Recognizing Red Flags in Teenage Behavior: A Guide for Parents and Caregivers

Teenagers can be moody. But sometimes these behaviors are more serious. Here's when to intervene if you notice red flag behaviors in your teen, and what to look for.

Medically reviewed by Samantha MannMedically reviewed by Samantha Mann

If your teenager often seems moody and volatile, you might be tempted to dismiss it as normal teenage behavior that will eventually pass. But sometimes the symptoms that most parents and caregivers of teenagers deal with are not just part of the normal changes all young people experience. Sometimes they could represent a more serious change to their behavior and personality.

When it comes to recognizing whether or not your teen’s mental health is suffering, most experts we talked with say that if your gut is telling you something is wrong, then likely something is wrong. And the sooner you address the issue, the better off your teen will be.

This is especially true since 1 in 5 teenagers have an impairing mental health disorder, says Helen Egger, MD, a child psychiatrist and co-founder of Little Otter, a mental health company. “Parents and other adults in the teen's life need to be aware of red flags that may indicate that a child is struggling.”

Here is what you need to know about red flag behaviors in teenagers, including how to recognize them and how to help.

Related: 7 Signs Your Child Should See a Therapist

What Are Red Flag Behaviors?

Red flag behaviors aren’t going to be the same for everyone, but generally speaking they are any observable change in mood or behavior that causes you concern, says Eric Wood, PhD, LPC, director of TCU Counseling and Mental Health.

“I know this is not a scientific answer, but many parents just know if something is off with their teen,” he explains. “What’s off may not be the worst-case scenario, but in my experience, parents—because of their history with the teen—are usually correct.”

To make the process of recognizing red flags easier, he suggests using the acronym BAES, which stands for behaviors, appearance, emotions, and situations.

For instance, changes in behaviors might include isolating oneself from peers, poor academic performance, or overindulging on social media. Other red flags might include changes in appearance can range from a sudden shift in style of dress to failure to maintain hygiene, says Dr. Wood. Changes in emotions might include intense anxious or depressed moods, and changes in situations can include interacting with a new negative social group or experiencing a sudden social rejection from peers, he adds.

Common Red Flags in Teenage Behavior

Identifying red-flag behaviors for mental health disorders in teens is a crucial part of early intervention and support, says Dr. Egger. Too often, parents and other adults dismiss these red flags as typical of the teenage developmental stage.

“While it is typical for teens to have strong emotions, some moodiness, and wish for privacy, it is not typical for these emotions and behaviors to be persistent and to interfere with the teen’s functioning at home or school,” says Dr. Egger.

When looking at potential red flags, keep in mind that you’re looking for a change in your child’s behaviors, emotions, appearance, and situation that lasts more than two weeks, happens nearly every day, occurs during different activities, and is adversely impacting your child’s functioning or the family’s functioning. If a parent notices any of these patterns, then it’s time to consider seeking help from a mental health professional. In the meantime, here is what Dr. Egger says to look for.

• Extreme fatigue: If your teen experiences persistent tiredness that is not alleviated by rest, this may be a sign of an underlying mental health issue like depression or anxiety.

• Sleep disruptions: When your teen has difficulty falling asleep, wakes up at night, cannot sleep in, or experiences day-night reversal where they are up during the night and asleep during the day, this is a red flag. Anxiety disorders, depression, PTSD, and other disorders are all associated with sleep disruption.

• Excessive worry: If your teen is experiencing anxiety and panic attacks or cannot seem to relax, this is a sign of an anxiety disorder that needs to be addressed.

• Persistent sadness: Irritability, hopelessness, loss of interest in previously enjoyed activities, and significant changes in appetite or sleep patterns are possible symptoms of depression that should not be ignored.

• Suicidal thoughts or remarks: Any comments about self-harm, hopelessness about the future, or remarks about wanting to die should be taken seriously and addressed immediately by a mental health professional. That includes when a teen says or writes actual threats, such as “I can't do this anymore,” “I am done,” or “I don't want to live anymore.”

