun conversations. This helps avoid confusing your teen and telling you that you want to spend quality time with them.
- When your child talks to you about his or her experience of suffering, try to maintain neutral verbal and nonverbal communication.
- Try not to single him out if your teen seems to be reluctant to talk to you. At Newport Healthcare, they emphasize a parent’s role in initiating communications with their child regardless of whether your child knows how to receive these communications in a healthy way. Whether your teen refuses conversation or admits his struggles, it may be time for professional help. If you feel professional help is best, McInnis recommends involving your child in this discussion and letting them be a part of their treatment provider selection process. They would be more invested if they could gain some control in the process.
In addition to talking to your children, 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 aggressive, but the parents’ role is to keep their children safe. Having tools to monitor online behavior makes perfect sense given all we know about the impact of social media and other online activities on teens’ mental health.
More important way to take action? Encourage your child to memorize several emergency numbers on his phone. This gives them the ability to get immediate help for themselves or a friend. Here are some important numbers to encourage your child to save:
- The phone number of a trusted friend or relative
- The non-emergency number for the local police department
- Crisis text line: 741741
- The National Suicide Prevention Lifeline: 1-800-273-TALK (8255).
Where do we go for help?
If you’re concerned, the best place to start is with your child’s health care provider, such as your family doctor or pediatrician. They can perform an initial evaluation, see if additional referrals are necessary, and help create a treatment plan if needed.
If your child does not have a primary health care provider, the National Institute of Mental Health (NIMH) has a list of resources to contact for help. Youth.gov also provides a comprehensive list of resources and suggests questions to ask when searching for a provider or treatment provider.
Treatment will depend on factors such as your child’s condition and symptoms, including their severity, general health, age, access to resources, and other considerations. It can include medication if appropriate, possibly including some form of psychotherapy (talk therapy) or other counseling. This can be done in a variety of settings, including regular visits with a mental health professional, outpatient care, or inpatient care through a medical center and treatment centers, and more. For example, McInnes explains, the Newport Academy Adolescent Therapy Program offers several levels of care for teens with mental health issues:
- Outpatient treatment: Determines the number of days and hours based on the teen’s clinical needs as well as his or her personal and family goals
- Intensive Outpatient Programs (IOPs): For teens who are starting to achieve career and educational goals and don’t need 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 Recovery 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 adolescents who require daily and structural support in a therapeutic setting, while still living at home.
- Residential treatment options: Programs offered across the country that provide evidence-based clinical, experimental and academic components in a safe and supportive home-like environment
While navigating the world of tweens and teen mental health can be daunting, it helps to get an idea of what to look for and where to turn for support if you or your child needs it. “Diagnosing and treating the problem early increases treatment success, decreases the frequency and severity of future problems, and reduces trauma surrounding the situation,” McInnes says.
If you think your child may have mental health issues, talk to your health care provider or mental health professional. Help is available.