Mary Rose O鈥橪eary has shepherded three children into adulthood, and teaches art and music to middle-school students.
Despite her extensive personal and professional experience with teens, the Eagle Rock, Calif., resident admits she鈥檚 often perplexed by their behavior.
鈥淓ven if you have normal kids, you鈥檙e constantly questioning, 鈥業s this normal?鈥欌 says O鈥橪eary, 61.
Teenagers can be volatile and moody. They can test your patience, push your buttons and leave you questioning your sanity 鈥 and theirs.
I鈥檓 not being flip. Mental health challenges are a serious 鈥 and growing 鈥 problem for teenagers: Teen and young-adult suicide has since the 1940s. The rate of 12- to 17-year-olds who struggled with clinical depression increased by 37 percent in a decade, according to a recent .
And schizophrenia and other psychotic disorders often manifest themselves in adolescence.
In fact, half of all mental health conditions emerge by age 14, and three-quarters by 24, says Dr. Steven Adelsheim, director of the , part of the university鈥檚 psychiatry department.
For parents, it鈥檚 often hard to separate the warning signs of mental illness from typically erratic teenage behavior.
When O鈥橪eary鈥檚 son, Isaac, now 23, was a teen, he had two run-ins with police 鈥 once for hosting a wild party while his mom was away, and again when he and a friend climbed up on the roof and challenged each other to shoot BB guns.
O鈥橪eary dismissed those incidents as teenage pranks. But she did start to worry when she was in the midst of divorce proceedings with her then-husband and noticed that Isaac started exhibiting some unusual behavior. He complained of stomachaches and racked up absences from school.
That鈥檚 when she decided it was time for the family to see a therapist. 鈥淚t鈥檚 a question of what鈥檚 normal for my kids,鈥 she explains.
O鈥橪eary is right. Mental health experts say the first step in recognizing possible mental illness in your children is to know their habits and patterns 鈥 to spot when they deviate from them 鈥 and to create an environment in which they feel comfortable talking with you.
Instead of asking your teen to talk, share an activity that will give your child the chance to open up: Cook dinner together, walk the dog, take a drive, says Tara Niendam, an associate professor in psychiatry at the University of California-Davis.
鈥淵ou just want to know how they鈥檙e doing as a person. How are things going at school? How are their friends? How are they sleeping?鈥 she explains.
As part of getting to know your teen, monitor and limit your child鈥檚 social media activity, says Dr. Amy Barnhorst, vice chair for community mental health in the UC-Davis psychiatry department.
鈥淪ocial media gives us this important window into what鈥檚 going on in teenagers鈥 lives,鈥 she says.
Once you know your child鈥檚 baseline, you鈥檒l be more attuned to signs of mental illness: persistent changes in your child鈥檚 everyday life that last more than a week or two.
Be aware of disruptions in sleep, appetite, grades, weight, friendships 鈥 even hygiene.
Maybe your son is spending even more time alone in his room. Perhaps your daughter, who is particular about her appearance, stops wearing makeup and isn鈥檛 showering.
鈥淚t鈥檚 really when you see kids falling off the curve in every sphere of their lives,鈥 Barnhorst says. 鈥淭hey鈥檙e having problems with their academics, problems with their family, problems with their friends, problems with their activities.鈥
Essentially, take note when 鈥渢here鈥檚 a lot of shifting and chaos鈥 in their lives, she adds.
Remember, you鈥檙e looking for changes in many aspects of your child鈥檚 life that last for a few weeks, not the typical 鈥 but temporary 鈥 sadness that comes with a breakup or the unfortunate mouthing off you get when you ask your kid to clean his room.
If your child still has the same friends and is participating in the same activities, unpleasant behavior 鈥渋s not necessarily something to worry about,鈥 Barnhorst says. 鈥淭hat could just be teenagers going through growing pains.鈥
But some behavioral changes could indicate a deeper problem. For instance, teenagers with depression may be more irritable than usual, Adelsheim says. They might snap at friends or even the family dog, he says.
鈥淵oung people will talk about their fuse being shorter than normal,鈥 Adelsheim says. 鈥淭hings that normally wouldn鈥檛 bother them do bother them.鈥
When you become worried that your child鈥檚 behavior may indicate something more serious, offer your child love and support 鈥 and seek help, experts say.
(And avoid phrases like 鈥淲hat鈥檚 wrong with you?鈥 and 鈥淪nap out of it鈥 when talking with your kids, Niendam advises.)
If your child threatens suicide, or you think he鈥檚 in imminent danger, take him to the emergency room.
If there鈥檚 no immediate danger, start with your child鈥檚 pediatrician or primary care physician. In some cases, the pediatrician will be able to address the problem directly 鈥 or may refer you to a mental health specialist.
This is where it could get tricky.
You may face a long wait for a specialist 鈥 especially if you live in a rural area 鈥 and may find that many aren鈥檛 accepting new patients. Barnhorst suggests calling your health insurance plan and asking for a list of in-network therapists, psychologists and psychiatrists. Then hit the phone and hope for the best.
鈥淥ne of the most serious problems we have in this country on the mental health front is the lack of access to care,鈥 says Dr. Victor Schwartz, chief medical officer of , a New York-based organization that works to prevent suicides in teens and young adults. 鈥淲e haven鈥檛 trained enough professionals. They鈥檙e not distributed well enough across the country.鈥
Another option, he says, is to check with nearby universities to see if they have mental health clinics that train students and see patients.
While you鈥檙e seeking medical help, don鈥檛 forget to contact your child鈥檚 school, which may be able to make accommodations such as offering your child extra time for testing, Niendam says.
She also suggests connecting with your local chapter of (namica.org), a grass-roots organization of people whose lives have been affected by serious mental illness.
鈥淚f you鈥檙e struggling, you can meet other parents and ask their advice,鈥 she says.
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