As children become adolescents, they start to experience several developmental changes that affect them physically, psychologically, emotionally and behaviorally. Because of these changes, parents may start to notice that their teens may be irritable, withdrawn and overwhelmed.
Some of these behaviors are natural during this developmental stage, but if these behaviors are recurring for many weeks, they may serve as a red flag that a teen is experiencing symptoms of anxiety and/or depression.
Baleska Alfaro, a licensed marriage and family therapist at CHOC’s Co-Occurring Clinic, helps parents understand the typical teen developmental changes and describes the signs and symptoms of depression and anxiety to watch for.
Adolescence is a time of many changes for teenagers’ physical bodies, how they connect socially and emotionally and how they think and learn, says Baleska. They are becoming autonomous — developing their own personalities and sense of connectedness.
Physically, teens might experience significant changes to their body size, shape or weight during adolescence.
Most teens assigned as female at birth will be physically mature by adolescence and most will have completed puberty. They may be developing breasts, experiencing hormonal changes and starting menstruation.
Teens assigned as male at birth may still be in the process of maturing physically at this time – they are hormonally driven, may develop a deeper voice and begin to grow facial hair.
For all teens, these physical changes can impact their mood — they may start to behave and interact differently with their family and friends.
During this time, teens may start to have more interest in romantic relationships and sexuality —however, they may not always be overt about this interest and may start asking questions about sexuality covertly.
In pursuit of autonomy, teens may start to withdraw from their families and start to form their own opinions about religion, politics and social world around them. This may cause conflicts with their parents because these new thoughts and changes may be confusing for their teens, causing them to be irritable or feel lost.
Although teens may show some distance from their families during this time, they will draw closer to friends. They start to have a deeper capacity for caring and sharing and want to develop more intimate relationships.
With all of these new feelings, emotions and relationships, teens may experience quick fluctuations in mood — often having difficulty regulating their emotions.
Because adolescence is just a step under adulthood, Baleska says that teens may be prompted — both biologically and socially — to think about their future. They may start to develop more defined work habits and a better work ethic.
Contrary to their previous tendency as kids to have concrete, structured thoughts — often only seeing the here and now — teens develop more abstract thinking. They can grasp bigger-picture thinking; they are able to give reasons for their own choices and start to realize that they may have long-term consequences.
All of these changes in thinking may lead teens to have the following teen behaviors, says Baleska:
Symptoms of depression may not be overt, such as a teen exhibiting sadness. It is common for teens to be overwhelmed easily during all of their developmental changes or appear irritated and withdrawn from family because they rather be with their friends.
It’s important for parents, caregivers and educators to be able to spot the difference between natural teen behavior and depressive behavior, says Baleska.
According to the Diagnostic and Statistical Manual of Mental Health Disorders (DSM-50), clinically diagnosed depression may be called Major Depressive Disorder or Other Specified Depressive Disorder.
The DSM-50 states that common symptoms of depression may include irritable mood, lack of motivation, inability to concentrate, fatigue, physical symptoms like stomach aches and headaches, social withdrawal, sadness and behavioral issues such as non-compliance and or defiance.
Additionally, depression is more commonly seen in teens assigned as female at birth. They may develop eating disorder symptoms like eating too much or too little or over exercising.
If your teen is not usually this way, Baleska explains, and if there is a pattern of these symptoms popping up for more than two weeks, it may be a red flag that your teen may be experiencing a depressive episode.
The DSM-5 lists the common symptoms of anxiety as excessive worries about one or more areas of daily life, muscle tension, irritability, inability to concentrate and trouble sleeping (insomnia). They may also have additional physical symptoms like stomachaches or headaches and an increase or decrease of appetite due to stress.
Anxiety is a sense of urgency to get something done or quiet a concern, says Baleska, some anxiety can be OK if it helps teens study for a test, train for a big game or prepare for a presentation.
However, if a teen is having excessive worries that are impacting their functioning, they may be having an anxiety episode or have an anxiety disorder.
The COVID-19 pandemic caused a spike in depression-like and anxiety-like symptoms such as isolation, lack of motivation, fatigue and even lack of hygiene, says Baleska. She encourages parents to watch for the following behaviors and compare them to how their teens normally behave:
If any of these behaviors are happening more often than not, says Baleska, it could be a sign of anxiety or depression.
“Small actions can make a big impact,” says Baleska.
Parents should know when to access professional help. If a teen is having suicidal ideation or wanting to harm themselves or others, seek immediate help. Call 911, a crisis team, or visit your nearest emergency department.
Baleska says that if a teen is exhibiting signs or symptoms of anxiety or depression that are not an immediate concern, consider the following ways to help:
CHOC’s Mental Health Education Programs (MHEP) offers free webinars to parents on a variety of topics. To view upcoming webinars, view the MHEP events calendar.
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