Teen years are a time of big changes — physically and mentally. As teens grow more independent and start figuring out who they are, they often face challenges like school stress, friendships, and emotions that may feel like a rollercoaster. While some ups and downs are part of growing up, others can be signs of underlying mental health struggles.
“Typical” Teen Behavior
Mood and behavior changes are a normal part of adolescent development, so it can be tricky to know what’s part of that process and what’s out of the ordinary and worrisome.
Some parts of your kid’s brain mature before other parts. The amygdala — the part of the brain that controls immediate, emotion-based reactions — develops before their prefrontal cortex. The prefrontal cortex is in charge of reason, attention, planning, and working memory, as well as social behavior and emotional regulation. Your brain doesn’t fully develop this part of the brain until your mid- to late-20s.
This means that in the years between childhood and adulthood, your teen is more likely to:
- Act impulsively
- Misread or misunderstand social cues and emotions
- Engage in dangerous or risky behavior and get into accidents
- Get involved in fights
They’re also less likely to:
- Think before they act
- Pause to consider the consequences of their actions
- Change their dangerous or inappropriate behaviors
Because of this, certain behaviors are more common. While some of these behaviors appear to overlap with anxiety or depression, in many cases they’re typical of the teenage years. These include:
- Mood swings that seem out of the blue
- Strong reactions to seemingly minor incidents
- Pulling away from family interaction
- Sleeping in on weekends and being tired on school mornings
- A slight dip in grades as schoolwork gets more challenging
- Dislike of foods they used to like
- Changes in the types of activities they like
But while it’s not unusual for your teen to seem very different from their younger self, the brain changes they’re going through in combination with their physical and social changes raises their risk of anxiety and depression, among other mental health challenges. Here’s what to watch for.
Signs of Anxiety in Teens
Anxiety is a normal part of life for anyone. Worry, stress, and nervousness are all under the umbrella of anxiety, and sometimes they work in positive ways, acting as motivation to get tasks done. But sometimes anxiety symptoms persist, even after a stress or worry ends. This type of anxiety makes everyday life harder.
Anxiety is a common issue in teens. Its symptoms can show up in different ways, depending on your teen’s personality and life circumstances. But there are certain themes. Anxiety can look like:
- Recurring fears and worries about routine parts of everyday life
- Irritability
- Trouble concentrating
- Extreme self-consciousness
- Extra sensitivity to criticism
- Withdrawal from social activity (not just family activities)
- Inability to leave the house
- Avoidance of difficult or new situations
- Drop in grades or school refusal
- Repeated reassurance-seeking
Your teen may also feel physical effects of anxiety. Pay attention if you hear them talking about symptoms such as:
- Racing heartbeat
- Stomachaches
- Sweaty palms
- Problems sleeping
- Muscle tension or sore muscles
- Headaches
- Startling easily
- Blushing often
- Hyperventilating (rapid breathing or a feeling of breathlessness)
- Sweating
It’s not uncommon for teens with anxiety to have panic attacks, which are sudden bouts of intense physical symptoms like hyperventilating, racing heartbeat, nausea, tightness in the chest, and dizziness or lightheadedness.
Anxiety vs. stress
Teens aren’t immune to stress. Pressures in school, sports, other activities, and in their social spheres are a big part of their life and can also feel bigger than they would to an adult brain.
Anxiety and stress have some overlapping symptoms. They both affect your mind and your body with symptoms such as:
- Excessive worry
- Uneasiness
- Tension
- Headaches or body pain
- High blood pressure
- Loss of sleep
But stress usually has an identifiable cause, like a big test or a fight with a friend. Stress symptoms tend to get better once the problem is resolved. Stress can also be a motivator to get work done on time, for example. Anxiety is more constant and gets in the way of daily activities.
Talk to your teen about the importance of stress-relief practices such as:
- Journaling
- Regular exercise
- A consistent sleep routine
- Relaxation practices such as meditation or deep-breathing exercises
Signs of Depression in Teens
Depression is a widespread issue for many people in the U.S., and teens make up a sizable percentage of those people. According to recent data from the CDC, 4 in 10 teens had persistent feelings of sadness or hopelessness, while 2 in 10 seriously considered attempting suicide.
Depression is more than just feeling sad or having a bad day — it’s a deep, lasting sense of unhappiness, hopelessness, or emptiness that doesn’t go away. It can change the way you think, feel, and act.
