Teen Mental Health: What’s Normal? What Isn’t?

No family is perfect. It’s natural to see some drama during the teenage years and it’s all too easy to assume other families have fewer problems. Due to the hormonal and physical changes that happen during puberty, teenagers are famous for being moody, difficult humans. So, what does being a “normal” teenager even mean? An old joke makes the point this way:

Q: “What’s a ‘normal’ person?”
A: “Someone you don’t know very well.”

At times, it can be hard to tell the difference between “normal teenage behavior” and the symptoms of depression, anxiety, eating disorders or other mental disorders. Teens may become irritable or be quick to anger as they begin to separate from the family. These years aren’t easy for parents or for teens themselves.

If you are worried that your teen might be struggling with their mental health, know the early warning signs of mental disorders and know how to talk about them with your teen.

Causes of Teen Mental Health Issues

A number of stressors can cause teens to experience symptoms of depression or anxiety that may come and go:

  • Troubles with girlfriends or boyfriends
  • Fights with friends
  • Being oversensitive or overly self-conscious
  • Not having coping tools to deal with stressful events
  • Academic stress or pressure to succeed in sports

Overall, if your adolescent or teenager has episodes of sadness, anxiety or extreme frustration, these episodes shouldn’t last more than a few days. Ongoing symptoms, or extreme forms of behavior, like unprovoked anger, however, could be signs of a serious mental disorder. Before you bring your concerns up to your teen, you may want to go through the mental health checklist shared below.

Symptoms of Teen Mental Health Problems

If your teen is chronically anxious or sad, you may be right to have concerns about their behavior. Before you speak with your teen or adolescent, consider this list of red flags for worried parents:

  • Decrease in enjoyment and time spent with friends and family
  • Significant decrease in school performance
  • Strong resistance to attending school or absenteeism
  • Problems with memory, attention or concentration
  • Big changes in energy levels, eating or sleeping patterns
  • Physical symptoms (stomach aches, headaches, backaches)
  • Feelings of hopelessness, sadness, anxiety, crying often
  • Frequent aggression, disobedience or lashing out verbally
  • Excessive neglect of personal appearance or hygiene
  • Substance abuse
  • Dangerous or illegal thrill-seeking behavior
  • Being overly suspicious of others
  • Seeing or hearing things that others do not

It’s important to remember, the experts say, that no one sign means that there is necessarily a lifelong problem. It’s all about the nature, the intensity, the severity and the duration of the symptom.

Overview of Teen Mental Health Disorders

Identifying mental illness in teens and adolescents can be difficult because young people often have trouble expressing their feelings, and ‘normal’ development varies from person to person. Here’s a rundown of symptoms for some of the most common mental disorders that affect teens and adolescents:


While all of us are subject to “the blues” from time to time, clinical depression is a serious mental health condition that could require immediate treatment. Look out for:

  • Changes in sleep patterns
  • Unexpected weeping or excessive moodiness
  • Eating habits that result in noticeable weight loss or gain
  • Expressions of hopelessness or worthlessness
  • Paranoia and excessive secrecy
  • Self-mutilation, or mention of hurting himself or herself
  • Obsessive body-image concerns
  • Excessive isolation
  • Abandonment of friends and social groups

Eating Disorders

Eating disorders are serious but treatable mental illnesses that can affect any age, gender, race, ethnicity or socioeconomic group. There are many different types of eating disorders, with disordered thoughts, emotions and behaviors about food and eating at the core of the illness. Distorted body image can also be part of an eating disorder.

Many eating disorders begin during adolescence, but an increasing number of younger children and older adults are being diagnosed with eating disorders. It’s impossible to know, simply by looking at a person, whether or not they have an eating disorder. Eating disorders impact children, teens and adults of all body types. This is why it’s so important to understand the symptoms and warning signs that indicate whether you or someone you know may be struggling.


Anorexia nervosa is an eating disorder classified by the unhealthy disturbance in body shape and image resulting in the refusal to maintain a minimum body weight. Individuals will go to extreme measures not only to starve themselves, but also to rid their bodies of any caloric intake they consumed through self-purging mechanisms such as self-induced vomiting, laxative, diuretics and extreme exercise.


Bulimia nervosa is a serious emotional eating disorder that involves eating excessive amounts of food in a short period (binging) followed by guilt and shame leading to self-induced vomiting, extreme exercise, or laxative abuse (purging). Many refer to it as the binge and purge eating disorder. Be alert for dramatic weight loss without obvious changes in eating habits (which could, of course, indicate other health issues that require a doctor’s attention) and also for immediate trips to the bathroom or private spot after a meal.

Substance Abuse

In addition to peer pressure, mental health issues can lead adolescents to experiment with alcohol and drugs, and also to use substances for “self-medication.” Watch out for paraphernalia or evidence. Be aware of the behavioral and physical signs of alcohol and drug abuse, such as hangovers or slurred speech. Parents should also be alert for prescription drug misuse and abuse. Some teens frequently abuse over the counter cough and cold medications.


