Your teen or ‘tween seems grumpier or moodier than usual. Is it just a normal adolescent phase, or do you need to be concerned? “Everyone has ups and downs and it’s normal for a child or teen to be upset about doing poorly on a test or not making a team or not getting the date he had hoped for,” says Lloyd Sederer, MD, medical director of New York State’s Office of Mental Health. “But if you see changes in your child that are really different from how he has always been—a good student is suddenly a poor student, or a very social kid is avoiding her friends and spending all her time alone—and if those changes last for at least two weeks there may be something more going on than just normal ups and downs.”
In his comprehensive, reader-friendly new book, The Family Guide to Mental Health Care, Dr. Sederer provides everything a parent needs to know about how to recognize if a child or other family member is having mental health issues. That includes where to go for help, and what to expect in terms of having a loved one evaluated, diagnosed, and treated for specific conditions such as teenage depression.
The first piece of advice: Jot it down. “If you are concerned about your child’s behavior, keep a log for a few weeks about unusual things you see your child doing,” says Sederer. “Our memories can be a little faulty and on top of that it’s hard to acknowledge that something is seriously the matter; often we try to minimize things. By jotting down notes about your child’s behavior over the course of a few weeks you see, ‘Boy, I’m not exaggerating here, and it’s not going away.’ A log can give you confidence in what you’re seeing, and becomes an excellent starting point and reference when you seek help from a mental health professional for your child or teen.”
What should you be noting? Write down if you see any of the following changes in your child or teen, particularly if the changes are not preceded by a serious physical illness or a major trauma such as the loss of a loved one, a natural disaster, or other significant problem. If any of these changes last two weeks or more, seek professional help:
Changes in eating patterns
Eating significantly more or less, eating odd foods, secretive eating or refusing to eat with others. A change in body weight may or may not occur.
Changes in sleeping habits
Sleeping more or less during the day or night, or difficulty falling or staying asleep
Changes in hygiene
Less frequent bathing or showering; wearing dirty, disheveled clothes or wearing the same clothes for many days; dirty, un brushed hair; an unusually messy bedroom
Change in activity
A sudden, even explosive increase in physical movement and activities—or the opposite, a significant reduction in physical movements and activities that makes your child look weighed down and slow
Changes in behavior
Any behavior that is markedly different from the norm for your child. Possibilities: Isolating himself at home or in his room; appearing highly preoccupied; talking to himself; exhibiting strange new behaviors like wearing layers of clothing on hot days or obsessively locking doors.
Changes in socializing
Not wanting to spend time with family and/or friends; not answering calls or text messages; not wanting to attend activities such as nights out with friends or team practices or events
Changes in mood
Seeming unusually sad or tearful; lack of interest in once pleasurable activities; excessively worried or anxious; irritable or quick to argue; unusually excited about things—everything seems overly important for a brief time, then another matter takes over
Changes in thinking
Talking seems sped up or slowed down; indecisiveness about even simple things; guilty feelings out of proportion to any event; thoughts or comments that don’t make sense, seemingly disjointed or confused; speaking or reacting in other ways to nonexistent things, such as staring at a blank corner of the room.
Substance use or abuse
Smoking cigarettes or marijuana, drinking, using street drugs
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