• Appetite changes: Significant weight loss or gain, as well as changes in eating habits, can signal emotional distress and can be associated with depression, anxiety, or a primary eating disorder such as anorexia or bulimia.

• Extreme mood swings: Rapid and intense shifts in mood, such as going from very happy to very sad without an obvious reason, can be a sign of mood disorders.

• Withdrawal from social interactions: Avoiding friends, family, and social activities can be a symptom of depression or social anxiety.

• Difficulty paying attention: Attention difficulties can present as difficulties with school work, procrastination, unfinished tasks like homework or chores, extreme messiness, and commonly losing things or forgetting things. These attention difficulties can be a sign of ADHD, but depression, anxiety disorders, and PTSD can also present with attention difficulties.

• Sudden decline in academic performance: A noticeable drop in grades or a sudden lack of interest in schoolwork can indicate that a teen is struggling with depression, anxiety, or PTSD.

• Excessive screen time: Spending an excessive amount of time on social media or electronic devices, especially when it replaces face-to-face interactions, can be a sign of underlying problems such as anxiety, depression, or internet addiction.

• Changes in appearance: Showering less frequently, changing clothing styles, wearing the same thing over and over, refusing to brush or style their hair, wearing long sleeves or heavy sweatshirts even in hot weather, and other similar behaviors also can be a sign that something is amiss that should be investigated.

"“If any of these behaviors are observed, it is important to communicate with your teen and seek guidance from a mental health professional to provide appropriate support and intervention,” says Dr. Egger."

Helen Egger, MD

How to Spot Red Flag Behaviors in Teens

It can be tricky for parents to know when to be concerned versus what is normal teenage angst, says Susan Tellone, RN, BSN, CSN, MSN, the clinical director of the Society for the Prevention of Teen Suicide.

“My rule of thumb is to give your teen about two weeks,” she says. “Everyone has a bad day or even a bad few days, but if that bad, sad, or low mood lasts for two weeks or more, parents, guardians, and caregivers should engage in a conversation with their teen about what they are experiencing. I often compare it to a physical health concern. If your child was in physical pain for two weeks, most people would bring the child to a doctor. It should be the same with mental health.”

Related: Teens Are in a Mental Health Crisis—Here's How Parents Can Help

Keep lines of communication open

Another way to spot red flag symptoms is to keep the lines of communication open. In fact, the lack of healthy communication can often exacerbate problems or cause feelings of isolation or loneliness.

Addressing any issues early also is key because it helps you and your teen identify thoughts and behaviors before they become entrenched. It also can help keep mental health issues from becoming more severe or persisting into adulthood—especially when they get the help they need.

“If your child is not receptive to discussing what they are experiencing with you, encouraging them to talk to someone about it is a great alternative,” says Tellone.

“Parents should always reach out to a medical professional or use the 988 national hotline if the situation reaches a point where they are concerned about the safety or life of their child.”

Susan Tellone, RN, BSN, CSN, MSN

At the end of the day, the important action to take is nudging your child to open up and discuss their emotions with people who they feel can best support them, she adds. It also can be helpful to tell them why you are checking in with them and discuss the behaviors you are observing.

“When you do this, you are explaining why you have become worried enough to ask these questions and begin an open and honest conversation,” says Tellone. “Talking to your child about how they are feeling can be difficult, but these red flag behaviors should not be ignored.”

Watch for secrecy

Another way to spot red flags is to trust your intuition, says Dr. Wood. Also, be on alert if your teen suddenly behaves secretively or avoids you in some way. In fact, some research studies have found that depression can lead to secrecy.

“There is a big distinction between privacy and secrecy, though,” explains Dr. Wood. “Parents should decide how much privacy they give a teen, but when a teen absolutely refuses to share something with a parent, that is usually a red flag in my experience.”

“It’s impossible to monitor everything that a teen is doing,” he continues. “However, if parents feel like they have to monitor everything, then this is a red flag.”

Note changes in baseline behaviors

If your teen usually behaves one way—for instance always showers in the morning—and then seemingly out of nowhere starts behaving in the opposite way—stops showering altogether—that could be a red flag.