Kids with anxiety disorders usually experience excessive distress that‘s out of proportion to a situation, displaying crying, physical symptoms, sadness, anger, frustration, hopelessness or extreme embarrassment. Signs of anxiety in teens include the following:

  • Becoming easily agitated when in a stressful situation
  • Asking repetitive reassurance questions: “what if” concerns
  • Acting inconsolable; not responding to logical arguments
  • Having headaches or stomachaches regularly, or being too sick to go to school
  • Anticipating the future and experiencing anxiety and worry hours, days or weeks ahead of an event
  • Having trouble falling asleep, frequent nightmares or difficulty sleeping alone
  • Being overly self-critical or having very high standards that make nothing good enough
  • Acting overly-responsible, people pleasing or having excessive concern that others are upset with him or her, or unnecessarily apologizing
  • Demonstrating excessive avoidance, refusing to participate in expected activities, refusing to attend school
  • Disrupting family functions, having difficulty going to school, friend’s houses, religious activities, family gatherings, errands or vacations
  • Needing excessive time to finish ordinary activities such as homework, hygiene or meals

Talking to Teens About Mental Health

Before you make assumptions or an amateur diagnosis, start by speaking in a supportive way with your child. Ask them about their feelings. After they have had a chance to open up to you, you may gently express any concerns  that you have. Open communication goes a long way in fostering the development of resilient teens. What may seem like a small matter to you can be a huge issue for an emotional adolescent or teenager. Starting a conversation is the first step.

If you have major concerns about your teen’s behavior, try to focus on a specific activity that troubles you. If at all possible, try to verbalize it in a non-threatening way. It may help if you can ‘normalize’ the concept of mental illness or make it easier to relate to. You can do this by referring to someone they might know that has a form of mental illness. You can also tell them that mental illness is common. One in four people have some form of mental illness, it’s just that most people don’t talk about it.

If, at any time, you are concerned that your teen is truly struggling and may have thoughts of harming themselves or someone else, please get professional help as soon as possible. You may want to call a crisis line like the National Suicide Prevention Lifeline or the Crisis Text Line.

Here are some additional tips to help your conversation go more smoothly:

  • Create an atmosphere that welcomes an open discussion by asking them what they notice and understand about the symptoms and behaviors.
  • Present fact-based information about the illness that you have researched and what you think you see.
  • Give them information about symptoms, recovery and the range of options that might help them.
  • Lead them to information they can read themselves, such as the simple explanations in the kids and young peoples’ section of mental health websites or magazines.
  • Teenagers often find it more comfortable to ‘talk while doing.’ For example, you might find it easier starting a discussion while you’re riding in the car, going for a walk or throwing a ball.
  • Try to make your child feel safe, so that they will ask questions and express their feelings.

It is never easy to start a conversation with someone about their mental health issues (or your own), but the following pointers may offer ways to alleviate some of the tension during a tense discussion with a teen:

  • Speak in a calm voice.
  • Say what you mean and be prepared to listen.
  • Try not to interrupt the other person.
  • Avoid sarcasm, whining, threats and yelling.
  • Don’t make personal attacks or be demeaning.
  • Don’t assume your answer is the only answer.
  • Try not to use words such as “always” or “never.”
  • Deal with the now, not the past.
  • Don’t try to get the last word.
  • Acknowledge that you are in this together.

This may be upsetting, but you should be prepared to hear things that might disturb you. If you feel that your teen is not able to function well enough to get by in life, or that their behavior is out of control, take action! The key to successful recovery is an early intervention. Prolonging the problem could lead to much more trouble and possible health risks.

Parents Need Support, Too

Helpguide.org reminds parents that the stress of dealing with any teenager, especially one that’s struggling with symptoms of a behavioral disorder, can take a toll on a parent’s mental health, so it’s very important to take care of yourself. This means looking after your emotional and physical needs as you learn to manage your own daily stress.

Be sure, the experts say, to take time to relax every day. Find ways to regulate your own feelings when you start to feel overwhelmed. If you are a single parent, don’t be afraid to ask for help from friends, relatives, teachers, school counselors, coaches or religious leaders. And get professional help if you need it.

Need More Advice?

Don’t despair. If your teen or adolescent is struggling with the symptoms of depression, anxiety, an eating disorder, or a behavior disorder, we can help you. Creative coping strategies are just one part of our successful comprehensive approach. Our personalized behavior modification programs are tailored to fit your needs, in warm, supportive residential settings. We’ve been helping families find ways to long-lasting recovery since 1997.

Discovery Mood provides multi-faceted levels of care for adolescents and teens with anxiety disorders, depression, bipolar disorder, self-harm behaviors, gender identity, oppositional defiant disorder, eating disorders and other serious mental health disorders. Click on the link below for a free assessment or virtual tour of our centers or call us at 800.760.3934. All calls are completely FREE and strictly confidential.

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  1. HelpGuide.org: Help for Parents of Troubled Teens. Retrieved October 10, 2016.
  2. Healthy Children Magazine: Mental Health and Teens: Watch for Danger Signs. Retrieved October 10, 2016.
  3. National Alliance on Mental Health; Know the Warning Signs. Retrieved October 10, 2016.
  4. Red Flags for Anxiety: What’s Normal, What’s Not?. Retrieved October 10, 2016.