In teens, this can look like:
- Crying spells for no reason
- Changes in appetite such as eating less and losing weight or craving foods and gaining weight
- Rage or intense frustration over small matters
- Annoyed mood most of the time
- Loss of interest in most activities, even ones they used to enjoy
- Low self-esteem that comes out as negative talk about themselves
- Feelings of worthlessness or guilt
- Fixation on mistakes or failures
- A need for constant reassurance
- Trouble remembering things
- Trouble concentrating or making decisions
- Slower body movements
- Sleeping too much (more than typical teen sleeping-in behavior)
Teens with depression may also stop taking care of their appearance and hygiene. You may notice them wearing the same clothes day after day, and not bathing or shaving. They may wallow in their room for hours, often in bed. You may also start to notice friendships start to fade away and their connections dwindle.
Physically, they may have:
- Headaches
- Stomachaches
- Body aches
- Slowed speech
At school, they may visit the school nurse more often.
Self-harm and substance abuse
Sometimes the emptiness and numb feeling that depression causes creates a desire to feel something, even if that thing is pain. Some teens with depression engage in self-harm behaviors such as:
- Cutting their skin with sharp objects
- Head-banging
- Burning themselves
- Pulling their hair
- Scratching of the skin to the point of drawing blood
- Punching themselves
- Inserting objects into body openings
- Drinking harmful substances such as bleach or detergent
- Attempt to break their bones on purpose
Most self-harm comes from a temporary need to escape or distract, not a wish to die. But it’s concerning behavior you should address and treat alongside a doctor. Your child’s doctor or mental health professional can help you and your teen with strategies to stay safe.
Teenagers who are anxious are also more likely to use recreational drugs as another way to manage discomfort. Most commonly, teens turn to marijuana and alcohol as self-medication. But although these substances may create a temporary relief from certain feelings, they’re not healthy ways to cope. The underlying issue doesn’t go away, and often, your teen becomes dependent on the substance, which creates more problems in the future.
Suicide Risk: What to Know
Depression is the most common condition associated with suicide. Certain factors can bump up the risk for a teen considering or even attempting suicide. These include:
- Access to lethal means including firearms and drugs
- Prolonged stress, such as harassment, bullying, relationship problems, or unemployment
- Stressful life events, like rejection, divorce, financial crisis, other life transitions or loss
- Exposure to another person’s suicide or to graphic or sensationalized accounts of suicide
- Discrimination
- Previous suicide attempts
- Family history of suicide
- Childhood abuse, neglect, or trauma
- Generational trauma
There can be signs when your teen is thinking about suicide. Many of them overlap with depression and anxiety symptoms. Pay attention to what they say and do and take note if:
- They change eating and sleeping behaviors.
- They’re using alcohol or drugs.
- They’ve withdrawn from friends and family members.
- They’re neglecting their personal appearance.
- They don’t respond to praise.
- They’re irritable.
- They have crying spells.
- They’re posting on social media expressing feelings of isolation or depression.
- They’re talking about or otherwise indicating plans to die by suicide or self-harm.
If your teen shows these warning signs, take them seriously. You can:
- Let them know you’re here for them and will listen.
- Encourage them to keep talking to you.
- Ask them directly if they’ve thought about suicide. (Research shows it will not put the idea in their head or push them into action. Often, they’ll be relieved someone cares enough to hear about their experience with suicidal thoughts.)
- Call their mental health professional, or connect with one if you don’t have one.
- Seek help from your primary care doctor or other health care provider.
- Reach out to a close friend or loved one.
- Contact a minister, spiritual leader, or someone else in your faith community.
Share this info with your teen so they have additional resources to help them in crisis:
- 988. Call or text 988 to reach the 988 Suicide and Crisis Lifeline, available 24 hours a day, seven days a week.
- TXT 4 HELP. Your teen can text the word "safe" and their current location to 4HELP (44357) for immediate help, with the option for interactive texting.
Mental Health Issues Are Treatable
Facing depression and anxiety in your teen can feel scary, but there are solid, science-based options for managing the symptoms and getting them relief.
The approach that works best will depend on the type and severity of your teens' mental health issues. A combination of talk therapy (psychotherapy) and medication can be very effective for most teens with depression and anxiety.
Talk to your child’s doctor for a referral to a mental health professional who can help.
Show Sources
Photo Credit: DigitalVision/Getty Images
SOURCES:
UK Health: “Is it typical teenage moodiness or depression? Here’s how to tell.”
National Institute of Mental Health: “The Teen Brain: 7 Things to Know,” “Anxiety Statistics: Any Anxiety,” “I’m So Stressed Out! Fact Sheet.”
American Academy of Child & Adolescent Psychiatry: “Teen Brain: Behavior, Problem Solving, and Decision Making,” “Your Adolescent - Anxiety and Avoidant Disorders.”
Child Mind Institute: “How Anxiety Affects Teenagers.”
Johns Hopkins Health: “Anxiety and Stress in Teens.”
