Mental health discussions among teens are more common today than ever. Social media, movies, TV series and the news are constantly referencing mental health talking points that can spark discussion. 

While all of this is great for the age of mental health (MH) awareness, many parents can still struggle when recognizing the signs in their teen. Teenagers may also be less likely to talk to their parents about their MH struggles. 

Recognizing some of the red flags of MH problems in your teen can help parents understand traits they may have previously ruled out as “typical teenage behavior”. 

Sleep Problems 

Teens should get 8-10 hours per night. Inability to fall or stay asleep can be a sign of severe stress or underlying mental health condition. A few common signs that your teen could be struggling with sleep disturbances include: 

  • Having trouble waking up 
  • Irritability or aggression
  • Falling asleep during the day
  • Sleeping extremely late on weekends 
  • Trouble focusing or lower academic performance 

Drug and Alcohol Abuse 

A serious sign your teen could be struggling with an MH problem is abuse of drugs & alcohol. Teens may start using drugs to cope. If you notice signs of drug use in your teen you should get them into a rehab program specifically tailored for teens as soon as possible. 

  • Irritability or rapid shifts in mood
  • Bloodshot eyes or dilated pupils
  • Decreased academic performance 
  • Secretive behavior 
  • Sleeping more than usual or staying in bed all day 
  • Decreased motivation  

Poor Academic Performance

Another red flag your teen could be struggling with their mental health is a decrease in school performance. MH problems can make it hard to focus or stay motivated. 

This is especially true if your teen is naturally a straight A student and suddenly starts failing all their classes. Low grades don’t always reflect a lack of effort or how smart your teen is, but can indicate an underlying mental health problem. 

Lack of Self-Care 

Mental health conditions are draining. They can make basic tasks such as brushing your teeth, taking a shower or cleaning your room feel nearly impossible. 

Sometimes our outer world reflects our inner world. If your teen is messy this could be a sign of anxiety, ADHD, depression or a mood disorder. Parents can support their teens by acknowledging and validating their struggles and helping them keep a self-care routine, rather than shaming them for being “dirty” or “lazy”. 

Extreme Mood Swings 

Moodiness is typical for teenagers experiencing heightened hormones. However, if rapid shifts in mood become so severe that they impact daily function, this could be a sign of a more serious problem. 

It can be difficult for parents to recognize the difference between moody teenage behavior and a MH disorder, here are three criteria that can help parents distinguish whether there is an underlying problem.  

  • Intensity: If moods become so intense that your teen loses control and interferes with their everyday life (starting fights in school, arguing with teachers, punching or hitting things)
  • Duration: On-going mood swings that seem to never end could be a sign of a mood disorder or other underlying mental health condition. Keep track of when your teen is experiencing mood swings (is it only now and then? How long do these episodes last?) 
  • Situations: Understanding the situations that cause your teen to be moody can help understand whether there is a problem. Is there a trigger that sets your teen off? Do they only have mood swings with you, or is it happening with friends, teachers, and other people? 

Isolation & Social Withdrawal 

It is normal for teens to want their alone time. But if your teen spends all their time in their room, withdrawing from friends and activities, this could be a sign of a bigger MH problem. 

Sometimes teens may isolate themselves in their rooms to play video games or talk with friends on social media. This isn’t necessarily a sign of a problem, however it is important to know the risks of excessive social media use in teens to prevent problems. 

Low Self-Esteem 

Teens with low-self esteem struggle to see their value and may have feelings of worthlessness. Years of research have shown us self-esteem is the number one predictor of depression in teens.

Low-self esteem is a symptom of not only depression, but several MH problems such as PTSD, personality disorders and mood disorders. 


Self-harm behaviors are a pretty clear sign your teen is struggling with their mental health. This can include more intentional self-harm such as cutting or burning themselves, or participating in reckless behavior with no regard to their safety (drunk driving, speeding, unprotected sex). 

Self-harm can indicate suicidal thoughts or ideation. If you notice your teen is self-harming it is important to seek professional help immediately. 

Excessive Worry 

It’s normal for teens to stress. Pressure from school, family, friends, and the future are common worries that adults experience. However, excessive worrying and tension can indicate the sign of an anxiety disorder. 

If your teen is always worrying about the worst possible outcome or avoiding situations due to fear, this could indicate a bigger underlying problem than typical teen stress.  

Physical Health Problems with No Underlying Cause

The mind and body are connected and influence each other day to day. Many times mental health problems can manifest as physical symptoms.

Of course, rolling out any underlying physical health problems is important. Still, if your teen is constantly struggling from physical health problems with no apparent cause, this could indicate depression, trauma, anxiety or another mental health disorder.  Some common physical symptoms that mental health issues can cause include: 

  • Frequent stomach aches 
  • Headaches
  • Joint and muscle pain

When To Seek Help 

Some of the red flags on this list are normal parts of teenage development. The occasional mood swing or night without sleep is normal. When these behaviors start to impact daily functioning, there could be a problem. 

For behaviors like self-harm or substance abuse, this is a pretty clear sign of an underlying issue and should be addressed right away to prevent serious problems in life, safety or health.

If you notice your teen is struggling with behaviors on this list that are limiting their daily life, parents should seek professional help.