Talking to Your Teenager about Mental Health

Shiby Abraham, MD, FAPA, Program Director of Psychiatry Residency at St. Catherine of Siena Hospital, shares what parents need to know about mental health issues during adolescence.

“Unfortunately, there are many myths about adolescent mental health, which makes it hard for parents to know the facts that can help them identify red flags indicating behavioral health issues,” said Dr. Abraham. “Getting a diagnosis means the sooner treatment can begin.”

 

Myth: Mental health is uncommon in teenagers.

Fact:

One in five teenagers is affected by mental illness at some point. Since the COVID-19 pandemic in 2020, mental health emergencies in 12- to 17-year-olds rose by 31%.

The National Alliance on Mental Illness (NAMI) reports that 75% of most mental health conditions are identified by age 24. At least half of mental illnesses begin by age 14 after adolescents go through puberty.

Anxiety disorders are the most prevalent mental health disorders in adolescents today. Depression is the second most common mental health disorder in adolescents. Other prevalent health issues include mood disorders, panic attacks, eating disorders, behavioral disturbances and substance abuse issues. 

Suicide is the second leading cause of death in people ages 15–24 years.

 

Myth: It is just a part of growing up, not a mental health issue. It will pass in adulthood.

Fact:

A common misconception about teenage mental illness is that it will generally go away without treatment, like a sore throat or a stomach ache. This is false and contributes to teenagers often not wanting to seek help. They mask their mental illness because they are concerned about being stigmatized, misunderstood or even bullied. Instead of seeking help, they try to live a “normal” teenage life—going to school, working part-time jobs, playing sports—all while struggling with their mental health.

While lifestyle changes can help with overall mental and physical well-being, most mental health disorders need some treatment. 

Treatment involves therapy alone, medication alone, or both. Early detection of mental health disorders and treatment helps with overall prognosis and functionality. 

It is essential as a parent to let your teenager know that they can talk openly about mental health and ask for help. Signs you may notice in a teen struggling with mental health include:

• A decline in grades, especially if this deviates from their usual performance in school.
• Changes in social habits, including isolation from school, family, friends and activities.
• Frequent mood fluctuations with irritability, aggression and frustration about everyday tasks like homework or chores.
• Changes in behaviors, including not caring for personal hygiene and changes in appetite and sleep. 
• Prolonged lack of motivation.
• Loss of interest in activities once enjoyed, such as sports, friends and video games.
• Substance use. 
• Incidents or altercations with peers, suspensions from school, truancy. 
• Avoidance of social situations (social anxiety) out of fear of being judged. 
• Feelings of guilt, being a burden to others.
• Self-harming behaviors such as cutting or burning.

Myth: Teenagers with mental health disorders are violent.

Fact:

The majority of people with (or without) a mental health condition are more likely to be the victim of a violent crime than the perpetrator. This misconception is particularly harmful among teens because those who are suffering from a mental illness might be more likely to be bullied or ostracized by other adolescents.  

 

Myth: Mental health conditions are lifelong.

Fact:

Most mental health disorders affecting teenagers are treatable with therapy, medication or both. Not everyone in treatment will need it for life.  

Some mental health disorders may need life-long treatment. With proper management by a mental health professional, an individual can live a productive life.

 

Myth: Poor parenting skills cause teenage mental illness.

Fact:

Poor parenting, abuse or neglect can contribute to mental illness, but it is not the primary or sole cause of mental illness. 

Similar to a health condition like diabetes or high blood pressure that runs in families, mental illnesses such as depression, bipolar, schizophrenia and substance abuse can also be hereditary. Other causes include environmental factors, trauma, a history of bullying and substance abuse.

 

Myth: Teens with mental health issues will not live independently as adults.

Fact:

The majority of teenagers who have a diagnosed mental illness live happy and healthy independent lives, but it depends on early detection and treatment of the mental illness. Teenagers with mental illness can grow up to land a job, get married, own a house and have children.

Some disorders diagnosed in teenagers may be severe and can impair their functionality. With intervention from mental health professionals, they can learn to function and live independently. 

 

Myth: Medications will “numb” my teenager or make them feel like a “zombie.”

Fact:

Another common misconception about mental illness is that treatment with medications will make the person feel numb, have no feelings or change their personality. 

Medications regulate feelings and emotions by effectively balancing neurotransmitters in the brain, such as serotonin, norepinephrine and dopamine. Psychiatric drugs do not affect character or personality. 

Sometimes, for example, with antidepressants, people will report feeling in a state of “numbness,” which is because of the effectiveness of the medications rather than a side effect.

 

Myth: Finding help for mental health is difficult.

Fact:

It can be overwhelming to know where to start, but the good news is that parents have resources to help teenagers struggling with mental health.

The recommendation is first to see a pediatrician or family physician familiar with the teenager’s medical history.

During an initial appointment to screen for mental illness, the doctor may ask:

• What are the symptoms the teen is displaying?
• What are the parents worried about?
• Does the teen have any concerns or stressors currently? 

If the doctor is not comfortable making a diagnosis on their own, they can recommend a psychologist or psychiatrist for a psychiatric evaluation, therapy and medication management.

“Frequently, parents may not identify signs of depression in their children or adolescents until it has advanced,” said Dr. Abraham. “To combat stigma, engage in open conversations with young individuals about mental health, reassuring them that seeking treatment is acceptable. When children and adolescents perceive family support for their mental well-being, they become more inclined to seek assistance.”