By Catherine Johnson

Remember how stressful, silly, awkward, and overwhelming life could be as a teen? Teens are trying to not only figure out their place in the world, but they’re also juggling the stress of school, extracurriculars, relationship difficulties, and trying to figure out next steps. These are normal teen experiences. However, sometimes how they are acting is more a cry for help than the normal ups and downs of being a teenager. It can be hard to know when your teen might need some extra support outside of what you’re able to offer as their caregiver. When do they need therapy? Below are some signs that therapy would be the next step for your teen. 

Obvious Signs

Thoughts of Suicide or Self Harm: If a teen ever attempts suicide, talks about being suicidal, or harms (cutting, burning, hitting, etc) themselves in any way, on purpose they need professional help as soon as possible. Even if the thoughts are not followed through by harmful behaviors, it’s still VERY important for teens to get help. 

Substance Abuse, Addiction, or Risk Taking: Any use of hard drugs, tobacco, or alcohol should be a sign that your teen is in need of mental health support. These are harmful coping behaviors, and they need to learn healthier coping skills. Other high-risk issues could include: excessive use of pornography, driving recklessly, unsafe sex, running away, meeting up with strangers online, etc.

Changes in Eating, Sleeping, or Hygiene habits: Struggling to stay/fall asleep or insomnia for days at a time, eating much more or less than usual, or ignoring basic hygiene are all red flags to pay attention to. Especially if physical health concerns have been assessed for and not found. 

Severe Mood Swings or Outbursts: If your teen seems to suddenly or unpredictably explode in a burst of energy, anger, hopelessness, or shut down completely, interrupting their daily life or the daily life of others, and it’s been going on for more than two weeks, it’s time to consult a mental health professional.

Withdrawal from Friends and Family or Hobbies: An average teen will have moments of withdrawal and want time alone. But pushing away from support, community, and things that bring them joy for a prolonged period of time shows there’s something deeper there to be addressed. 

Issues in School: If a teen is consistently being written up for disturbing class, refusing to do work, sleeping in class, in detention frequently, or has grades dropping, something is up. They could be struggling with learning disabilities, having problems in relationships, or experiencing a wide variety of other mental health issues. 

Less Than Obvious Signs

Body Symptoms: Physical experiences like pain, shaking, emptiness, nausea, and fatigue, when not related to a medical diagnosis, can be signs of mental health issues.  

Low Self Confidence: This is not being shy, this is about them struggling to know who they are and show up as themselves with confidence. If a teen struggles to communicate who they are, how they feel, what they need, and connect with others, this will only continue to impair their ability to operate in life. 

Consistent Conflict with Peers or Friends: We are not talking about normal distress between teens like, fighting over a spot on the soccer team. Those moments come and go. This is when your child is very consistently talking about being on the outs or in conflict with others. This could be a sign of them either being bullied or struggling with emotional management or other issues needing to be addressed.

Perfectionism: When they are unable to accept that they will make mistakes, like when they feel panic over grades less than an A or when they need constant reassurance from others that they are “doing the right thing,” they could be dealing with anxiety, OCD, high shame, or low self confidence.

Major Changes, Threats to Safety/Connection, or Uncommon Circumstances: Anything that has caused an increase of disconnection, shame, fear, or loss in a teen’s life, especially if it is sudden or unexpected,  and it could include situations like divorces, death, a global pandemic, natural disasters, moving, having family in the military or going to jail, being in an accident, being in foster care, getting cancer, very sick siblings, etc. 

Therapy is not a one stop shop to “fix” what your teen is struggling with, but it’s a crucial piece of the support system that they, and you, may be missing. The more of the issues you see on this list they have, the more important it is to get teens the support they need. However, no matter the situation, if a teen asks to go to therapy please get them to therapy.