Teenage years can be tricky for adolescents and parents/caregivers! More teens are struggling with mental health concerns like depression, anxiety and suicide since the pandemic. Social media can also have an impact on how a teen feels.

If your child doesn’t receive the support they need, it can complicate the situation and concern and lead to substance use, family struggles, and issues at school.

Help is available in Maryland through your primary care provider, school counselor, telehealth, a 211 teen texting program called MDYoungMinds, and public and private mental health counselors, social workers, psychiatrists, and psychologists.

Sad teen at school with head down

Teen mental health

Research shows that 50% of mental health problems have emerged by age 14. Navigating these concerns as a parent and teen can be difficult. Know that you are not alone, and help is available.

In many kids, the problems go undetected or they don't get help.

Mental health concerns in teens and adolescents can appear in several ways. According to the Mental Health Association of Maryland, parents and caregivers should look for these signs of a mental illness or mental health condition:

  • Difficulty at home, school, or socially. The child may get into fights or do poorly at school.
  • Worries all the time.
  • Noticeable changes to sleep, mood, appetite, or behavior.
  • Patterns of repetitive activity that interfere with attending school, sleep, or appetite.
  • Increased feelings of sadness, anger, stress, worry, low self-esteem, and grief.
  • Doesn't laugh or smile.
  • Frequent tantrums, stomaches or headaches with no known medical cause.
  • Unable to sit still.
  • Doesn't appear to listen to instructions.
  • Acts without thinking.
  • Has behaviors that developmentally should no longer be an issue like clinginess, wetting, or soiling.
  • Has trouble making friends because of aggressive or frightening behavior.
  • Spends more time alone.
  • Avoids activities or things the individual once loved.
  • Harder time in situations that used to be okay.
  • Needs more support.
  • Has sexual behavior that's more than normal curiosity.
  • Plays with fire repeatedly.
  • Cruelty to animals.
  • Hears voices or sees things.
  • Uses drugs or alcohol.

If you have a concern, get help and support. Trust your gut as the parent or caregiver.

Signs of teen depression

Depression is one type of mental health condition. 20% of adolescents aged 12-17 years have experienced a major depressive episode, according to the CDC.

While we often think of depression as having the "blues," that's not always the sign, especially in children, teens/adolescents and young adults.

The signs of depression may change as the individual ages.

For example, some of the symptoms in a child with depression may be anxiety, being cranky, clinky or refusing to go to school.

Older children and teens may get in trouble at school, get frustrated easily, feel restless or have low self-esteem.

Young adults may be irritable and have a negative view of life, among other symptoms.

Depression is more than being moody. When these feelings continue most of the time for weeks and you can't focus or do things you once enjoyed, it's time to get help.

The National Institute of Mental Health suggests asking yourself these questions.

Does my child or do I feel….?

  • Sad, anxious, worthless or “empty”?
  • Uninterested in activities I once enjoyed?
  • Easily frustrated, angry, or irritable?
  • I’m withdrawing from friends and family?
  • That I’m not doing as well in school?
  • My daily eating and sleeping habits changed?
  • Tired, fatigued or have experienced memory loss?
  • Like harming myself or committing suicide?

Your symptoms may vary from a friend or family member’s symptoms. You can have a few symptoms above or just a few.

Social Media Warning Signs

There is a link between depression and perceived isolation and teens with high social media use.

High internet use and internet addiction are also linked with self-harm. Teens who spend three or more hours per day on an electronic device are 35% more likely to have a suicide risk factor like making a plan, according to research published in the Association for Psychological Science.

If you know a teen who talks about harming themselves or others, get help immediately. Call 2-1-1 and Press 1 for immediate crisis support with a trained professional.

Monitor your child’s social media and online activity.

Know the warning signs of psychological distress. These may include messages like:

  • “I can’t do anything.” #hatemsyself
  • “I hate everyone.”
  • Another day not going to school.
  • Negative hashtags and emojis like #depressed and #cutting.
  • Talk of wanting to die, intense and urgent emotional despair, giving away personal items, saying goodbye.
  • Impulsive behavior.
  • Insomnia posts.

