Mental Health Red Flags - What to Watch For?
Is this behavior ‘normal’ or should I be worried?
Over the years, this is by far the most common question I receive from parents. And for good reason. The statistics on the state of adolescent mental health are, to be blunt, grim. So paying close attention to your teen’s behavior is critical, but deciphering it can be confusing. After all, what’s the difference between overreaction and diligence, between developmentally appropriate and aberrant? Sometimes, it’s a thin line and honestly can be complicated terrain for parents to navigate. Still, in my nearly twenty years of working with teens, I do believe there are some classic red flags that all parents would be wise to watch out for:
Rapid Change
Be on the lookout for when your child’s behavior undergoes a sudden or abrupt change. Are they all of a sudden sleeping a lot less or a lot more? Eating a lot less or more? Has your normally tidy child’s room been conspicuously messy or has your child’s hygiene been off lately?
As Cathy and I talk about in our podcast Sh*t Your Teenagers Won’t Tell You, episode 4, a rapid amount of change - physical, neurological, emotional - does happen in adolescence. Only from the stage of birth to 1 year old are the developmental changes more significant. Thus, not all observational change in adolescence is necessarily a sign that something is wrong, but the rapidity of that change and the duration (does it last longer than 1 - 2 weeks?) is a significant indication that further investigation should be considered.
Loss of Interest
Whether sudden or gradual, if you are starting to notice your child withdrawing from activities or people that previously were sources of happiness and joy, it’s time to start asking some questions. Sometimes, this shows up as ‘I’m too tired for x’ or ‘I’m just not into that anymore’. While those may be reasonable explanations, if your radar is going off, or you’ve noticed that a loss of interest in one activity isn’t being replaced by renewed interest in another, talk to your child about why.
Self-Harm or Talk of Self-Harm
Self-harm is defined as any behavior that involves the deliberate cause of pain or injury to oneself. Have you noticed your child picking at their face more than they used to? Is there a disturbing amount of hair in the bathroom or their room? Are you running out of OTC medications more quickly than you typically do? When your child is upset, are they throwing or hitting things? If you notice any of these signs or even think you might be noticing some of these signs, talk to your child directly and seek out guidance from mental health providers and your child’s pediatrician.
Physical Symptoms
If you’ve noticed your child presenting with physical symptoms that are new or atypical, it’s good to investigate further. For example, have they mentioned having increased headaches or digestive problems. These physical changes may be an indication of a mental health issue, but also may be indicative of a physical issue. Regardless, if the symptomology persists, it’s a great time to pick up the phone and call your child’s pediatrician.
They’re Telling You (or their school, doctor, or mentor is telling you…)
Years ago, a student showed up at my office door sobbing uncontrollably and in the midst of a full blown panic attack. After calming her down and trying to suss out what had upset her so severely, I later called her parents to fill them in and share my concerns. The parents minimized my concern, explaining that they’d gotten into a huge fight that morning with their daughter and that her coming into my office was an attention seeking ploy designed to get her out of academic deadlines.
Listen parents, I’m going to be straight with you. ‘Attention seeking’ behavior is just that - your child's way of saying ‘pay attention to me!’ If your child approaches you and outright tells you they are having a hard time, that’s huge and should be taken seriously. Often, though, children will ‘tell’ you they’re struggling less directly, so it’s important not to dismiss or minimize signs. If they’re mood is volatile, or they’re more defiant, or listless, or exhibiting atypical and risky behavior, they might be trying to send you a message. And most definitely, should you receive feedback from someone at your child’s school or from another individual who interacts with your child regularly that something is off, take that information seriously.
Your parent radar is going off
My own mother called me last week and just out of the blue said, “I just got this weird feeling something was off.” And you know what? She was right! If your gut is telling you something is off, follow that lead. After all, you’ve finely tuned that instrument over the years, so if you detect a shift in the ‘parent force’, trust that. Your gut isn’t always right but it certainly shouldn’t be underestimated either.
At the end of the day, if you believe there might be something off with your child or if you’re just not sure, that’s more than enough reason to reach out for expert guidance and support. Start with your pediatrician or counselor at your child’s school and ask for a basic assessment to be done. This is one of those areas where erring on the side of caution and reaching out to experts makes a lot of sense.
Resources
National Alliance on Mental Illness (NAMI)
Cornell University Self-Injury and Recovery Resources
Support Lines (teens should save these in their phone)
National Suicide Prevention Lifeline - 1-800-273-8255
Starting July 16, 2022, anyone can dial ‘988’ and be routed to National Suicide Prevention Lifeline
Crisis Support Textline: Text HOME to 741741
California Youth Crisis Line: (800) 843-5200
RAINN: (800) 656-HOPE
The Trevor Project: (866) 488-7386