In the last few years, the incidence of mental health problems among teenagers has risen rapidly and alarmingly around the world. This is concerning for mental health professionals—but it is even more alarming for parents of children and teenagers. Worries about their child developing a mental health problem such as an eating disorder or depression are probably among the top concerns for many parents.

This page aims to shed a little light on the issue of mental health and teenagers, including some of the issues that may cause or exacerbate mental health problems. It also explains how you can help your child to access support.

A Common Problem

Unfortunately, mental health problems are not at all uncommon in teenagers (see box).

Many common mental health problems, such as eating disorders, are most likely to surface during adolescence. It is not clear why this is the case, but it seems likely to be a combination of hormonal and physical changes plus societal pressures. Certainly adolescence is a time of huge change—both physical and social—and also a time when young people come under pressure to perform in public exams and make decisions that will affect their futures.

Factors that can Affect Mental Health in Teenagers

There are many factors that can affect mental health in teenagers.

Indeed, the website of the charity Young Minds lists 26 separate issues in its ‘A to Z guide to mental health for parents’, ranging from abuse and domestic violence through bullying, divorce and separation, exam time, gaming and gender identity, to social media and trauma.

For example:

• Young people who are questioning their gender identity and trying to work out who they really are may find the experience very stressful. They may be confused, or may experience bullying because they are ‘different’. They may also feel unable to ‘be themselves’ with those they love best—perhaps because they are unsure of themselves, but also because they fear the reaction if they ‘come out’ about a change in their gender identity.

  There is more about this in our page on Gender Identity and Body Dysphoria.

• Bullying can have a huge impact on a child or teenager’s wellbeing. It can lead to them refusing to go to school, or problems with schoolwork, and spiral into anxiety or depression.

Life can therefore have an impact on mental health and wellbeing.

For example, gender or body dysphoria is a condition defined as confusion or distress arising from a mismatch between your physical sex and your perception of your gender. It is included in the diagnostic manual for mental health problems, but is not in itself considered a mental illness. However, it is often associated with—and is thought to lead to—mental illnesses such as anxiety and depression.

Mental health problems can also affect life.

For example, children who are anxious may feel unable to go to school. A recent statistical report in the UK found that 11 to 16 year olds with a probable mental health problem were less likely to feel safe at school than those without any such problem. They were also less likely to enjoy learning, or have a friend that they could talk to.

The real challenge is that some children and young people may be exposed to one or more of these triggers without developing any mental health problems.

Others, possibly less exposed or not exposed at all, may develop problems without ever having shown any previous signs.

It is therefore extremely hard to predict which young people will develop mental health problems.

Recognising Mental Health Problems in Teenagers

There are a number of signs and symptoms of various mental health problems. However, these are fairly generic, and may also be a sign of nothing at all.

They include:

• Changes in weight or appetite, including losing interest in eating, which may be a sign both of eating disorders and depression;

• Changes in clothing choices, such as wearing baggy clothes or long sleeves, perhaps to hide weight change or signs of self-harm—or perhaps because that is fashionable;

• Being very tired, which may be a sign of depression or eating disorders—or simply staying up too late chatting on social media with friends;

• Behavioural changes, such as becoming more withdrawn.

Generally speaking, any change in behaviour is worth investigating further, because it could signal a problem of some kind. Struggling to cope can also be a signal that your teenager needs additional help.

For more about signs of specific problems, see our pages on Eating Disorders, Depression, Anxiety, and Gender Identity and Body Dysphoria.

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Supporting Your Teenager Through Mental Health Problems

All the evidence suggests that the most important aspect of getting through any serious mental health problem is to get professional help as early as possible.
For parents, this means:

• Encouraging your teenager to see the family doctor to ask for help.

  You may need to go with them, or make the appointment, or even go to the doctor first to seek their help. Teenagers with eating disorders or who are self-harming will often try to hide the problem, and may therefore be reluctant to seek help. There are legal provisions in place to ensure that they can be helped before they do themselves any serious harm—but for those to be invoked, professionals have to be aware of the issue. The best place to start is with your family doctor.

