Understanding Child & Teen Mental Health: What Every Adult Should Know

Understanding the Full Picture of Mental Health in Children and Teens

When children and teenagers are mentally healthy, they function well at home and school, and in society. However, when health care professionals, parents, and teachers discuss mental health in children, they are often talking about those experiencing mental health disorders.

It’s important to identify the characteristics of a mentally healthy child or adolescent. By understanding what a mentally healthy child looks like, we can learn to identify symptoms of disorders and recognize health care problems that need to be addressed.

Learning

Children and teenagers who are mentally healthy are strong learners. This includes learning in the classroom, but also learning how to function socially.

Children who feel well-adjusted with regards to schoolwork, extracurricular activities, and chores at home are likely to experience healthy development as they grow up. Furthermore, teens who have jobs should be able to function appropriately at work as well.

Expressing Emotions

Kids and teens who are mentally healthy should also be able to feel, manage, and express a wide range of both positive and negative emotions. It should be relatively easy to tell when mentally healthy children are happy or sad.

Furthermore, children and teenagers who are mentally healthy should be able to talk about these topics. While it is normal for children and teens to have some degree of privacy, they should also be able to open up.

Relationships

Young people should be able to form and maintain positive relationships with others. This includes not only their peers, but also their siblings, parents, and teachers. If there are pets in the home, then they should have positive relationships with non-human members of the family as well.

Coping Mechanisms

Children and adolescents should be able to cope with and manage fluctuating circumstances. Even though it is normal for kids and teens to express some degree of uncertainty when it comes to changes in their schedules or routines, they should be able to adapt with the help of others. When children and teenagers have strong coping mechanisms, this is an indicator of good mental health.

Defining Common Mental Health Disorders

Now that we understand what some signs of positive mental health are, it is time to take a closer look at some of the common mental health disorders affecting children and teenagers.

Anxiety Disorders

Anxiety disorders can impact children at any age and at any time. Overall, anxiety disorders involve persistent and excessive fears, worries, or concerns. Some of the most common types of anxiety disorders include generalized anxiety disorder, social anxiety disorder, and phobias.

Attention Deficit/Hyperactivity Disorder (ADHD)

Children with ADHD often have trouble with both attention and hyperactivity, as the name of the disorder indicates. Some children have more difficulty with attention while other children have a harder time with hyperactivity. Most of the children with ADHD have symptoms that fall in both categories.

Children commonly develop this disorder around the age of six—most diagnoses are made between the ages of six and twelve. Furthermore, symptoms of this disorder must be present in multiple settings, such as school, sports, extracurriculars, and home.

Autism Spectrum Disorder (ASD)

Autism spectrum disorder presents with a wide range of severity—not every person with ASD experiences the condition the same way. Some children with autism might have mild symptoms that only impact them in certain social situations. On the other hand, children with autism might also have a disorder that is so severe that they can never live independently. For this reason, early diagnosis and treatment of autism is incredibly important.

Eating Disorders

Eating disorders often present in teen years and are more common in girls than boys. Eating disorders are often underdiagnosed or overlooked in males, which may contribute to an imbalance in diagnosis rates.

Some of the most common eating disorders include bulimia, anorexia nervosa, and binge eating disorder. Adolescents may become fixated on attaining an unrealistic body type, trying to control part of their life when other things are in flux, or use eating habits as a coping mechanism for another mental health condition.

Mood Disorders

Mood disorders are common in children and adolescents, including depression and bipolar disorder.

When a child has depression, they usually have feelings of persistent sadness, a loss of interest in activities that used to bring them joy, and an inability to function well at school or interact with their peers.

Another common type of mood disorder is bipolar disorder. Bipolar disorder may present as shifts between moods, including mania (periods of euphoria) and depression (periods of sadness).

Personality Disorders

Borderline personality disorder (BPD) is often marked by intense emotional instability. People with BPD are often “on edge,” have confusion over their sense of self, are impulsive, or have intense fear of abandonment.

Signs and Symptoms of Mental Health Disorders in Young People

When talking about common signs and symptoms that might indicate mental health issues in children, it is helpful to know that a child or teen might present with only one or two of these symptoms—others might present with many of them. Caregivers need to remain vigilant when they see behaviors that may be concerning.

