Could your teenager have a mental health problem? A child psychologist explores

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Mental health struggles among teenagers are on the rise. Here’s expert help on how to deal with this sensitive issue

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The teenage years can be emotionally turbulent. This year, the pandemic has presented additional challenges for young people and many are facing increased struggles with their mental health. As a parent, how can you spot the signs and encourage them to open up to you? And what are the best ways to suggest getting help — without alienating your teenager?

A new UK study shows that almost half of 16 to 24 year-olds reported higher levels of stress. Almost 1 in 2 without previous mental health problems reported high levels of depressive symptoms, and 1 in 3 experienced moderate to high anxiety. Almost half said they were overeating to cope with their moods.

But while around 50% would ask for help for a personal or emotional problem, from a partner, friend or parent, and one-third would seek help from a mental health professional – worryingly, around 1 in 3 wouldn’t ask for help.

‘The teenage years are a formative period in life when you start to forge your identity,’ says Martin Forster, child psychologist at Kry. ‘So, the pandemic restrictions are having an effect on teenagers, not only on a practical level, but also on an existential one.’

Here, Forster answers questions for any parents worried about their teen’s mental health.

What’s going on in a teenage brain?

‘It’s normal for teenagers to become more moody,’ says Martin. ‘This is mainly down to a complex interplay between hormonal shifts during puberty and brain development that occurs in this period.’

Research shows that the prefrontal cortex — the area to do with planning, prioritising and impulse control — is one of the last regions of the brain to mature, and this can take until 25 to reach maturity, Forster explains. ‘Quite often, teenagers are described as being very emotional and not having the best judgement when it comes to taking risks,’ he says. But in recent years, research has shown that this is actually not true — teenagers don’t have a lesser ability to assess risks than adults.

‘But, what is specific to the adolescent brain is that there’s an increase in activity in the neural circuits using dopamine, a neurotransmitter central to creating the drive for reward,’ Forster explains. ‘This means they may react more strongly to temptation and find it harder to resist different types of rewards such as alcohol, drugs or sexual behaviour.’

It’s also natural for teenagers to become more rebellious as they transition from childhood to adulthood. ‘This is a time when they crave more freedom and this can lead to conflicts with parents,’ he says. ‘But, as a parent it’s important to remember that this is a normal and even healthy part of a teenage development. Teenagers need boundaries to rebel against.

The key is to help them navigate this difficult period by remaining calm, firm and steadfast, and giving them just enough leeway without totally crushing their will.’

How can I handle my difficult teen?

  • Involve your teenager in negotiations on boundaries and house rules, but stick to your agreements
  • Try to remain calm, firm and consistent
  • Talk about your concerns to friends, or join a support group
  • Look after your own mental health, so you’re better equipped to handle tricky situations

What are the signs of mental health problems in teenagers?

If mood swings are normal during adolescence, how can you tell if there’s something more serious going on? ‘If your teen is moody, this in itself isn’t necessarily a sign that they’re having mental health issues,’ says Forster. ‘The general sign to look for is any sudden change in behaviour or habits — this could indicate they’re struggling’.

Here are some more key signs:

  • Generalised anxiety: They seem excessively worried about everyday matters and can be restless and on edge
  • Depression: They seem persistently sad or low, can’t seem to function normally, are having problems with energy, sleep and concentration and have lost interest in doing things they used to once enjoy
  • Substance abuse: Their behaviour has become erratic. They might be talking more quickly or slowly than usual. They seem spaced out or high. You notice physical changes. For example, they may look thinner or their pupils may be dilated
  • Self-harming: You notice cuts or scratches on their body that they try to hide
  • Eating disorders: They’re avoiding food, are rapidly losing weight, or overeating. They may also be spending more time in the bathroom (this suggests they may be making themselves sick, which is a sign of bulimia)

How can I talk to my teen about their mental health?

‘If you’re worried, it’s crucial to get the right help,’ says Dr Forster. ‘Confronting a teenager directly probably isn’t the best tactic‘.

Instead, Forster advises trying to spend more time with them, even if this means cancelling things in your diary. ‘Find things that you can do together where they can feel safe and relaxed such as watching a film, doing sport, going for a walk, preparing a meal or giving them a lift in the car,’ he suggests. ‘That way, there’s more chance they’ll open up to you.’

When they do speak up, really listen to what they’re saying, Forster says. ‘At this point, it’s important not to shy away from sensitive matters and dare to ask straight questions, even if you as a parent may be afraid of the answer,’ he asserts. ‘For example, if your child hints that he or she is having suicidal thoughts — do ask about that.

‘Don’t be judgmental or overanxious and gently suggest that it might be helpful to talk to a doctor, psychologist or other health professional.’

How a doctor can help

‘A doctor will evaluate the physical and emotional symptoms, and advise on the appropriate treatment,’ says Forster.

This may be a referral to a psychologist, a specialist clinic, for example for eating disorders or substance abuse, or a support group.

Cognitive behavioural therapy (CBT), for example, can be effective for treating anxiety disorders and depression. In some cases, medication may be prescribed.

This article has been reviewed by Dr. Martin Forster, child psychologist

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