5 Common Mental Health Disorders in Adolescents and Treatments

Five common mental health disorders in adolescents are anxiety disorders, depression, eating disorders, obsessive-compulsive disorder (OCD) and trauma-related conditions such as PTSD. Each can affect school, friendships, sleep and family life, and each is treatable. Treatment usually centers on psychotherapy, with family involvement and, for some teens, medication monitored by a prescriber.

This guide is for parents, caregivers, teachers and coaches of teenagers. It describes the signs of each condition, how it is usually treated, how to start a conversation and when to get help fast. This article is general information, not a medical recommendation. Do not start, stop or change any medication without talking to your prescriber.

Why do mental health disorders often start in adolescence?

Adolescence is a period of fast brain development, new social pressures, academic stress and changing sleep patterns, all of which can bring mental health problems to the surface. The National Institute of Mental Health (NIMH) advises families to seek help when behaviors last weeks or longer and cause distress.

Many conditions first appear or become noticeable in the teen years. Early support usually means less disruption to school and relationships, so it helps to know what to look for.

Mental health disorders in adolescents also tend to overlap. A teen with anxiety may develop low mood, and an eating disorder can occur alongside depression or OCD. That is one reason a full evaluation is more useful than guessing from a list of symptoms. The five conditions below are common, but they are not the only ones; substance use and bipolar disorder can also begin in the teen years.

1. What do anxiety disorders look like in teens?

Anxiety disorders in teens often look like constant worry, avoidance and physical complaints rather than obvious fear. The Centers for Disease Control and Prevention (CDC) lists separation anxiety, phobias, social anxiety, generalized anxiety and panic disorder among anxiety disorders in young people.

• Stomachaches or headaches before school.
• Avoiding presentations, parties or new activities.
• Irritability, anger or trouble sleeping.
• Repeated reassurance-seeking.

Usual treatment: The CDC notes that cognitive behavioral therapy (CBT) is used to treat anxiety in children, and that medication may be considered in consultation with a health care provider. If anxiety is keeping your teen home, see when your teen refuses school.

2. How is depression different from teen moodiness?

Depression differs from moodiness because it lasts longer, shows up most days and affects many areas of life. The American Academy of Pediatrics (AAP) advises talking with your child's doctor if signs such as sad or irritable mood, loss of interest, and changes in sleep or appetite occur every day for more than two weeks.

• Irritability or anger that seems out of character.
• Pulling away from friends and favorite activities.
• Falling grades or trouble concentrating.
• Sleeping much more or much less than usual.
• Statements of hopelessness or worthlessness.

Usual treatment: Psychotherapy, sometimes with medication. The AAP notes that what can look like laziness or irritability may be a symptom of depression. For more, read phase or depression?

3. What are the signs of an eating disorder?

The signs of an eating disorder include intense focus on food, weight or body shape, along with changes in eating behavior. MedlinePlus describes eating disorders as serious mental health disorders that often begin in the teen years or young adulthood, and lists binge-eating disorder, bulimia nervosa and anorexia nervosa as common types.

• Skipping meals, strict food rules or cutting out food groups.
• Eating in secret or large amounts at once.
• Vomiting, laxative use or excessive exercise.
• Rapid weight change or frequent comments about body size.

Usual treatment: MedlinePlus says treatment is individualized and often involves a team, with psychotherapy including family therapy, medical monitoring and nutrition counseling. Some people need hospital or residential care, so prompt evaluation matters.

4. What does OCD look like in adolescents?

OCD in adolescents looks like unwanted, distressing thoughts followed by repeated actions or mental rituals meant to reduce the distress. NIMH describes OCD as a disorder of recurring obsessions and compulsions that can take up more than an hour a day, and notes it often begins in childhood, adolescence or early adulthood.

• Washing, checking, counting or arranging that is hard to stop.
• Needing things to feel "just right."
• Repeated questions seeking reassurance.
• Being late or exhausted because rituals take so long.

Usual treatment: Therapy, often a type of CBT that involves gradually facing fears, sometimes combined with medication. Teens often hide rituals out of embarrassment, so a calm, curious tone helps.

