As parents or guardians, we naturally want the best for our children, especially when it comes to their mental health. Adolescence is a period of significant change and growth, and sometimes it can be challenging to discern between typical teenage behavior and signs that your teen might be struggling with his/her mental health. Yet, each year the need to recognize symptoms of mental distress becomes more necessary. According to the National Institute of Mental Health (NIMH), mental health disorders are now quite common in children and adolescents in the United States. Here are some key statistics on the five most common mental health concerns for youth post Covid-19:
Attention – Deficit/Hyperactivity Disorder (ADHD):
ADHD is one of the most common mental health disorders in children. As of 2022, approximately 9.4% of children aged 2-17 years old have been diagnosed with ADHD in the United States, according to the Centers for Disease Control and Prevention (CDC). Many don’t recognize the symptoms of ADHD, especially in the inattentive type which doesn’t seem to exhibit hyperactivity at all. Furthermore, many parents assume that children with good grades and acceptable behavior in school cannot have ADHD. This is a false assumption which often leads to delays in treatments. These delays may cause problems for children later in life.
Anxiety Disorders:
Anxiety disorders are also prevalent among American youth. In a national survey, the NIMH found that an estimated 31.9% of adolescents aged 13-18 had an anxiety disorder at some point in their lifetimes. These disorders may only be temporary but should still be treated to avoid escalation or other complications. They may be caused by genetics, trauma, environment, depression, stress, or other causes.
Depression:
Depression is a significant mental health concern among adolescents. According to the NIMH, approximately 3.2 million adolescents aged 12-17 in the United States had at least one major depressive episode in 2020.
Suicide:
Suicide is a leading cause of death among adolescents. In 2019, suicide was the second leading cause of death for individuals aged 10-24 in the United States. According to the CDC, suicide rates among youth have been increasing in recent years.
Substance Use Disorders:
Substance use disorders, including alcohol and drug abuse, also affect many American youth. The Substance Abuse and Mental Health Services Administration (SAMHSA) reports that approximately 7.1% of adolescents aged 12-17 had a substance use disorder in 2020. Not always, but often, these disorders stem from a desire to self-medicate one of the undiagnosed disorders above.
These statistics are based on data available up to 2022, and mental health trends may have changed since then. Disparities in mental health care access and outcomes exist among different groups, emphasizing the need for equitable care. Recognizing mental distress symptoms is crucial for your child’s safety and well-being. While a degree in psychology isn’t required, trust your instincts. If something feels off, don’t hesitate to consult a healthcare professional.
Common Signs of Mental Distress
Extreme or Persistent Mood Swings:
Adolescence is often marked by mood fluctuations, but if your teen or tween experiences intense and rapid shifts in mood that interfere with daily functioning, it could be a sign of underlying mental health issues such as bipolar disorder or depression. Similarly, if you witness persistent changes such as prolonged sadness, irritability, or frequent mood fluctuations it might indicate an underlying issue. Pay attention if your teen seems consistently withdrawn or expresses feelings of hopelessness.
Social Withdrawal:
If your once-social child begins to self-isolate from friends and family, avoiding social interactions and activities he/she once enjoyed, it may indicate feelings of depression, anxiety, or other mental health concerns.
Changes in Academic Performance:
A sudden decline in academic performance or lack of interest in school may signal emotional distress or difficulty coping with stress. This could include increased absences, incomplete assignments, or a significant drop in grades.
Changes in Sleep Patterns:
Pay attention to any drastic changes in your teen’s sleep habits. Insomnia, excessive sleeping, or irregular sleep patterns can all be indicators of mental health issues such as depression, anxiety, or substance abuse.
Changes in Appetite or Weight:
Significant changes in eating habits, including sudden weight loss or gain, can be red flags for eating disorders like anorexia nervosa, bulimia nervosa, or binge-eating disorder.
Physical Symptoms:
Watch for unexplained symptoms like headaches, stomachaches, or frequent illness. They may indicate underlying mental health issues.
If a primary care physician can’t identify a cause, these symptoms are still real. Caregivers should avoid invalidating them.
Substance Abuse:
Experimentation with drugs or alcohol is unfortunately common among teenagers, but if it becomes frequent or excessive, it could indicate an attempt to self-medicate underlying mental health problems. It can be difficult to determine whether or not your child is using drugs or alcohol. Besides obvious and unexplained changes in friend groups, behavior, or responsibilities, focus your attention on more telltale evidence such as dishonesty, missing valuables, odd paraphernalia (pipes, lighters, small bags with residue, vape pens, syringes, empty liquid containers), bloodshot eyes, frequent nosebleeds, tremors, unexplained and frequent bruises, unusual smells on clothing, breath, or belongings.
Self-Harm or Suicidal Thoughts:
Although self-harm is often an activity of stress release for teens as opposed to a sign of suicidal tendencies, this should always be taken as seriously as suicidal thoughts since the behavior could in fact lead to accidental death or permanent harm. Any indication of self-harming behaviors, such as cutting or burning, as well as any mention or evidence of suicidal ideation or threats should be addressed immediately and decisively via a psychologically or medically trained mental health care professional. Likewise, verbal expressions of hopelessness, worthlessness, or similar extreme ideas require immediate attention and intervention.