Depression

Depression in children can present in many ways. Common signs and symptoms of depression may include:

• Trouble with sleep, either sleeping too much or not at all
• A loss of interest in activities that used to bring pleasure and joy
• Excessive feelings of guilt regarding situations that are not the fault of the child
• A generalized loss of energy
• Trouble concentrating, either at home or at school
• Changes in appetite, either eating too much or not at all
• Feelings of agitation regarding situations that should not bring any sense of anxiety

Anxiety

Anxiety in children can present in multiple ways depending on the exact anxiety disorder.

One of the most serious issues regarding anxiety is panic attacks. If you can identify a panic attack quickly, it can be de-escalated quickly and cause less distress for the child. Some of the most common symptoms of panic attacks include:

• A sharp, stabbing pain that is usually present in the middle of the chest
• An attack that arises suddenly in situations of extreme stress
• A heart rate that rises rapidly
• Feelings of shortness of breath or a feeling that someone cannot catch their breath
• Excessive sweating and shaking
• Feelings of tingling in the hands

Bipolar Disorder

While bipolar disorder is not as common as some of the other disorders on this list, it can be incredibly intense for both children and the adults. Children with bipolar disorder experience fluctuations in their mood, alternating between periods of mania and periods of depression.

Some of the most common symptoms of mania include:

• Extremely high levels of energy
• A perceived lack of need for sleep
• Speaking loudly and quickly
• Grandiose ideas and delusions
• Engaging in incredibly risky behaviors, such as unprotected sex or spending a tremendous amount of money

Eating Disorders

There are numerous eating disorders that children might develop.

Some of the most common signs of anorexia include rapid weight loss, eating small meals, a refusal to eat at certain times, unhealthy levels of exercise, and hair loss.

Some children may intentionally throw up or take laxatives to avoid calories, often being diagnosed with bulimia. Some additional signs of bulimia include damaged fingernails and poor dental hygiene.

Binge eating disorder is another common eating disorder that may result in weight gain from excessive overeating. Children may eat even when they’re full, not hungry, or even uncomfortably full. They may also eat a large amount of food over a small period, like a couple of hours. Unlike bulimia, binge eating doesn’t try to offset the number of calories taken in through vomiting, excess exercise, or taking laxatives.

Avoidant/restrictive food intake disorder (ARFID) can involve a significant amount of weight loss, but the child who experiences it doesn’t want to lose the weight. The weight loss happens usually because of another challenge connected to eating or food—often due to fear, anxiety, or OCD, etc. This disorder gets in the way of a child’s everyday life, such as eating meals with their family, eating lunch at school, and attending extracurricular activities.

Eating disorders need to be treated quickly because they can lead to physical health issues such as heart problems and other types of organ damage.

Many kids with eating disorders may deny that they are trying to lose weight. Without additional information—such as weight gain or loss tracked over doctor’s appointments—it can be hard to make a diagnosis. Annual check-ups with a pediatrician can provide a full picture of weight changes and can help assess if an eating disorder is present.

What To Do If a Child Needs Help

If you’re concerned that someone you know or care for needs help, don’t delay in reaching out to a licensed health care provider. Too often, people wait too long to get help. Intervening early can lead to better health outcomes for children and their families.

A primary care provider, such as a pediatrician, is a great starting point for seeking mental health help, as they may be able to help with testing, evaluation, or treatment. They’ll be able to ask questions about behaviors, provide resources to help, and make referrals to specialized providers, if needed.

If you’re concerned about behaviors occurring outside of the home, talking to teachers, school counselors, or coaches is another option. They’ll be able to share anything they’ve noticed that may be cause for concern.

If there is an emergency, you should immediately call 911 or go to the nearest emergency room.

If a child or teen is showing signs of self-harm or suicidal behaviors, you can also call 988 or 1.800.273.TALK (8255) to reach a 24-hour crisis center or text MHA to 741741 to receive guidance on what to do.

Students and Suicide: What Parents Can Do

Most high school and college students struggle while trying to succeed in the classroom, fit in with their peers, and cope with all the highs and lows of growing up.

Those stressors often lead to depression and anxiety. Unfortunately, those same stressors can lead to thoughts of suicide.

Some parents are unaware of the signs that their kids are struggling. Other parents may also be in denial, refusing to believe their children are experiencing anything other than the normal ups and downs of young adulthood.

Know the Signs and What To Do

Parents need to be aware of the stressors that may put their children at risk.