5. How does trauma affect teenagers?

Trauma can affect teenagers' mood, behavior, sleep and relationships, sometimes long after the event. The CDC defines adverse childhood experiences (ACEs) as potentially traumatic events in childhood, such as abuse, neglect or witnessing violence, and notes that toxic stress can make it harder to form healthy, stable relationships.

• Nightmares, trouble sleeping or being easily startled.
• Avoiding reminders, places or people.
• Angry outbursts, risk-taking or withdrawal.
• Feeling numb or detached.

Usual treatment: Trauma-focused psychotherapy, with attention to safety at home and school. Caregivers are often involved in treatment.

What should parents know about medication for teens?

Parents should know that medication can be part of treatment for some teens, but it requires close monitoring and regular follow-up. The U.S. Food and Drug Administration (FDA) has a boxed warning about increased risk of suicidal thinking and behavior in children and adolescents treated with antidepressants, and advises contacting the prescriber about agitation or unusual changes.

Medication decisions for mental health disorders in adolescents are usually made with the teen and parents together, weighing possible benefits against side effects.

Ask the prescriber what to watch for, how often follow-up visits will happen and who to call with concerns. NIMH notes that for children and teens, medication is often combined with psychotherapy.

How can you talk with your teen about mental health? Step by step

You can start a conversation by choosing a calm moment, describing what you have noticed and listening more than you speak. Teens often open up during side-by-side activities, such as driving or cooking, rather than face-to-face talks.

1. Pick the moment. Avoid starting right after a conflict.
2. Describe, don't diagnose. "I've noticed you've been skipping dinner and staying in your room."
3. Ask open questions. "How have things been feeling lately?"
4. Listen without fixing. Let them finish before offering ideas.
5. Validate. "That sounds really hard."
6. Offer next steps. "Would you be willing to talk with your doctor about this?"
7. Follow up. Check in again in a few days.

What should you tell the pediatrician or clinician?

Tell the clinician what changed, when it started and how it affects school, sleep, eating and relationships. NIMH suggests also asking teachers what they have noticed, since school behavior can differ from home.

• "Over the past month, she has stopped seeing friends and sleeps most of the afternoon."
• "He spends over an hour a night checking the locks and his backpack."
• "Her teacher says she has missed several assignments and seems withdrawn."
• "We have a family history of depression."

For help choosing where to start, read pediatrician, therapist or psychiatric evaluation?

When should you get help right away?

Get help right away if your teen talks about suicide, harms themselves, stops eating or drinking, or seems out of touch with reality. These situations need same-day attention. The 988 Suicide & Crisis Lifeline is free, confidential and available 24/7 by call, text or chat, for teens and for parents seeking guidance.

• Statements like "I wish I wasn't here" or giving away belongings.
• Fainting, dizziness or very rapid weight loss.
• Severe agitation, especially after starting a new medication.

The AAP advises storing medicines, alcohol and weapons safely, such as in a lockbox, when a child is struggling. If you are unsure whether a situation is an emergency, it is safer to call and ask than to wait and see.

What should Texas families know?

Texas families often start with their child's pediatrician or school counselor, who can help with referrals. Your health plan's member services line can tell you which outpatient mental health clinicians are in network for your teen. Keep notes on symptoms and dates, since you may be asked the same questions by several offices.

If you use telehealth, the teen generally needs to be in the state where the clinician is licensed during the visit, and rules vary by state. Lyte Psychiatry offers telehealth visits to patients who are physically located in Texas at the time of the visit.

Getting support in Texas

Lyte Psychiatry offers therapy, psychiatric evaluation and medication management in Texas. In-person visits are available at Lyte Psychiatry's clinic in Pantego, in the Dallas–Fort Worth area. All Lyte Psychiatry services are available in Spanish. Availability for adolescents, insurance and clinician fit require confirmation, so contact the practice or visit the therapy page.

For younger children, see common mental health disorders in children.

If you are in a mental-health crisis in the United States, call or text 988. Call 911 for immediate danger.

Educational information, not a diagnosis or individual treatment plan.