Teenagers deal with a host of unique challenges and threats to their mental well-being that earlier generations did not have to worry about, and it takes a coordinated effort on the part of both parents and teens alike in order to overcome them.

The ramifications for not dealing with a mental illness can be dramatic: the National Institute for Mental Health reports that around half of students with a mental illness over the age of 14 will drop out of school before graduating.

In this guide, we cover the main threats to teens’ mental health and how to address them properly.

Dangers to Teens’ Mental Health

Bullying

Bullying continues to affect the lives of millions of U.S. teens even as recent media and public health campaigns seek to raise awareness of the issue. Alarmingly, stopbullying.gov reports that more than 1 in 4 students in the U.S. claim to have been bullied at school.

Victims of bullying are at risk for developing serious mental health issues--and may even contemplate suicide--so its tantamount that parents identify and address bullying if they suspect their child is a victim. Some of the warning signs for bullying are:

Abrupt changes in sleeping or eating habits.
Slipping grades or school attendance. A child may fake sick or make excuses in order to not make it to school.
Unusual bruises or injuries.
Talk of attempting self-harm.
Coming home with missing possessions, like electronics or jewelry.
Ripped, or damaged clothing.

If you recognize any of these signs in your child or a friend, it’s time to take action.

Bullying doesn’t have to be physical: the most common types are verbal and social bullying, followed by physical bullying and cyberbullying. (stopbullying.gov)
Victims of bullying are 2 to 9 times more likely to contemplate suicide compared to those that haven’t experienced it. (Yale University study)
Female students claim to be bullied at a higher rate than male students (23% vs. 19%) (National Center for Educational Statistics)

Cyberbullying

Cyberbullying--bullying that takes place on smartphones and laptops through text messaging and on social networks--is on the rise: the percentage of students that have experienced cyberbullying nearly doubled in the ten years from 2007-2016, rising from 18% to 34%. The increase correlates with the ubiquity of smartphones and easy access to the internet.

Due it taking place on screens rather than out in the open, cyberbullying can be harder to spot compared to other forms of bullying, but it helps by knowing its common manifestations. Here are some of the frequent varieties of cyberbullying:

Cyberstalking: Often occuring after a nasty breakup, cyberstalking victims receive a barrage of unwanted texts from a former partner, often explicit or sexual in nature, that may include threats of violence.
Harassment: An unrelenting stream of cruel hurtful messages via text or social media.
Denigration: Posting of rumors and gossip with the intent of destroying reputations or relationships.
Outing: The sharing of revealing information or photos on social media or another public forum. Outing often involves photos meant for a former partner, or rumors involving the victim’s sexual orientation.
Impersonation: Posing as another student in order to spread rumors or make them the object of ridicule.

12% of students have cyberbullied another student at one point.
Overweight teens are much more vulnerable to instances of cyberbullying. (Cyberpsychology, Behavior, and Social Networking)
Around 42% of LGBTQ students have been cyberbullied in their lives, which is a higher rate than other students. (GLSEN)

Relationships

While teen romance is often linked with the fondest memories of youth, unhealthy relationships--or the fallout from a bad break up--can lead to serious mental health issues for teens. Adolescents are inexperienced in romantic situations, and often respond poorly to relationship disappointments, impacting their performance at school and behavior at home.

According to a study published in JAMA Pediatrics, relationship issues are the most common reason behind cyberbullying. (JAMA Pediatrics).
Break-ups and post-relationship difficulties have been linked to resultant mental health issues (36.8%), as well as suicide (9.9%), and self-harm (22.6%). (Behavioral Sciences)

A normal level of stress isn’t a bad thing. Unfortunately, modern teens are more stressed than ever, experiencing elevated levels that lead to the development of anxiety disorders. It is unknown why stress levels are so high in today’s adolescents, yet the necessity of juggling school, extracurricular activities, sports, and relationships--with the added pressure of having to curate their social media identity--are likely to blame.

Teens often don’t have the time or tools to manage their stress: the APA reports that 42% of teens claim that they do not know how to manage their stress effectively, while 13% admit to never setting aside time for stress management.

If you think that your child is overstressed, sit them down and talk to them about lightening their activity load and taking time to relax.

Teens report elevated stress levels during the school year relative to vacation periods (5.8 compared to 3.9) that are also higher than adults’ average stress levels (5.1).
In APA’s Stress in America survey, 30 % of teens admit to sad or depressed feelings due to stress while 31% feel overwhelmed by stress.

Family issues and divorce

Not all of the dangers to a teen’s mental health occur at school or on the internet. In fact, adolescents dealing with family issues such as financial concerns or divorce are some of the most likely to develop mental disorders like depression and anxiety, according to numerous studies.

Parents must realize the impact that their own interpersonal conflicts and issues may have on their children. Teens have enough to worry about without having to stay up at night at night worrying about a parental separation or job layoff. Mitigate the fallout from these adult problems and let your kids know that your issues aren’t theirs to worry about.

