“What’s the difference between normal teenage stress vs. a real mental health problem?”

“Is my daughter just overly dramatic, or is she really this sad?”

“Aren’t teenagers supposed to be moody and irritable”?

These are all great questions. And the answer, when it comes to any teenager-related question, is always complicated. Teens face day to day struggles with stress, grief, bullying, sadness, guilt, shame, feeling overwhelmed about their future, dating drama, gender identity issues, etc. It can be difficult to know when your teen is working though some of these issues in a healthy way or when they might need the help of an expert.

When is the right time to call?

As a psychotherapist who has worked with teens and their families for over 20 years, I’ve been asked this question many times. Parents will call me while experiencing a low point in parenting a teenager and wonder if they’re jumping too fast, or not giving their kid and themselves enough credit to ride the ups and downs together. Parents will second guess themselves, torn between wanting help and support and wanting to give their kid room to grow and manage life on their own.

You are the expert on your own teenager! Even though some days they seem like scary, moody, foreign creatures, this is your child and you know them best. Trust your instincts.

Here are some signs that it might be time to seek the advice of a professional:

1 | Home, school, or community struggles

  • Has their behavior in one or more of these areas changed dramatically?
  • Has their school performance changed?
  • Are they under more stress than usual?
  • Are they getting grades that are out of the norm?
  • Are they moody and miserable at home?
  • Are they getting in trouble at school or in the community?
  • Are they avoiding school or community?

2 | Change of friends

  • Is your teen no longer hanging out with friends or have they changed friend groups completely?
  • Are they avoiding all social functions recently?
  • Are they angry at all of their friends?
  • Hanging with new friends?
  • No friends? 

3 | Angry and irritable

  • Is your teen more irritable and quicker to anger than they used to be?
  • Is anger or irritability starting to affect their life?
  • Is the anger preventing them from functioning?
  • Could they be at risk of hurting themselves or someone else because of the anger or moodiness?

4 | Excessive worry

  • Is worry stopping them from doing things?
  • Is worrying about school and grades so overwhelming they are in tears?
  • Is worry affecting his/her sleep or mood?

5 | Dramatic changes in sleep habits

  • Are they sleeping much more, much less?
  • Always tired?
  • Choosing to sleep in the middle of the day or always needs a nap? 
  • Sleeping instead of doing something they once found fun?

6 | Self-destructive behavior

  • Cutting?
  • Drinking?
  • Drugs?
  • Excessive risk taking?
  • Do they not seem to feel pain?

7 | Talking about death or thinking about it often

  • Is your teen obsessed with death?
  • Is he/she talking about or thinking about hurting himself or someone else? If so, call for help immediately.

If the decision is still not clear, the best way to determine if your teen could benefit from counseling is to ask them. Ask if they think it would be helpful to talk to someone. You don’t have to go into a lot of details or even have a clear idea about what he wants to talk to a therapist about. Try questions like: “Are you overwhelmed?” “Would it be helpful to talk to a counselor?” “Would you be willing to give therapy a try?”

Your child may know that it’s time. Or maybe they just needed to know it’s an option. By asking if they’d like see a therapist, you’re showing your teen that there’s no stigma or shame in trying counseling.