For example, young adults with previously diagnosed mental health conditions are more likely to consider suicidal thoughts or behaviors. Children with a history of trauma, those who have had a family member attempt or die by suicide, LGBTQ kids, and members of minority groups are also more vulnerable.

In interacting with their kids, parents need to become more engaged and aware. Listen more than talk—and take your child’s words seriously.

A young adult who says they feel trapped or “can’t go on this way” may mean exactly what they say. Do not ignore these words. Instead, express your concern and emphasize your willingness to help. Tell your child that, together, you can address these problems and move forward.

Also, if you find out your child is looking for information on how to take their own life or seeking to obtain a gun, take steps to ensure safety. Hide or remove any weapons you might have and lock up dangerous medications. If you find yourself in this situation, please contact a mental health professional immediately.

If your child appears increasingly anxious, depressed, or hopeless, don’t wait to seek help. Early awareness and treatment is crucial for the mental well-being of kids and teens.

The Reality Behind Teens and Suicide

Suicide is the second-leading cause of death for individuals between the ages of 15 and 24, with young adults having the highest occurrence of serious suicidal thoughts and suicide attempts amongst all age groups.

A 2019 CDC report found high rates of suicide and suicidal ideation among high-schoolers, with nearly 9% of all students claiming they have attempted suicide.

“Clinically, we have seen an increase in young adults presenting with first-time suicidal attempts, depression with suicidal ideations, increased anxiety, and increase in substance use,” according to Omotola T’Sarumi, MD, a psychiatrist at McLean.

Unfortunately, the pressures of being a young adult do not go away during the college years. A 2018 study by Harvard Medical School researchers found high rates of mental health disorders and thoughts of suicide among the more than 67,000 students attending more than 100 colleges.

More than 20% of respondents said that they had experienced situations that increased their stress levels, leading to a range of mental health issues, including suicide attempts and self-harm.

Importance of Early Intervention

Did you know that 50% of all lifetime cases of mental health disorders begin by age 14?

Statistics like this make clinicians, like Dana B. Sarvey, MD, want to spend every possible minute educating parents, pediatricians, and other adults who care for children about the importance of mental health and early intervention.

Identifying mental health conditions early changes treatment outcomes—the earlier you treat, the greater the impact can be.

Studies show that early diagnoses and interventions improve immediate outcomes. They also improve lifelong prospects for individuals with a range of mental health conditions.

“We know that more than half of all adults with a psychiatric disorder began to show signs of the condition while they were teenagers,” Sarvey states. “We also know that how severe a condition becomes is often related to how early we see these signs.”

The Developing Brain

The brain’s ability to be flexible—particularly the adolescent brain—is a key reason why early intervention is important and effective.

Adolescence is an important window of opportunity for intervention, and early experiences can influence future outcomes. Although brain development is often thought of as something that happens when children are very young, neurons replicate rapidly before birth, and that extends into early childhood.

But the ‘pruning’ process—or the paring down of certain pathways and the reinforcement of others to accelerate nerve transmission—seems to play a major role in brain development during adolescence.

Sarvey explains that through childhood, the brain develops “in a predictable pattern from back to front.” This process has consequences when it comes to emotional and cognitive development.

The brain development process does not end until the age of 25. Two key areas of the brain that are critical to understanding teen behavior are:

• The limbic area, which consists of a set of structures in the midbrain and develops years before the frontal lobe. The limbic area regulates emotion and provides a feedback system for reward and motivation. It also helps process social interactions and forms memories.
• The frontal lobe is the part of the brain that is most associated with organizing, planning, and judgment. Since this area is the last to develop, it is most susceptible to being influenced by environment and experience and less by genetics.

“There is a great deal of emotion-driven decision-making during adolescence,” says Sarvey. “Think gas—without much in the way of brakes!”

In other words, a lot is going on in every teen’s brain.

Understanding these stages of brain development can have a major impact on how individuals respond to the symptoms of mental health disorders. Adolescence is when certain conditions can impact the brain in a permanent way.

For example, substance use during adolescence can negatively affect the creation of essential pathways in the brain and can lead to abnormal reward responses. If the creation of these neural pathways goes awry, psychosis could be the result.

When Does a Young Person Need To Seek Care?

Mental health concerns can arise at any age, and kids benefit from support as soon as symptoms appear. But how can parents, educators, and clinicians know when it’s time to seek help?

Some ups and downs are normal. Young children may have tantrums or separation anxiety, while teens often show moodiness or test limits. These behaviors are expected.

