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Recognizing the signs of mental illness in teens

If there is a teenager in your life, you face the challenging task of sifting through typical behaviors and signs that your adolescent may be suffering from more than just growing pains. It is important that all adults with young people in their lives are aware of signs and symptoms of mental illness, including depression, and how these manifest in younger individuals.

Concerning signs and symptoms, according to the National Alliance on Mental Illness are:

▪ Excessive worrying or fear

▪ Feeling excessively sad or low

▪ Confused thinking or problems concentrating and learning

▪ Extreme mood changes, including uncontrollable “highs” or feelings of euphoria

▪ Prolonged or strong feelings of irritability or anger

▪ Avoiding friends and social activities

▪ Difficulties understanding or relating to other people

▪ Changes in sleeping habits or feeling tired and low energy

▪ Changes in eating habits such as increased hunger or lack of appetite

▪ Changes in sex drive

▪ Difficulty perceiving reality (delusions or hallucinations, in which a person experiences and senses things that don’t exist in objective reality)

▪ Inability to perceive changes in one’s own feelings, behavior or personality (lack of insight)

▪ Abuse of substances like alcohol or drugs

▪ Multiple physical ailments without obvious causes (such as headaches, stomach aches, vague and ongoing aches and pains)

▪ Thinking about suicide

▪ Inability to carry out daily activities or handle daily problems and stress

▪ An intense fear of weight gain or concern with appearance (mostly in adolescents)

No one sign means that there is a problem. It is important to place the signs in context by weighing them against the nature of the teenager, intensity and severity of the issue and the duration for which the troubling symptom lasts.

If you suspect or are worried about the mental health of a young individual, trust your instincts and act on them. Specifically ask him or her what’s wrong. Share specific concerns such as, “I’ve noticed that you haven’t been hanging out with your friends as much,” or “I can’t help but notice you are complaining of stomach aches and eating less lately.” Be sure to allow the teenager a chance to respond, let them know that that you are there to help, support and face any challenges together.

These conversations can be difficult, but there are some simple things you can to do to make the experience as positive as possible. Be sure to initiate the conversation in a comfortable and neutral space. Speak in a calm voice, be prepared to listen and avoid interrupting the other person. Sarcasm, threats and yelling are likely to end meaningful communications, so remain calm and encouraging but firm in your responses. Do not use words such as “always” or “never,” and be sure the conversation focuses on the now and not past actions or issues. If you feel that the discussion becomes heated or no longer feels productive, take a break but revisit the issue at a later time and don’t hesitate to seek help from a family doctor or school counselor.

Again, be sure to listen to your instincts, and make sure you have ongoing conversations with the young person in your life. Do ask specific questions about noted behaviors and concerning behavior changes. Take action if you feel that your teen is not improving or not doing well as intervention is the key to addressing early and avoid great difficulties down the road.

Candace Good, MD, behavioral health, Mount Nittany Medical Center, is board-certified in general and child & adolescent psychiatry and a psychiatric provider at SunPointe Health in State College.