Struggling Teens. Normal Growing Pains or Mental Illness?

Is it teen angst or something else?

Almost half of all chronic mental illness begins by age 14, three quarters by age 24. Yet teens are unlikely to ask for help or recognize they need it. Sometimes it’s the stigma and other times it’s not knowing what is happening to them or what to call it.

In Charles’ case, he didn’t know how to label his anxiety. I remember him describing the feeling he got in middle school and telling him that what he was experiencing was called anxiety.

It is hard to tell what is real distress and what is “normal.” To complicate adolescence further, there are sometimes medical or lifestyle issues at the root of emotional and behavioral change.

If you have a nagging feeling that something isn’t right, it usually is not. The trouble is we’ll look for any excuse not to think our child is in real distress. I understand that because I wanted to believe everything was OK and grabbed onto anything positive that happened like it was a life raft.

Here are some clues to help you discern what is alarming and what is normal.

Wanting more privacy vs becoming secretive and hiding something

It was when Charles started lying about passwords and erasing his surfing history on the internet that I became suspicious. I knew something was up and he was hiding things and I resorted to spyware which revealed a shocking list of drugs and behaviors that I had been unaware of.

Moving from childhood likes to teen pursuits vs losing interest in favorite activities and not replacing them with something else

When Charles started to drop most of his extracurricular activities, I was alarmed. It wasn’t like His drug use had escalated to being more important and he was using them to self-medicate his way out of the reality he felt. He was suffering from thoughts of suicide and drugs pushed them away temporarily.

Trying substances vs daily or obsessive substance misuse or dependence

When Charles’ substance misuse started to become a constant issue, I knew there was an underlying cause. He was using marijuana as medication every day. Daily pot users are also three times as likely to attempt suicide between the ages of 18 and 32.

Shift in school performance vs. a drop in grades and caring about them

Teachers might cite behavior problems and hound parents about homework. But something is up with that teen if there is a noticeable drop in grades. This was a significant sign of my son, Charles.

Self-doubt vs. self-harm and self-hatred worsening self-esteem

We all suffer self-doubt. But if you hear comments such as, “I’m worthless,” “I don’t deserve to live,” or “I’m a piece of crap,” don’t take it lightly or brush it off. This can be a sign of depression or can be a sign of suicide.

Becoming more of a night owl vs not sleeping or sleeping too much

Teens are naturally night owls. But serious sleep deprivation or excessive sleeping of 12 hours or more, or days in a row is not normal unless your child has the flu or some other medical issue.

Fearful vs. paranoia

Developing real-world fears is natural. But hearing voices and hearing your child say they are being followed, are part of a secret government operation, or really elaborate stories that don’t add up can be a sign of mental illness. A psychological evaluation can help diagnose the issue.

This is not a definitive list but I hope it helps. And simply because you see these behaviors doesn’t mean your child has a mental illness. The first step is to be open to conversation.

And remember that recovery is not only possible, it’s probable. As always, find help for you. That’s where you get educated and learn more. It’s a lot easier to get a child to get help if you are getting it yourself.

• NAMI Family Support Groups
• NAMI Family to Family
• A multitude of other national and online support

Concrete strategies that helped me work through my teen depression