Warning signs appear when struggles are persistent or disrupt daily life. A child might withdraw from friends or lose interest in play, while a teen may show ongoing sadness, irritability, or changes in school performance or attendance. When symptoms consistently affect functioning, it’s time to seek professional support.

Connecting Kids and Teens to Care

The good news: treatment works. Children and teens are often receptive to help and can make progress quickly, especially when care starts early.

Yet many young people don’t get the treatment they need. One in five adolescents has a diagnosable condition, but fewer than one-third receive care. Expanding outreach among families, schools, pediatricians, and community groups can make screening and referrals more accessible.

Awareness efforts like McLean’s Deconstructing Stigma campaign also help reduce misconceptions, while families can turn to resources from the National Institute of Mental Health and the American Academy of Child and Adolescent Psychiatry for support.

While adolescence is a key time for intervention, treatment at any age can make a difference. Brain development continues into adulthood, and support at any stage can promote healthier outcomes.

Mental Health Conditions Are More Common Than You Realize

To help break some stigma regarding mental health, it’s helpful to look at some of the statistics surrounding them. Once parents, teachers, and children realize how common mental health disorders are, it is easier for everyone to be candid about issues that may be impacting them in their lives—and if someone is experiencing symptoms, they can get the help they deserve.

Some important statistics from the CDC include:

• Behavior disorders in children most commonly present between the ages of 6 and 11
• Just over 11% of children struggle with ADHD
• Approximately 11% of children struggle with anxiety disorders
• Approximately 4% of children struggle with depression
• Depression and anxiety both get more common as children get older

What Causes Mental Health Conditions in Children?

There is no singular cause of any single mental health condition in children, so it is helpful to learn about some common risk factors that might make it more likely for a child to develop a mental health condition. By understanding risk factors, it is easier to identify children and teenagers who might be at risk.

Common risk factors include:

• Kids with a family history of depression, such as parents who struggle with mental health disorders
• Kids who have low self-esteem or have negative self-image
• Kids with a history of child abuse
• Children with poor social skills or communication problems
• Children who have experimented with drugs and tobacco products
• Kids with a history of a traumatic brain injury (TBI)
• Children who undergo puberty at an earlier age
• Kids from a single-parent family or who have been through a parental divorce
• Children who live in a household where parents use drugs or tobacco products

Diagnosing Mental Health Conditions in Children

Health care professionals make a diagnosis based on the symptoms of the patient, diagnostic criteria or screening tests, and patient and family history.

For example, ADHD may be diagnosed using a Vanderbilt screening test. This is a form that is filled out by parents and teachers before being scored by a pediatrician or other licensed health care professional. In some cases, a trained child psychiatrist might also use the Vanderbilt form.

When it comes to eating disorders, though, there are lab tests and objective measurements that can be helpful. For example, rapid weight loss is a common symptom. A doctor may run labs to examine the patient’s electrolyte and nutrient levels to make sure there is nothing that needs to be urgently addressed.

Childhood Mental Disorders Can Be Treated

Children and adolescents with mental health concerns have many paths to support and recovery. With timely care and the right guidance, young people can develop skills to manage their symptoms and thrive—there is always reason for hope.

Understanding Treatment Options

Therapies like cognitive behavioral therapy (CBT) are specifically designed for young people. CBT helps children and teens shift from emotion-driven reactions to more thoughtful responses, teaching strategies to manage feelings and change behavior. Research shows that CBT can be as effective as medication alone for treating depression or anxiety in adolescents.

In some cases, combining therapy with medication is most effective. Common medications, such as selective serotonin reuptake inhibitors (SSRIs), can help normalize brain signaling and improve emotional processing. Studies suggest these medications may even support positive brain development.

Early intervention matters. The sooner a mental health condition is addressed, the better the outcomes. Each child’s treatment is tailored to their needs, and plans are adjusted as progress is monitored. Collaboration between young people, families, and health care providers ensures a comprehensive approach.

With consistent care, children and teens can build resilience, learn coping strategies, and flourish.

Moving Forward With Hope

No matter the challenges, treatment offers a path forward. Children and teens can overcome difficulties, strengthen their emotional skills, and grow into capable, confident individuals. Families and caregivers play a vital role, supporting young people as they navigate treatment and build resilience.

Every step taken toward care—big or small—helps open the door to a brighter, healthier future.

Contributors

Dana B. Sarvey, MD