A 2015 British adolescent mental health services survey concluded family relationship problems to be the number one teen mental health issue.
In an APA survey, family financial concerns (65%) was the third biggest stress factor for teens.
A study published in the Journal of Family Psychology concluded that children of divorced families suffered from significantly higher rates of behavioral problems as compared with children from intact families. (Journal of Family Psychology)

Teen Mental Health Conditions: How to Recognize and Combat Them

Depression

Developing as a result of bullying, stressful relationships, or a genetic tendency towards the illness, depression is a serious, yet all too common disorder plaguing teens. In 2015, the Department of Health and Human Services reported that 3 million American teens had experienced at least one major depressive episode in the preceding year.

Some of the signs your teen may be experiencing a depressive episode are:

Leaving or running away from home for extended periods
Excessive internet or smartphone use
Slipping grades or apathy towards social interaction
Bullying of peers, or other violent behavior
Drug and alcohol abuse, unsafe sex, or other reckless behavior.

If your child or a friend are exhibiting any of these behaviors, opening up a dialogue with them is the best course of action. Teen depression is both underreported, and under treated: around 60% of adolescents suffering from depression do not receive any form of treatment, according to the National Institute of Mental Health.

Teens are often reticent to share their feelings, so patience is key. However, it’s important to be persistent when you confront them, as depression can lead to reckless behavior and serious forms of self-harm.

Of the adolescents with major depressive episode, about 70% were severely impaired.
20 to 50% of teens that had experienced a depressive episode have a family member with depression or related mental health disorder.
The frequency of depression is much more common in adolescent females (19.4%) compared to males (6.4%)

Anxiety

A common result of the stress experienced by teens is anxiety: the National Institute of Mental Health reports that approximately 20% of boys and 30% of girls (6.3 million teens, overall) have suffered from an anxiety disorder. While the condition is not considered as severe as depression, its mental and physical effects can be debilitating.

One way for teens to cope with anxiety is through practicing mindfulness: the use of meditation and other relaxation techniques to mitigate the effects of school-related stress. Many schools and youth organizations now teach students these techniques and they are proven effective. Left Brain Buddha hosts an excellent guide on getting teens started on the path to mindfulness.

The percentage of modern teens and college students experiencing anxiety and related mental health issues is five times that of surveyed teens and college students during the Great Depression. (Jean Twenge, San Diego State University)
Just 20% of youths suffering from an anxiety disorder receive proper treatment. (Child Mind Institute)

Body image issues

The perpetual media barrage of skinny models wearing expensive clothes has a considerable effect on the minds of teens, and girls in particular. An MACMH survey reported that an alarming 53% of 13 year-old girls in the U.S. express dissatisfaction with their bodies, a number that increases to 78% by age 17.

Let your teens know that they should be comfortable in their skin, and to ignore unrealistic media representations. While peer pressure and social media are tough to combat, you support goes a long way.

Over 30% of teen males and 50% of teen females use unhealthy methods like fasting, skipping meals, vomiting, taking laxatives and smoking to control their weight.
56% of teens claim that advertisements are the primary cause of their self-esteem issues.

Eating disorders

Teens especially dissatisfied with their bodies may develop a dangerous eating disorder. If your teen avoids meals, exhibits sudden weight loss, or excessively examines themselves in the mirror, they may be suffering from bulimia or anorexia.

Eating disorders can have serious health consequences. Dealing with them usually necessitates a coordinated approach involving therapy and family involvement, so early intervention is important.

5.4% of American teens aged 13 to 18 (around 2.2 million) will be afflicted with bulimia, binge eating disorder, or anorexia in their lifetime. (National Institute of Mental Health)
70% of those suffering from an eating disorder do not seek treatment.

Substance abuse & addiction

As with other age groups, teens often cope with stress and mental health issues by abusing illegal drugs and alcohol. While illicit drug use is down, overall, in the U.S., it remains a persistent concern.

The National Survey on Drug Use and Health (NSDUH) concluded that approximately 2.5 American teens between the ages 12 and 17 regularly use illicit drugs. (NSDUH)
In positive news, use of illicit drugs other than marijuana dropped to the lowest in two decades among 8th, 10th, and 12th graders according to a 2017 study. (NIH)

A PEW survey reported that 73% American teens own or can gain access to a smartphone. While responsible use of phones and social media is fine and even beneficial to a teen, overuse is linked to depression and unhappiness.

A recent study published in Emotion using data gathered from over a million 8th, 10th, and 12th graders in the United States concluded that teenagers who were physically active, played sports, and were social were happier than those who spent a large amount of time on their phones using social media apps and texting.

Talk to your teens about their smartphone and internet use. Make sure they know the dangers, and limit their use to 1-2 hours a day. We know that teens that spend less time on their phones are happier and healthier, and they will soon find out for themselves.

