A Guide to Common Mental Health Issues in Teenagers

Mental illness in adolescents is on the rise. The commonly diagnosed mental disorders among children are ADHD, behavior problems, anxiety, and depression. According to the Centers for Disease Control and Prevention (CDC):

• One in 6 children aged 2 to 8 years has a mental, behavioral, or developmental disorder
• Depression and anxiety among young children increased 3% from 2003 to 2012
• 9.4% of children have received an ADHD diagnosis
• 7.4% of children have a diagnosed behavior problem
• 7.1% of children have diagnosed anxiety
• 3.2% of children have diagnosed depression

The CDC describes mental disorders among children as serious changes in the way children learn, behave, or handle their emotions. Unfortunately, mental health issues in adolescents can be difficult to identify because of the typical hormonal shifts in behavior and personality that occur during puberty. However, it is crucial for parents to be able to correctly identify problems, to get teens the support they need.

Undiagnosed or untreated mental health disorders in adolescents can cause a range of problems that persist into adulthood. These problems can impact school performance or physical health. They may even lead to addictive behaviors.

Anxiety

Nearly 1 in 3 adolescents will experience an anxiety disorder. Anxiety disorders can cause children to be extremely scared of daily life. They can affect kids of all types. Teen anxiety can have many causes:

• High expectations and pressure to succeed
• Watching the news
• School safety drills and lockdowns
• Interactions on social media

Three kinds of anxiety disorder are common among teenagers:

• Generalized anxiety disorder (GAD): The person is excessively worried about many things that cannot be controlled. GAD is typically diagnosed when a person cannot control their worry for a number of consecutive days.
• Panic attack disorder: People with panic attack disorder have sudden and repeated attacks of unreasonable fear that last several minutes or longer. During a panic attack, the person has a fear of disaster or of losing control when there is no real danger.
• Social anxiety disorder: This condition is a chronic form of irrational anxiety related to social interactions. The individual may have a fear of being judged or may worry about embarrassment or humiliation.

People with anxiety disorders often avoid talking about their problems. They feel that other people would not understand. Scientists are still unsure of the causes of anxiety disorders. However, there are treatments and coping mechanisms that can help a teen living with anxiety:

• Counseling sessions can help a teen understand why they are feeling anxiety
• Breathing techniques can help ground a person and bring them back to the present
• Eating well-balanced meals can improve general health
• Getting enough sleep allows body and mind to rest
• Taking a break from a stressful situation can allow the person to relax
• Talking about symptoms may destigmatize anxiety
• Avoiding or limiting alcohol and caffeine may help to prevent anxiety

Depression

Depression is one of the most common mental health disorders. An estimated 3.2 million young adults have had at least one depressive episode, according to the National Institute of Mental Health (NIMH). A major depressive episode is a period of at least 2 weeks where the person had a depressed mood along with most of the following symptoms:

• Loss of appetite
• Problems in sleeping
• A loss of interest in daily activities
• Lack of self-worth
• Trouble in concentrating

Studies from Harvard have shown that there are many possible causes of depression, including:

• Faulty mood regulation by the brain
• Genetics
• Stressful life events
• Medications
• And medical problems

Depression can be hard to treat, as it can severely affect energy levels and mood. However, there are many treatments and coping mechanisms that are proven to be helpful, like:

• Staying connected with friends and family
• Participating in activities that are enjoyable
• Moving or being active
• Talking with a mental health professional
• Eating a healthy diet
• Walking in nature
• Challenging negative thoughts

Substance use disorders

In 2017, 9% of high school students admitted that they smoked at least one cigarette a day. The same study also stated that 30% of high schoolers reported they had had at least one drink within the past 30 days. Unhealthy patterns of substance use can include using illegal substances or using legal substances in harmful ways (e.g., too much or too often). The substances most commonly used among teenagers include the following:

• Alcohol
• Prescription drugs
• Tobacco
• Illegal drugs including marijuana

Substance use disorder can have major effects on a teen’s body and brain, such as:

• Affecting growth and development;
• Initiating other risky behavior, like drunk driving;
• Contributing to problems later in life, like heart disease or high blood pressure.