• Seeking a referral to mental health services

  Your family doctor can prescribe basic antidepressants—but you may also need to get your teenager to specialist child and adolescent mental health services. This is particularly true if they have an eating disorder, because these can become life-threatening quite quickly. Your family doctor should provide a referral, but you may need to ask.

• Engage with their treatment

  Mental health problems often mean that other members of the immediate family (parents and siblings) may have to make changes to their behaviour. For example, if your teenager has an eating disorder, you may need to change your eating habits to encourage more healthy behaviours. You may have unknowingly been enabling unhealthy behaviours, and you need to understand that. It is therefore important that you engage with your teenager’s treatment. If there is family therapy offered, it is wise to attend as a family—not least because this shows your teenager that you are all involved and care. It also models good compliance with treatment, and this is essential.

  You are the adult, and you have a responsibility

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  It is important to remember that you are the adult in a relationship with your teenager. Your teenager will be seeking—and being given—more responsibility for themselves. However, if you have serious concerns about their health, you have a responsibility as their parent to do something about those concerns.

  It may feel like a betrayal to call in professional mental health services, especially if your teenager is denying that there is a problem. However, sometimes it is the best—possibly only—way to help.

  After all, you would call a doctor if your teenager had broken their leg, or had a serious physical illness. It’s the same with mental health.

  Our page on Dealing with Concerns about Your Teenager explains more about the concept of parental responsibility and how it may apply here.

  
  

  Beyond this, there are also some things that you can do to help support your teenager through mental health problems. For example:

• Be available to your teenager when they want to talk to you

  Children who have had eating disorders have reported that it is helpful if their parents show that they are able to discuss the problem, and don’t avoid talking about it. They also want their parents to be open-minded, and focus on what it is like for the child, avoiding making assumptions.

  These seem like good principles for any conversation with teenagers, as is keeping a channel open for communication. This may be especially difficult if your teenager is shutting themselves away in their room, but try to make time. Our page on Communicating with Teenagers contains ideas that may help.

• Keep seeing your teenager, as well as their mental health problem

  Patients of all ages often complain that doctors don’t see them as a whole, only their symptoms. This is equally true for mental health problems. Try to keep reminding yourself that your teenager is still themselves, with their own set of interests and issues—and not just a mental health problem that needs treating. It may be especially helpful to support them to keep up those interests, and continue to do their chosen hobbies or see their friends.

• Be aware that social media is unlikely to be totally positive

  It is hard to ban any teenager from social media: it is, after all, where they spend most of their lives, and keep up with their friends. However, you need to be aware that there is plenty of content on social media that may be actively damaging to a young person with mental health issues. For example, there is a considerable amount of pro-anorexia content, as well as information about self-harming.

  The best option is to talk to your teen about what they are viewing, and discuss harmful or disturbing content. You can also try checking their viewing history, though a canny teen will probably clean it up before giving you their device.

• Help your teenager to manage social situations if that is causing them a problem

  Sometimes social events and situations can be uniquely stressful for teenagers with mental health problems. For example, a teenager with eating disorders may be very anxious about the prospect of eating out with friends, because of having to choose a meal. You can help them to find the menu ahead of time, and decide what they are going to eat. Another young person might be worried about what family members will say at an event. You can help by warning relatives not to ask about their health, or make any comments about their looks, weight or anything else.

• Look after yourself

  You will be unable to help or support your teenager if you are completely worn out. It is therefore important to look after yourself: eat well, get enough sleep, and take time for yourself. This can feel difficult when you think you ought to be looking after your teenager—but it is a key part of that process.

  There is more about this in our page on Self-Care for Parents.

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A Final Thought

If your teenager has a mental health problem, it can seem all-encompassing. However, most people with mental health problems recover well with the right treatment—and that includes teenagers.

The best thing you can do is keep reminding them that you love them, show them that they matter to you as themselves, and not just because of their illness, and help them to access support.

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