Intense Anxiety or Panic Attacks:
Persistent feelings of worry, fear, or panic that interfere with daily life may indicate an anxiety disorder requiring professional evaluation and treatment. Symptoms of panic attack include sudden onset of extreme fear or anxiety, rapid heart rate or palpitations, shortness of breath, chest pain or discomfort, dizziness, tingling sensations, sweating, shaking, strange feeling or unreality, feeling of going crazy or loss of control, feeling of doom, hot or cold flashes, nausea, upset stomach, or a sudden urge to escape or flee.
Please keep in mind that the sudden onset of these feelings can sometimes be so embarrassing that the youth tries to hide it, cover it up, or justify the feelings in terms of righteous rage at something irrational. It is natural to try to hide something embarrassing in public or to try to cover up feelings of panic, as there is often an unjust stigma of weakness associated with panic.
Behavioral Changes:
Watch for any significant changes in behavior, such as increased irritability, aggression, impulsivity, or recklessness. These could be symptoms of mood disorders, ADHD, recent trauma, or other mental health conditions.
Extreme Perfectionism or Self-Criticism:
While striving for excellence is admirable, extreme perfectionism or self-criticism can be damaging to your teen’s mental health. Look out for signs of excessive self-pressure or unrealistic expectations.
Family History:
Consider any family history of mental illness or substance abuse, as these factors can increase the likelihood of similar struggles in your teen.
Less-Obvious Signs of Mental Health Distress
While many warning signs of mental health issues in teens and tweens are well-known, there are also some less common indicators that may warrant attention and potential mental health treatment. Here’s a list of less-common warning signs to be aware of:
Obsessive Gaming or Internet Use:
Excessive time spent on gaming or the internet, to the detriment of other activities or responsibilities, can be a sign of underlying mental health issues such as depression, social anxiety, or avoidance behavior.
Extreme Sensitivity to Sensory Stimuli:
Heightened sensitivity to sensory stimuli such as light, sound, or touch, beyond what is typical for his/her age, may indicate conditions like sensory processing disorder, anxiety, or trauma-related issues. Although autism is not a mental health disorder (it is neurological in nature) this is also common for people on this spectrum and can be detected during a series of mental health assessments.
Unusual Preoccupation with Death or Morbid Themes:
While some curiosity about death is normal during adolescence, an intense preoccupation with death, dying, or morbid themes could signal underlying mental health concerns such as depression, trauma, or suicidal ideation.
Excessive Daydreaming or Fantasizing:
Spending a significant amount of time lost in daydreams or fantasies, to the extent that it interferes with daily functioning or relationships, could be a manifestation of underlying issues such as dissociation, ADHD, or coping mechanisms for stress or trauma.
Extreme Empathy or Emotional Absorption:
While empathy is generally considered a positive trait, excessive empathy to the point of absorbing others’ emotions to an unhealthy degree may indicate difficulties with emotional regulation, boundary-setting, or empathic distress.
Avoidance of Certain Foods or Food Rituals:
Unusual food rituals, extreme pickiness, or avoidance of certain foods beyond typical preferences may indicate underlying eating disorders, anxiety disorders, or sensory sensitivities related to autism spectrum disorders.
Excessive Attachment to Objects or Routines:
Unwillingness to part with certain objects, insistence on strict routines, or extreme distress when routines are disrupted may signal underlying anxiety disorders, obsessive-compulsive disorder (OCD), or autism spectrum disorders.
Difficulty with Time Perception:
Problems with understanding the passage of time, frequent lateness, or a distorted sense of time may be indicative of attention deficits, executive functioning issues, or difficulties with reality testing associated with certain psychiatric disorders.
Unexplained Regression in Developmental Milestones:
Reverting to behaviors or developmental stages that they had previously outgrown, such as bedwetting, tantrums, or baby talk, may be a sign of emotional distress, trauma, or underlying mental health issues requiring intervention.
It’s important to remember that every child is unique, and not all of these signs will necessarily indicate a mental health concern. However, if you notice persistent patterns or a cluster of these less common warning signs, it may be advisable to seek a comprehensive evaluation from a qualified mental health professional to ensure your teen or tween receives appropriate support and treatment.
Parents, as an additional resource, I’ve created a worksheet to help you determine the mental health needs of your child. Under no circumstances should you consider this worksheet a comprehensive test to determine if your child needs to consult a mental health professional. It’s simply a tool intended for information gathering. In the end, if you have uncertainty about whether or not your child needs therapy or an assessment, please ask his/her primary care physician.
Works Cited:
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
National Institute of Mental Health. (n.d.). Child and Adolescent Mental Health. Retrieved from https://www.nimh.nih.gov/health/topics/child-and-adolescent-mental-health/index.shtml
Centers for Disease Control and Prevention (CDC). (2022). Data and Statistics on ADHD. Retrieved from https://www.cdc.gov/ncbddd/adhd/data.html
National Institute of Mental Health (NIMH). (n.d.). Child and Adolescent Mental Health. Retrieved from https://www.nimh.nih.gov/health/topics/child-and-adolescent-mental-health/index.shtml
Substance Abuse and Mental Health Services Administration (SAMHSA). (2022). Key Substance Use and Mental Health Indicators in the United States: Results from the 2020 National Survey on Drug Use and Health. Retrieved from https://www.samhsa.gov/data/sites/default/files/reports/rpt29393/2020NSDUHFFRPDFWHTML/2020NSDUHFFR090120.htm