Teens hide their substance use from their parents and pediatricians. This makes substance use hard to diagnose and harder to treat. Teens experiment with drugs mostly in social settings, when their parents are not watching. However, parents can often notice signs that could suggest a possible substance use disorder:

• Difficulties at school and declining grades
• Poor performance
• Changes in physical appearance
• Altered behavior, such as an increased desire for privacy
• Drastic changes in relationships
• A lack of energy during daily activities
• Spending more money than usual or requesting to borrow money
• Changes in appetite
• Bloodshot eyes, poor skin tone, and appearing tired
• Defensiveness when asked about substance use

If you or your teen is suffering from substance use disorder, it is important to contact a doctor to discuss rehabilitative treatment options.

Eating disorders

Eating disorders can cause serious problems in adolescents. One study found that 2.7% of teenagers have already had a diagnosis of an eating disorder. The NIMH warns that eating disorders are typically accompanied by anxiety, mood disorders, impulse control disorders, and substance use disorder. Three eating disorders are common among teens:

• Binge eating: This eating disorder is characterized by eating a large amount of food while feeling a loss of control
• Bulimia: This disorder involves binge eating, followed by purging, fasting, or excessive exercise
• Anorexia: This eating disorder involves dangerous weight loss, or a failure of proper growth in a growing child or adolescent. The person may eat very little food. The person may also purge after eating or exercise compulsively

Unfortunately, it is common for young people to feel uncomfortable with their bodies. Puberty and hormones are just a couple of reasons why adolescents have a hard time controlling their weight. During adolescence, eating disorders are more common in females than in males. Signs of an eating disorder might include the following:

• Excessive worry about weight
• A severe diet
• A desire to eat alone
• Using the bathroom often after meals
• Unhealthy actions to lose weight
• Guilt that is triggered by eating
• Abnormal stress surrounding eating habits

If an adolescent shows signs of an eating disorder, there are general steps to take:

• Immediately seek professional help
• Identify treatment options
• Talk to a registered dietitian
• Work to normalize healthy weight and eating patterns

Borderline personality disorder

Borderline personality disorder (BPD) is a condition in which the person has intense and unstable emotions, unstable relationships, and an unstable sense of identity. Of course, adolescence is a period of transition. Some emotional instability and questioning of identity are normal in adolescence. Thus, many experts feel that the diagnosis of BPD should not be made for patients younger than 18. However, the most recent edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) discusses BPD diagnosis in children as young as 13. Hopefully, earlier diagnosis could lead to better treatment for this serious condition.
The symptoms of BPD include:

• Fear of abandonment
• Unstable relationships
• Unclear self-image
• Impulsive, self-destructive behaviors
• Self-harm
• Extreme emotional swings
• Chronic feelings of emptiness
• Explosive anger

While teenagers and adults with BPD may experience the same symptoms, teens may express them differently. BPD is treated mainly with psychotherapy; however, medication can be added. There is also a chance of hospitalization if a doctor deems it necessary. Luckily, more and more therapists are aware of BPD, its symptoms, and how to treat it.

Other mental health conditions

There are also less common mental health disorders teens may experience. These include:

• Obsessive-compulsive disorder (OCD): People with OCD have obsessions that lead to compulsions. An obsession is a recurring, unwanted thought or feeling. A compulsion is an urge that someone cannot resist. People with OCD have unusual thoughts or fears that lead to behaviors, such as repeatedly washing or checking things, that disrupt their life. The obsessions often involve themes, such as fear of germs or certain organization techniques. Treatments include therapy and medication.
• Post-traumatic stress disorder (PTSD): PTSD is a person’s reaction to an experience that was so upsetting that the person is having difficulty in recovering from it. PTSD is commonly diagnosed in combat veterans, however, anyone can get PTSD at any age. Symptoms include flashbacks, nightmares, heightened reactions, and anxiety. Treatments include medication and trauma-focused therapy sessions.
• Attention-deficit hyperactivity disorder (ADHD): ADHD is a chronic condition that includes difficulty in focusing, hyperactivity, and impulsive behavior. This disorder is often diagnosed in young children. Treatments include medication and talk therapy.

A diagnosis of a mental health problem is not always a bad thing. Diagnosis can be the first step toward solving problems. The diagnosis itself shouldn’t hold anyone back from common life milestones, like marriage or pursuing a career. However, it is crucial for these disorders to be diagnosed correctly and as soon as possible, so that treatment can be discussed and teens can go on to live full and healthy lives.