It can be difficult sometimes to know how to separate “normal” teenage stuff from something more serious. A question that often comes up.. "Does my teenager need professional help?" It’s not always an easy question to answer, but here are some helpful guidelines..
You should call in reinforcements if there is..
1) Drug and alcohol abuse
A single instance of your kid at a bff's sleepover and finding Mom and Dad’s liquor cabinet, resulting in a headache, nausea and a great deal of regret may not warrant an insta-call to a therapist, however, repetitive use is nothing to mess around with. Smelling alcohol on their breath, slurred speech, glassy eyes, stumbling through the door, etc. are all signs something more serious is going on.
2) Self-harm or self-injury
These are phrases used to describe literal skin cutting with a razor or other sharp object, hair-pulling, excessive skin scratching (picking at wounds,) etc.
These behaviors can—believe it or not—temporarily alleviate anxiety, help someone feel something when they feel emotionally ‘empty’ inside, or express such feelings as anger or rejection when they can’t verbalize them. These self-soothing strategies can actually become more severe over time, so if your teen is self-harming in any way it’s important to address it as soon as possible.
3) Talk of suicide
“I wish I were dead.” “I just want to go to sleep and not wake up in the morning.” These statements might just sound like dramatic grumblings, but they’re nothing to disregard. On the contrary, get curious and take them seriously. Wise words from a professor.. "Ask them.. 'Are you thinking of hurting yourself?' If they're not thinking about suicide, you're not going to give them the idea. If they are thinking about suicide, now you've opened a conversation that might save their life."
4) Explosive anger or fighting at school
Moodiness and irritability are normal. Extreme anger (consistent yelling, punching doors and walls, etc.,) or getting into multiple fights at school are not. As a colleague reminded me, depression in teenagers can look an awful lot like anger. So, that anger is bubbling up from somewhere, and a professional can help figure that out.
5) "I can't get her out of bed" or "I can't get him to go to school"-type depression and anxiety
This category has a special place in my heart--I used to be one of these kids. If your teen is so weighed down with sadness that even getting out of bed is too difficult, it's time to get them some help. As depression's kissing cousin, anxiety can wreak similar havoc, and can be a real battle. No need to try and handle it all on your own. *Important.. Often when we don't understand or have not wrestled, ourselves, with mental illness, it can be easy to guilt or shame the one suffering, even our children. It's important that their struggles are met with kindness and compassion.
A Judgement call...
Adolescence is a difficult transition time for many, but the below list, if excessive can mean something more is going on. This is where the “I know my kid” sort of gut feeling comes into play. Even if you’re wrong—and you may be—initiating a conversation with your teen is never a bad idea. If you broach the topic of counseling and they’re not completely opposed, I’d make an appointment with someone. If they don’t turn you down right away that might be an indication they’re willing to talk to someone which may mean they have something to say they’re not so keen to talk with you about.
- More mood swing-y than normal
- Excessive sleeping
- Losing interest in activities they used to love
- Isolating from friends
- Rapid weight fluctuation up and - or down
Take seriously.. if your teen asks to go to counseling
If your teen hints at or even asks to see a counselor, I would be inclined to oblige them. If you’re not in the heat of a conflict where some drama might be flavoring the moment, I would pay close attention to the request. They may be struggling but a little embarrassed to talk with you about whatever it is. An answer like “Well, honey, I would be happy to ask around for a recommendation, would that be okay? I want you to have all the support you need” shows a) you’re not overreacting to their request, b) you’re not threatened by them asking for someone other than you, and c) that you’re respecting their privacy by getting their permission to ask around. An interaction like that can go a long way in strengthening your relationship and reinforces they can trust you with their thoughts and feelings.
Lastly, something to watch out for...
a teenager who “behaves” and is “good” but has become quite a bit more withdrawn. They may be having a rough time and having difficulty talking about it but their pain doesn’t manifest as “problematic behavior" at home or at school. The danger here is them going unnoticed or ‘unseen’ simply because they’re not being a squeaky wheel.
General guidelines like these are helpful but not perfect, so if you’re still not quite sure, simply ask your teen. Sincere interest and conversation is good, and, if handled well, communicates a) we all have difficulties at times and b) there’s no shame in talking about it or asking for help.