Teens are the most frequent users of social media platforms. (CDC)
Social media use has correlated with mental health issues such as sleep problems and eating disorders.
A recent study linked smartphone addiction to chemical imbalance in the brains of young people. (EurekAlert!)

Self harm

Teens that cut themselves, or practice some other form of self-harm, are looking for a means to manage their anxiety and emotional pain. While it doesn’t mean that the teen is suicidal, teens that harm themselves are far more likely to attempt suicide, rendering it an issue of the gravest concern.

Considering the severity of self-harm, psychotherapy or even a 30-day inpatient program may be necessary to deal with the problem. As in the case of depression, firmly, yet gently approach your teen and start a dialogue if you witness any evidence that they may be hurting themselves.

Teens that had been treated for forms of self-harm were found to have a 25 times greater likelihood than their peers to commit suicide within the forthcoming year. (Pediatrics)
5% of cyberbullying victims report inflicting self-harm at some point.

Suicide

Suicide is the worst nightmare for the parents of a teen, and sadly, it’s on the rise in America. ANY evidence of suicidal thoughts or tendencies must be handled with utmost urgency. The signs of suicidal ideation are similar to depression, but also include:

Talk of suicide or unusual fascination with death.
Giving away cherished possessions.
Apathy towards activities that they previously enjoyed.
Reckless behavior and unnecessary risks
Marks or scars on the body indicative of self-injury
Calling old friends or estranged relatives out of the blue

If your child or a friend exhibits any of these behaviors, yet you are afraid to approach the situation alone, the National Suicide Prevention Lifeline (800-273-TALK) will help you through the crisis..

Suicide is the third leading cause of death for young people, with about 4,400 deaths per year.
For every teen suicide, there are 100 suicide attempts.
Every 100 minutes a teen dies from suicide.

Tips and Tools for Parents and Teens to Maintain Good Mental Health

Open communication

A common thread running through this guide is that communication with your teen child can help them cope with their mental health issues. Yet, it’s easy said than done. Here are some tips on how to communicate effectively with your teen:

Don’t lecture them. Teens respond negatively to patronizing lectures. Hit your points, but be patient, kind, and avoid coming off like a cop.
Listen. Yes, you are eager to let them know what you think, but listening to what your teen has to say may open your eyes to issues that you haven’t considered.
Let them know beforehand. Ask your kid when they are ready and open for a talk so they can mentally prepare for it and aren’t blindsided by you bringing up weighty issues.
Stay calm. Teens may not respond the way you want them to, but remember to keep your cool and not explode into anger, even if your teen acts dismissive or moody.

Diet and fitness

A healthy and fit teen is most often a happy teen. Unfortunately, most adolescents don’t get the right amount of exercise.

The CDC recommends 60 minutes of physical activity a day, with 3 days of moderate-to-vigorous activity a week for teens. Exercise is a proven way to relieve stress and improve mental health.

More than 80% of adolescents fail to meet national guidelines for physical activity. (HHS)
There’s a 70% chance that overweight adolescents have a 70% will become overweight or obese adults.

Sleep

According to the National Sleep Foundation, teens need at least 8 to 10 hours of sleep a night for proper functioning. Unfortunately, teens may consider that unrealistic in light of their academic and social demands.

However, a good night’s sleep should take priority over almost all else, as the effects of sleep deprivation can be serious, leading to depression, anxiety and reckless behavior.

Let your kid know the benefits of sleep, and the dangers of not getting enough of it. A few consecutive nights of adequate rest may be all the convincing they need to make it a greater priority in their lives.

60 to 70% of American teens live with a borderline to severe sleep debt. (CMI)
Lack of sleep leads to teens to impulse control issues and participation in reckless behavior such as drug use and unprotected sex.

Therapy and medication

When all else fails to help your teen cope with their mental health issues, therapy or counseling is the next logical step. Consult with your pediatrician or general practitioner for help in scheduling an appointment with a therapist.

Sometimes all it takes is someone outside the family and friend circle to talk with about the issues they are facing, while in other cases more intensive psychotherapy or medication prescribed may be necessary.

40.2% of adolescents suffering from serious mental or behavioral issues received non-medication mental health services in a community clinic within the past 6 months. (CDC)
Around 50% teens who take antidepressants see improvement. It may take up to six weeks of taking medication at the appropriate dose to start feeling better.

Mental Health Resources for Teens and their Parents

National Institute of Mental Health: The institute’s website provides facts and information on a large swath of mental health issues.
Teens Health: A friendly, accessible source of doctor-approved information on the many concerns teens face, regarding mental health and otherwise.
American Academy of Child and Adolescent Psychiatry: An excellent site with guides on coping with various mental health issues, educational videos, and a directory of places where teens can seek help for mental issues.
Girls Health.Gov: A government-sponsored website focusing on the specific issues facing young girls and woman, and advice on how they can navigate the traumas and feelings associated with being a teenage girl.

Center for Young Women’s Health and Young Men’s Health

A Guide to Teen Mental Health: Advice for Kids and Parents in the Internet Age