How to Tell Typical Teenage Behavior from A Mental Health Issue


Mar 9, 2016


The teenage years are often a mystery to parents. The sheer range of behaviors and emotions at this age can bewilder even parents with the closest relationships to their children. It can also cause a lot of worry. In adults, wild mood swings are typically seen as a sign something is wrong. So the emotions of a teen often concern parents from a mental health standpoint. But teenage behavior is governed by very important developmental changes in the brain that are not symptoms, but rather completely natural – and, luckily for parents, temporary – behaviors and attitudes.

That said, teens can have mental health struggles, like anyone else. Parents can look after teen mental health by knowing what is normal and what is cause for concern.

Typical teenage behavior, or mental health issue?

Teens changing the way they look.

Normal: Teen appearance tends to be driven by two factors: one, fitting in with their peers, and two, expressing their fledgling personalities. The first often manifests in chasing after the latest fashion trends, however revealing, bizarre or unflattering. The second can manifest in a variety of ways, from growing facial hair, to drastic changes in hair style (dyeing it vivid colours or chopping it short), to body piercings or tattoos. These two goals may seem at odds, but ultimately they aim to garner a teen the acceptance or adulation of peers.

Cause for concern: Changes in eating/sleeping patterns. Changes in appearance are typical, but sustained changes in fundamental behaviour could be cause for worry. Remember, though – most teens require more sleep than adults and operate on a late-night/late-morning circadian rhythm, so staying up late and waking late is normal.

Teens cutting off from the family.

Normal: During adolescence, there is always a degree of withdrawal from the family. Establishing and testing their independence is not only natural for teens, but also important to their development into self-sufficient adults. Friends become more important to teens; their opinions, of greater consequence. So while it may appear a teen is withdrawing from the world, the reality is they are still well-connected to a support network of their peers.

Cause for concern: Cutting off from friends. Introvert or extrovert, one friend or 30, all people need friends. The size of a teen’s friend circle is less concerning than if a teen is withdrawing from it. Teens begin to rely on friendships for validation and guidance to a greater degree than earlier stages of development, and a withdrawal from these relationships could be a sign of struggle.

Mood swings in teens.

Normal: A seemingly out-of-control teen can swing from the extreme happiness, to despair, to anger, all in the matter of a few days – or even a few hours. This unpredictability again bewilders parents and can make it difficult to engage with your child, let alone reason with him or her. It may even mean some kids spend most of their time at home behind a closed door. As long as this isn’t accompanied by any of the other causes for concern in this article, it’s normal behavior.

Cause for concern: Physically abusive behavior or destruction. Physical abuse or destruction is not a normal or healthy expression of emotion for anyone. It’s also dangerous to the people around the individual acting out. It’s best to get to the root cause of this behavior, rather than attempt to correct it episodically.

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Teens fighting with family.

Normal: As teens start establishing a life outside the family and experience deeply felt moods, it’s natural for conflict to follow. Depending on the personalities of parent and child, this can vary from mild arguments to full-blown shouting matches. The latter isn’t the best choice by a parent, who is responsible for setting the tone of a clash, but it isn’t particularly abnormal for the home to be a place of tension during these years.

Cause for concern: Not attending school or a decline in academic performance. Playing hookie once in a while might be nothing more than typical teen rebellion. But regularly missing classes or a sudden / surprising decline in grades or involvement is a red flag of something greater.

Teen d-r-a-m-a.

Normal: A small zit, a passing comment, a break-up with a girl/boyfriend – the number of things teens care about and the depth of feeling for each and every one is, for parents, inexplicable at best and exhausting at worst. Adolescents are oversensitive, self-conscious and still learning to master the art of coping with life’s disappointments, big or small. Navigating the teen years’ drama is an important part of developing the resilience needed for the rest of life’s ups and downs. It may mean hours or days of your teen feeling low, morose and overwhelmed, but he or she will bounce back.

Cause for concern: Self-harm or frequent physical responses to the ‘drama’ such as stomach, head or back aches. Self-harm is a serious issue in the teen years, and shouldn’t be taken lightly. Even if it seems more of a ‘cry for help’ rather than a serious attempt, it’s imperative the teen get the help he or she needs. Physical symptoms like regular (and physiologically inexplicable) stomach, head or back aches are also cause for concern.

Teens behaving irresponsibly.

Normal: The part of the brain that keeps people out of trouble – responsible for judgment, insight and impulse control – is still developing in teens, which means they often act and speak without thinking. From missing deadlines, to not studying, to trying a cigarette, your teen won’t be thinking about the consequences, and that’s a very natural (though frustrating) behaviour.

Cause for concern: Seriously reckless behaviours like binge drinking, underage driving, etc. If a person starts taking serious risks that jeopardize their or others’ safety, it’s time for a check-in. This is generally true for any age; the risks could be manifestations of less obvious problems.

All the above causes for concern may not always point to mental health problems; one-off episodes are very different from mental health problems, so think of your teen’s behavior and attitude as a whole. But ultimately, consulting a mental health professional can only be a win-win for you and your child: either you get reassurance that your child is going through a normal phase (and some suggestions on how you both can cope), or your child gets the help he or she needs.


Written By Dr. Pervin Dadachanji

Dr. Pervin Dadachanji is a practicing psychiatrist with a special interest in child and adolescent psychiatry. She completed her MBBS and M.D. (Psychiatry) from Seth G.S. Medical College and K.E.M. Hospital, Mumbai. She has also done a stint in the Child and Adolescent Psychiatry Department at The Royal Free Hospital, London. She has been in private practice since the past 20 years. She conducts parenting workshops for various parent groups, schools and nurseries in Mumbai. She also does workshops for children and adolescents on sexuality and body science. She has written a book called Recipes for Parenting and is consultant psychiatrist at Ummeed, a Child Development Centre in Mumbai.


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