Behavioral Warning Signs

Changes in an adolescent’s usual behavior, especially alterations that persist for days or weeks, can indicate mental health and/or substance abuse issues. Below are signs that a teenager may need help:

• Sudden and uncharacteristic anger, such as unusual temper flareups, emotional outbursts, showing rage and/or talking about seeking revenge;

• Wearing clothes that do not match the weather (i.e., long sleeves or layers when it is hot or lacking warm apparel when it is cold);

• Changes in friends, including a reluctance to talk to or spend time with existing ones, or associating with known substance abusers;

• Secretive behavior, such as frequent trips to the bathroom, basement or storage rooms;

• Excessive guilt;

• Nausea and continual illnesses; frequent headaches, nosebleeds, runny noses and sniffing; or increased visits to the school nurse;

• Borrowing money from friends, family members and coworkers;

• Jitteriness, nervousness, aggression and other physical agitation;

• Stealing small items from home, school and/or work;

• Increased tiredness, such as falling asleep in class;

• Giving away possessions if there is no special occasion;

• Taking risks and becoming self-destructive by driving recklessly, refusing to eat and smoking or drinking heavily, etc.;

• Wearing sunglasses at inappropriate times;

• Tidying up his or her room and life to an extreme degree, paying back loans and responding to long overdue texts, E-Mails or letters;

• Changes in skin color, such as looking pale and/or gray; and

• Seeming to have lost his or her self-esteem, including making negative comments like “I can’t do anything right.” or “I’m so stupid.”

Life events, including significant losses like the death of a parent, sibling or close friend; a break-up with a boyfriend or girlfriend; and parental separation or divorce, can cause depression. Likewise, expressing fear about going to school and/or making excuses to stay home, missing or destroyed possessions and an unwillingness to talk about school can indicate that an individual is the victim of bullying, which can increase the risk of depressive disorders.

Broken bones, keeping sharp objects on hand, spending a great deal of time alone, relationship difficulties, wearing long sleeves and/or pants even in hot weather, and claiming to have frequent accidents can signal that self-injury may be occurring. Similarly, exercising obsessively, engaging in food rituals, frequently feeling faint or dizzy, dressing in baggy clothes or layers, and avoiding situations in which food is served or consumed can be symptoms of unhealthy weight control.

Untreated depression can lead to academic failure and substance abuse. Keep a diary that tracks the changes in mood or behavior you are seeing. That will give you a clear record of your concerns to share with a doctor or other mental health care provider. Rather than being a source of stigma or shame, mental health discussions and treatment are about promoting wellness and making good decisions. Help is available and you and your child are not alone.