On Your Health

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How Teenagers Ask for Help Without Actually Saying It

Mental health doesn’t discriminate. If you’re a parent, there’s a chance you’ll deal with a child who faces depression. In fact, one in five adolescents will battle with depression during their teen years.

The Centers for Disease Control and Prevention reports 7.4% of children ages 3-17 have a diagnosed behavior problem and 3.2% have diagnosed depression. A lack of neurotransmitters can cause depression in teens. This is an imbalance in the chemical messengers that affect physical and psychological functions. Inherited traits and childhood trauma also play a role.

In Oklahoma, teen depression is prevalent due to adverse childhood experiences. Oklahoma ranked as the worst state in childhood trauma, as a National Survey of Children’s Health found 30.4% of children dealt with two or more adverse childhood experiences (ACE) during their childhood (ages 0-17). Dealing with these experiences heightens your risk in developing a litany of issues, including problems with mental health.

These numbers are important, as awareness is key. If you can recognize your teen is seeking assistance, getting out in front of it and addressing problems head-on can help halt issues before they grow into something bigger. We’ll discuss some of the ways your teen may be asking for help without ever saying it.

Signs and Symptoms to Look For

Your teenage years are difficult. Parents, of all people, know this as they’ve experienced many of the same things in their early years. Teens deal with different types of stressors and phases. Often, it’s hard to differentiate between acute periods of sadness and real issues that need to be addressed.

“For many parents trying to distinguish regular teen behavior from that of a teen who is struggling with mental health issues can be hard,” said Charvee Cotrone, therapist for the intensive outpatient adolescent program at INTEGRIS Decisions.

She said to keep an eye out for changes at school, sleeping patterns, and a general lack of motivation. There are several verbal cues, too. Cotrone said warning signs include giving up on goals, statements about being a burden to others, feelings of hopelessness, talking about suicide or not wanting to exist, or saying they have no reason to live. 

Here is an expanded look at emotional and behavioral signs and symptoms to keep tabs on if you think your teenager may be suffering from depression.

  • Problems at school - Depression can cause fatigue or lack of energy or a lack of enthusiasm and motivation. Either of these may attribute to poor grades and a lack of attendance.
  • Running away - Many times, your teenager may make what seems like a rash decision as a cry for help.
  • Drug and alcohol abuse - If you notice them taking more of an interest than normal in these activities, it may be a sign they are attempting to cope with their struggles.
  • Low self-esteem - Feelings of guilt or shame may arise as your teen struggles with insecurities. 
  • Smartphone addiction - Do you find your teen with their head buried in their phone? This is another way of isolation to cope with depression.
  • Reckless behavior - This ties in with drug and alcohol abuse, as teens may turn to risky behaviors as a way to take their mind off depression.
  • Violence - Teens sometimes use this as another way of acting out as a cry for help.

Additional symptoms

Symptoms can vary from sadness and hopelessness to irritability, anger, or hostility. The latter is what most commonly differentiates teen and adult depression. Instead of constant sadness, they may act out and become hostile, easily frustrated, and demonstrate angry outbursts. 

Additionally, you should look for a lack of interest in activities they love, general lack of enthusiasm and motivation, and changes in eating or sleeping habits. 

“Many symptoms between adults and teens are the same, but it’s important to note that sometimes teens who are depressed identify themselves as being angry, irritable, or having mood swings,” Cotrone said. “Although teens can isolate when depressed, it’s common for them to keep a few close friends they trust or they change friend groups.”

Teenagers Mental Health

Overcoming Mental Health Stigma

Uncovering a mental illness isn’t as simple as diagnosing a broken arm or leg. Layers exist to personalities and tendencies, so some mental health problems are harder to uncover than other common ailments.

It helps to provide an environment free of judgment, and one that is conducive to your teenager feeling comfortable.

“Many teens in my group say that they are afraid to tell their peers about their mental health struggles because they do not want to be labeled as ‘crazy,’” Cotrone said. “I also have had group members say they don’t want to get accused of faking mental health issues in order to get attention and they don’t want to appear ‘weak’ to others. They don’t want to be treated differently or excluded due to their struggles, so they keep these feelings inside.”

Mental health stigma is common, regardless of age or diagnosis. There are social stigmas and self-stigmas. Your teenager may not want to give off the appearance they are weak or vulnerable. Understanding more about mental health can better prepare you for what to look for and how to handle issues should they arise.

This stigma further complicates the problems, as it can lead to even more isolation, decreased self-esteem, and a lack of support. In turn, teenagers are less likely to receive help.

We see this in Oklahoma far too often. The state ranks as the seventh-worst for youth mental health prevalence. This means the state has high rates of mental illness and lower rates of access to care.

How to Communicate with Your Teen

One way of breaking down these barriers is to effectively communicate with your teen.

Be supportive, patient, and encouraging. Don’t ignore any potential red flags. You shouldn’t assume they will snap out of it.

“When communicating concerns, remember the teen is most likely already feeling like a burden, so talk to the teen without placing blame and without overreacting,” Cotrone said. “One of the most important things you can do when talking to your teen is to validate their feelings to help them feel heard.”

It’s important to make them feel at ease. Discuss depression and other mental health issues by treating it like any other ailment. Make them feel comfortable knowing what they are dealing with isn’t abnormal. There are solutions to their issues.

Don’t be afraid to ask tough questions, either. You should approach your teen about any negative feelings they may have, even if it feels uncomfortable asking about suicidal thoughts. There’s a fine line between pushing too hard and being available to prevent issues from escalating. 

“Acknowledging that something is going on is important. Getting help from a professional in the mental health field is the best way to go,” Cotrone said.

For more information about INTEGRIS Health's services for teens, contact our adolescent medicine team and schedule an appointment. We’re here to help you and your teen overcome challenges during this period of life.  


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