If you or someone you know is showing signs of crisis, contact a trained professional immediately through 211, Press 1.

teen on phone looking sad

Suicide prevention among teens

The LIVEFORTHOMAS Foundation also supports teens struggling with mental health and illness. It's a foundation that Amy Ocasio started to honor her son Thomas who died by suicide. The foundation raises awareness and helps prevent suicide among teens and adolescents. She talked with 211 Maryland on "What's the 211?" podcast.

She spoke about the warning signs, including a shift in mood. She thought her son was improving because he was more upbeat after finding out he could graduate early to enlist in the military. Days later, he died by suicide.

That sudden shift in mood is a warning sign that an individual has come to terms with their plan and will follow through.

She talked about the stigma that prevented him from getting treatment and how on the outside he seemed like a happy person. She provides advice for talking to teens about their mental health and getting men to open up about it.

Talking about suicide can prevent it. Learn about the best words to use during these candid conversations.

How Parents and Teens Can Get Help

You know what to do when your child has a fever or ear infection, but what about treating their mental health? You can do the same thing - call your child's pediatrician.

They can help with mental health concerns like teen anxiety, depression, eating disorders, trauma and more.

Have an honest conversation. If the pediatrician doesn't offer in-office support, they can get you and your child support through the statewide mental health support system.

parent comforting depressed kid

Talking to your pediatrician

So, how do you talk to your pediatrician about your child’s mental health? Call and speak with the office and ask them for an in-person or telehealth appointment. Determine who should go to the appointment. Should both parents/caregivers attend, and should the child to go to the appointment?

The Mental Health Association of Maryland and BHIPP have a tipsheet with step by step instructions for talking to your doctor about your child’s mental health including detailed questions and talking points to start the conversation and get your child the help they need.

Before your appointment, document behavior and concerns so you have something to reference during the discussion and specific examples to discuss.

Be honest and detailed in these conversations. Remember, you are not alone and help is available. If the conversation is difficult, let your physician know that. Remember, you’re having that meeting because you care deeply about the child.

Your doctor may refer you to a wide variety of mental health professionals, including:

  • psychiatrist
  • psychiatric nurse
  • social worker
  • licensed professional counselors
  • psychotherapists
  • neuropsychologists

Telehealth support in Maryland

If you have a teen who is struggling with mental health, talk with your child’s school and their pediatrician. Maryland Behavioral Integration in Pediatric Primary Care (BHIPP) works with pediatricians, emergency medical professionals, family physicians, school nurses and other health professionals to support teens and adolescents.

Your doctor can speak with a mental health specialist to help you and your child manage mental health concerns.

Specialists are available in areas such as:

  • Medication management:
  • Diagnostic issues
  • Developmental delays
  • School/learning issues
  • Autism spectrum disorders
  • Trauma
  • Early childhood mental health

Through your physician, a referral can be made to BHIPP TAP. It’s a program providing specific mental health support such as telepsychiatry (consultation, evaluation, medication), telepsychology, and telecounseling (motivational interviewing, cognitive behavioral therapy).

Referrals are made through your primary care physician.

Find local behavioral health resources

If you or someone you know is in crisis, call 2-1-1 and Press 1 for immediate support.

211 Maryland has a comprehensive database of local behavioral health resources. You can search for counseling and support groups.

Organizations like the Maryland Coalition of Families support mental health services for children. They can help you navigate services at school and in the community, and advocate for your child at every stage of development.

You can also download the Children's Health Matters Family Resource Kit in English or Spanish. It's a comprehensive guide to mental health symptoms and signs while also providing treatment options and support in Maryland.

The Mental Health Association of Maryland also has detailed information for specific mental health conditions and resources that can help.

Teens can also connect with peers who’ve experienced a mental health concern or trauma through the Taking Flight program.

MDYoungMinds Text support for teens/adolescents

There is also a youth-focused text message support system available. Teens can sign up for MDYoungMinds. It provides supportive text messages. These may include resources on depression, teen and adolescent mental health and support programs.