Normal teenage behaviour vs. early warning signs of mental illness

By Jaimie Byrne

It is not uncommon for parents to wonder whether their child is acting like a normal teenager or behaving differently due to mental illness, drug use or behavioural difficulties. Normal teenagers are often moody due to hormonal and physical changes that happen during puberty. However, when mental illness is involved, it may be difficult to differentiate “normal teenage behaviour” from the symptoms of depression, anxiety and other emotional difficulties.

Teenagers may be short-tempered and get angry easily, especially when they begin to naturally separate from the family and feel they do not have enough distance or privacy. The natural process of separation begins in early adolescence; this is when parents see that their child begins to be embarrassed by them and spends increasing amounts of time with friends and very little time with the family. You may be worried that your teenager spends hours on end on the computer or locked in his or her room chatting on the phone and gets defensive when asked what he or she is doing or who he or she is talking to. This type of behaviour is normal. Teenagers need to naturally separate in order to gain their independence in early adulthood and often react defensively in order to attain this goal. During this time, you should be able to see that even though your teenager may cringe at spending quality time with the family, he or she is still able to enjoy time with friends and engage in healthy social and extracurricular activities outside of the home. If you see that your teen is not engaging in other activities or with friends and is chronically disconnected, angry and sad, this is when the behaviour becomes abnormal and requires intervention. Les

Along with the teenage years comes drama. This is a phase of new experiences, and what may seem like a small affair to an adult may be a big deal for a teenager experiencing it for the first time. Teens may be distraught when they are having difficulty with girlfriends/boyfriends or when fighting with a friend, when they do not do well on a test or even for not having the right thing to wear to school one day. Teenagers are often oversensitive and self-conscious and have not developed adequate coping tools to appropriately deal with events such as these. Therefore you may notice that your teenager experiences episodes of sadness, anxiety, frustration and feelings of being overwhelmed. These episodes should not last more than a few days at most; if these feelings are continual and your teen is chronically anxious or sad, then you should speak to him or her about your concerns and consult your family doctor to see if there may be a more serious problem than normal teenage angst.
It can be difficult to tell the difference between symptoms of mental illness and normal problems that all teenagers experience from time to time. If you begin to worry that your teenager may be suffering in silence or acting in a way that is concerning, but not enough to call the doctor, you may want to talk to other parents or organizations to compare your teen’s behaviour to those of his or her peers.
Often as adults we compare our teen’s behaviour to that of our own at that age. This can be anxiety provoking for many parents due to the changes in today’s social norms. Teens these days are engaging in sex, drugs and alcohol at a much earlier age. Parents often panic when they find out that their 15-year-old is already having sex or has started drinking socially. If all of your teen’s friends, classmates and colleagues are engaging in this behaviour then you have a good sense that although you do not approve or support it, this behaviour is “normal” and there is less of a possibility that mental illness is present. If you find that your son or daughter is out of the norm, then you may have reason for concern and should contact your family doctor. Here are some things that you may observe in your teen that will help to decipher the difference between mental illness and normal teenage behaviour.

Some concerning behaviours
• Decrease in enjoyment and time spent with friends and family
• Significant decrease in school performance
• Strong resistance to attending school or absenteeism
• Problems with memory, attention or concentration
• Big changes in energy levels, eating or sleeping patterns
• Physical symptoms (stomach aches, headaches, backaches)
• Feelings of hopelessness, sadness, anxiety, crying often
• Frequent aggression, disobedience or lashing out verbally
• Excessive neglect of personal appearance or hygiene
• Substance abuse
• Dangerous or illegal thrill-seeking behaviour
• Is overly suspicious of others
• Sees or hears things that others do not

*It’s important to remember that no one sign means that there is a problem. It’s important to examine the: nature, intensity, severity and duration of a problem.
Know who your teenager is
Although your child is growing up and changing rapidly, as his or her parent you are in the best position to know who your child is. You have raised your child with values, beliefs and a set of guidelines to work from; you know when your child is acting out of character and when he or she is having difficulty. Trust your instincts and don’t be afraid to act on them. Even though your teenager may give you attitude when you ask him or her what’s wrong, asking on occasion lets him or her know that you care and that if he or she wants to talk, you are open to it.
Pride and denial can often get in our way of accepting that there is a problem with our child. As parents we have dreams and hopes for our children and we begin to see them come together in the teenage years as the adult personality emerges. Often teens who are intelligent, talented and creative become ill just as they are becoming mature enough to use these skills in a productive way. This can be earth-shattering for parents and makes it very easy to deny that a problem exists. Ignoring the problem does not make it go away and can contrarily make the problem worse. As with any illness, not getting the appropriate treatment prolongs the symptoms, which will likely get worse with time. Being open, honest and non-judgmental with your teenager about his or her difficulties will help you to be more in tune with his or her needs and facilitate a trusting relationship between the two of you.
Talking to your teen about your concerns
If you have major concerns about your teen’s behaviour and moods, it is very important to have a conversation with him or her about it. Try to identify specific concerns, i.e., “I’ve noticed that you haven’t really been going out much lately and you don’t answer the phone when your friends call.” Or “I can’t help but notice that you haven’t been eating much at dinner and your stomach aches have been getting worse.” Your teen will most likely not want to talk about it, but give him or her enough space and time to respond. Let him or her know that you are there to help and that you can work out the difficulties together. Seek help from a family doctor or local CLSC, who can evaluate your child and offer the appropriate services.
It is never easy to start a conversation with someone about mental illness, but the following tips offer a way to lessen tension during the discussion.
• Speak in a calm voice.
• Say what you mean and be prepared to listen.
• Try not to interrupt the other person.
• Avoid sarcasm, whining, threats and yelling.
• Don’t make personal attacks or be demeaning.
• Don’t assume your answer is the only answer.
• Try not to use words such as “always” or “never.”
• Deal with the now, not the past.
• Don’t try to get the last word.
• If things get too heated, take a break and come back to the discussion later.
• Make allowances for the other person.
• Parents: Remember what it was like to be a teen.
• Teen: Remember that parents frequently react strongly because they know the stakes are high.
• Acknowledge that you are in this together.
The teenage years can be the most difficult for a parent. During this time, there are many changes that make it difficult to know how and when to intervene with your teen. It may even be difficult to identify when there is a problem and when your teen is just being a teen. Listen to your instincts and get involved. Ask questions and take action if you feel that your teen is not doing well. Early intervention is the key to success; prolonging the problem may lead to more difficulties.
Resources for parents
• Centre for Addiction and Mental Health: www.camh.net
• The Mood Disorders Society of Canada: www.mooddis orderscanada.ca
• The National Eating Disorder Information Centre: www. nedic.ca
• National Network for Mental Health: www.nnmh.ca
• Schizophrenia Society of Canada: www.schizophrenia.ca
• Statistics Canada: www. statscan.ca

References
Miklowitz, D.J. George, E. (2008) The Bipolar Teen; What You Can Do to Help Your Child and Your Family.
Mondimore, F.M. (2002) Adolescent Depression; A Guide for Parents.
http://www.mental-health-matters.com
http://www.kued.org/productions/voicesofhope/normal.php
www.heretohelp.bc.ca
http://www.cmha.ca