This might also look like withdrawal from friends, isolating in their room, opting out of social situations that they have enjoyed in the past, changes in sleep or eating habits, or even a sudden change in mood improvement for the better, explains Tellone.

Although you might have trouble keeping up, try to pay attention to your teen’s academic and social life. Teens experiencing stressful situations, like an embarrassing situation at school, getting into trouble with a teacher, or feeling rejected by friends, may lead to mental health concerns.

“Pay attention if they have overwhelming emotional pain or distress, frequent visits to the school nurse, unusual patterns of tardiness, absences from school, irritability, and loss of interest in activities,” Tellone adds.

Even physical pain can be a sign that something is wrong. In fact, complaining of physical aches or pains, having headaches, experiencing stomach cramps, or having digestive problems without a clear reason—and that doesn’t go away with treatment—could be a sign of a mental health condition.

Another tell-tale red flag behavior is when a teen says or writes actual threats, such as “I can't do this anymore,” “I am done,” or “I don't want to live anymore.”

Related: Frequent Moves During Childhood Increases Risk of Depression, Study Finds–Here's What Parents Can Do

What to Do if You Notice Red Flags

If you notice that your teen is displaying red flag behaviors, start by talking to them about their mental health in a way that avoids making them feel judged.

“It is so helpful to give your child space to talk and validate their feelings, even if we don't fully understand them,” says Tellone. “Take a moment to try and understand their perspective. Listen without judgment and try to refrain from giving advice or trying to fix it. It is important for children to believe that—with our support—they themselves can begin to problem solve.”

“[And] if others such as teachers, coaches, peers, or siblings are raising concerns about your child’s emotions or behavior,” she adds, “take these concerns seriously.”

Here are more strategies for addressing mental health red flags with your teen.

• Seize the moment: When your teen provides an opening to talk, seize that moment and follow your child’s lead, Tellone says. “If you are being invited to talk with your teen, take it!” Give your teen your full attention, and listen without interrupting, she adds. “Show that you are genuinely interested in what they have to say.”

• Choose the right time and place: Find a quiet, private, and comfortable setting to have the conversation, Dr. Egger says. “Ensure there are no distractions and that both you and your teen have enough time to talk. Sometimes teens are more open when you talk with them side-by-side while doing an activity together like cooking or playing a game rather than face-to-face.”

• Be open and honest: Dr. Egger suggests approaching the conversation with sincerity and honesty. “Let your teen know that you are concerned because you care about their well-being. Use ‘I’ Statements and frame your observations in a way that focuses on your own feelings and concerns rather than accusing or blaming. For example, say ‘I’ve noticed you’ve seemed really sad lately, and I’m worried about you’ instead of ‘You’ve been so moody and difficult.’”

• Validate their feelings: At the same time,“Let them know that it’s OK to feel the way they do and that their feelings are valid,” he adds. Another way to validate your teen is to emphasize that mental health is an important aspect of overall health and that it’s normal (not shameful) to talk about it.

• Ask open-ended questions: Encourage your teen to share their thoughts and feelings by asking open-ended questions that require more than a yes or no answer, says Dr. Egger. “For example, ‘Can you tell me more about what’s been going on?’ or ‘How have you been feeling lately?’”

• Offer support: Let your teen know that you are there for them and willing to help, Tellone says. Discuss potential solutions or resources together, such as talking to a school counselor or seeing a mental health professional. This step is especially important because one study found that nearly 50% of kids with a mental health disorder did not receive treatment or counseling from a mental health professional.

• Follow-up: Continue to check in with your teen regularly. Let them know that your support is ongoing and that you are always available to talk.
  

""Each red flag is a green light to say something,” says Dr. Wood. “The earlier you say something the better. Some parents worry about ‘making a big deal out of nothing.’ However, it’s not weird to check in with your teen, even if everything is OK. If the red flags continue to pile up, then intervene. Use all the resources that you have, including other family members, your church, counseling, their teachers, and their peers.”"

Eric Wood, PhD, LPC

For more Parents news, make sure to sign up for our newsletter!

Read the original article on Parents.