Kids can be kids, and sometimes their reactions and responses reflect that fact. Teenagers and preteens, in particular, are notorious for conflict with parents and family members as they learn to navigate hormones, a bigger desire for independence, and increased responsibilities.

It's important for parents to understand what mental health issues can look like for children, and better recognize when an issue is a routine rite of passage for an adolescent, and when it is more serious. In fact, the Centers for Disease Control and Prevention say studies reveal that children aged 3 to 17 years identify as having a current diagnosis of the following:

  • Attention-deficit/hyperactivity disorder (ADHD) (6.8%)
  • Behavioral or conduct problems (3.5%)
  • Anxiety (3.0%)
  • Depression (2.1%)
  • Autism spectrum disorder (1.1%)

The CDC also says that among adolescents aged 12 to 17, 4.7 percent have partaken in illicit drug use in the past year, with 4.2 percent identified as having alcohol abuse disorder. “Suicide, which can result from the interaction of mental disorders and other factors, was the second leading cause of death among adolescents aged 12 to 17 years in 2010,” the CDC says.

According to the National Institutes of Mental Health, research shows that half of all lifetime cases of mental illness begin by age 14.

So how do you know when your child’s behavior needs more attention and help? And what should you do?

“One of the first signs that your child is entering adolescence is a push for privacy and independence. They are reaching a stage in their development where they are gaining more of an understanding of ‘self’ apart from the family,” says Dustin Webb, administrator of Texas Health Behavioral Health. “They want to be able to show that they have an identity that stands apart from the family. This is actually a necessary step in order for them to learn how to become adults.”

So that eye-rolling, that insistence on being dropped off and not walked in someplace—all of it is fairly normal. “They get more embarrassed to be around parents,” Webb explains. ““Don’t take it personally. It all comes from a need to have their own identity that isn’t reliant on their parents.”

“This doesn’t mean that they no longer enjoy time spent with family. While they may be slow to admit it, they still love and need family.” Webb continues.

“If you find that your child has lost interest in his normal activities or is spending less time with friends, take note. If he seems to be sad or angry a lot of the time, this could be an indicator of something beyond typical teenage moodiness.”

“While it is normal for teens to go through ups and downs and to be easily upset about things that may seem more trivial to you and I, do pay attention to certain warnings signs,” Webb said. “Has it gone on longer than normal? Have you noticed behavior changes that seem out of character? They could be an indicator of an emotional or mental problem needing to be addressed.”

Of course, other more serious incidents would require professional help.

“It’s helpful to know what is okay to let go and what is concerning. Symptoms to look out for include feelings of hopelessness, worthlessness, decreased interest or pleasure in previously enjoyable activities, changes in energy and/or concentration, a decrease in school performance and changes in sleep or appetite, just to name a few. If your child begins to harm herself, begins taking risks that could endanger her or expresses thoughts of wanting to die, these could be signs of serious emotional and mental distress that need immediate attention.”

Another area to consider is substance use. If you notice that your teen has had a fairly sudden change in friends, or you notice that he begins to have anger outbursts, this could also be a sign of drug use. If you suspect that this may be involved, it can be helpful to approach this topic with the help of a mental health professional.

“If a teenager is going to deal with a mental illness, it can manifest well into his 20s,” Webb said. “In fact, some of the more severe mental disorders can begin in the late teen years and early 20s.”

If you are concerned, NIMH recommends reaching out to your child’s primary care doctor as a first step.

“Ask questions and learn everything you can about the behavior or symptoms that worry you. If your child is in school ask the teacher if your child has been showing worrisome changes in behavior,” the agency says. “Share this with your child’s doctor or health care provider. Ask if your child needs further evaluation by a specialist with experience in child behavioral problems. Specialists may include psychiatrists, psychologists, social workers, psychiatric nurses, and behavioral therapists. Educators may also help evaluate your child.”

So how do you support your child if they are diagnosed with a mental illness? In short, Webb says, keep talking.

“If you believe that your child may need help, seek out professional support. Maintain open and honest communication with him along the way. Be sure that he knows that you care and are working to help him have a happy life.”

Often, Webb says, the stigma attached to mental illness causes parents to shy away from advocating for their child when needed. “If your child had juvenile diabetes, a parent likely would take great care with her school to be sure that they understand how to support them. What we often see with something like depression or anxiety is that parents want to keep it quiet and certainly don’t approach the principal or teachers about it. What they may not see is that they are perpetuating the stigma of mental illness and role modeling to their child that this is something to be kept quiet and ultimately to be ashamed of. The best thing a parent can do is to treat it like any other issue that needs help and to be open and honest with all involved. This normalizes it for others and most importantly for their child.”

And while all this sounds overwhelming, Webb says there are support groups filled with fellow parents going through the same things that can give advice, or just a hearing, empathetic ear. ““We find that a lot of people aren’t aware of the resources out there meant to help support their child and also them. Most communities have support groups for children and their families. There is currently a wealth of education and support online as well, including forums where peers educate and support each other.”

“Beyond support groups, there are treatment centers and outpatient mental health professionals in many cities that can treat mental and substance use disorders,” Webb continues. “Most of these programs have family programs that help to educate them on how to be of support. If you aren’t sure where to start, SAMHSA has an abundance of resources and a facility locator. I would encourage any family member to explore their site.”

The biggest tip, Webb says, in knowing when something is more amiss than the usual travails of growing up, is communication. “Ultimately, the best approach is to keep communication going with your child. Allow her to initiate it whenever possible, and do your best not to judge what she says. This will help with trust and encourage her to be more willing to bring their struggles to you when they happen.”

“Be real. Don’t be afraid to go deep. Allow space for the difficult topics, like puberty, peer pressure, bullying and sex. These are part of their experience, and they need to see that you understand that.”

“After all, if we think back, we went through many of the same things in our adolescence. We needed to know how to navigate them, and our younger selves surely would have wanted to know that our parents were there to support us if we were struggling. If we do this, our kids will see us as someone on their side – and when they need help, they reach out to someone on their side.”

If you or someone you know is struggling with depression or other mental health issues, call the helpline at 682-236-6023, available 24/7.

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