It starts, as it often does, with something small. Your daughter seems quieter at dinner. Your son stops mentioning the friend he used to text constantly. The grades slip a little, or a lot. Sleep schedules become erratic in ways that feel different from typical teenage chaos. You find yourself standing in the hallway outside their bedroom door, wondering: Is this just adolescence, or is this something else?
For millions of American parents, this question has become both more urgent and more confounding. The statistics are stark and by now familiar: according to the CDC's most recent Youth Risk Behavior Survey, forty percent of high school students report persistent feelings of sadness or hopelessness—a figure that, while slightly improved from the pandemic peak of forty-two percent in 2021, still represents a ten-percentage-point increase from a decade ago. One in five high schoolers has seriously considered suicide. Diagnoses of anxiety among adolescents have risen sixty-one percent since 2016. These numbers describe what public health officials now routinely call a crisis, but they don't tell you what to do when your own teenager won't make eye contact at breakfast.
The challenge for parents isn't just recognizing that something might be wrong—it's distinguishing between the normal turbulence of growing up and the clinical symptoms that require intervention. Adolescence has always been difficult. Teenagers have always been moody, withdrawn, occasionally impossible. But the landscape has shifted in ways that make the old intuitions less reliable. How do you know when your child needs more than time and patience? And once you know, where do you turn?
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The distinction between normal teenage stress and clinical mental health concerns isn't always obvious, even to experts. Dr. Kathleen Ethier, director of the CDC's Division of Adolescent and School Health, notes that adolescence is inherently a time of emotional volatility. Hormonal changes, shifting social dynamics, the pressure to perform academically and establish identity—these create genuine stress. Some anxiety before a big test or sadness after a breakup is appropriate, even healthy.
What matters, clinicians say, is persistence, intensity, and interference with daily life. A teenager who seems withdrawn for a few days after a disappointment is processing normal emotions. A teenager who has been withdrawn for two weeks or more, who has stopped engaging with activities they once enjoyed, who can't concentrate on schoolwork or seems unable to experience pleasure—that's a different picture. "We tell parents to watch for changes that last," says Dr. Yesenia Marroquin, a clinical psychologist at Children's Hospital of Philadelphia. "If your child's behavior shifts dramatically and stays shifted for weeks, that warrants attention."
The specific warning signs vary somewhat between anxiety and depression, though the two frequently overlap. Depression in teenagers often presents differently than in adults—irritability and anger can be more prominent than sadness. A teenager might seem constantly frustrated, snapping at family members over minor provocations, unable to tolerate even small stressors. They might sleep excessively or not at all, lose or gain weight rapidly, complain of unexplained headaches or stomach problems. Their grades might plummet. They might seem physically slowed down or, conversely, agitated and restless.
Anxiety tends to show up as excessive worry about everyday situations, difficulty concentrating, muscle tension, and avoidance behaviors. A teenager with social anxiety might stop wanting to go to school or refuse to attend events they previously enjoyed. They might seek constant reassurance about things that don't seem worth worrying about. Physical symptoms—racing heart, sweating, trembling—often accompany moments of acute anxiety. Panic attacks, while frightening for both teenagers and parents, can be an indication that anxiety has become severe enough to require treatment.
Perhaps most critically, parents should take seriously any expressions of hopelessness, worthlessness, or thoughts of self-harm. Twenty percent of high school students reported seriously considering suicide in the CDC's most recent survey, with rates significantly higher among girls and LGBTQ+ youth. Warning signs include talking about being a burden, giving away prized possessions, sudden calmness after a period of depression, or researching methods of self-harm. These are urgent signals that require immediate professional attention.
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Much of the public conversation about teen mental health has centered on social media, and for understandable reasons. The timeline of declining adolescent well-being tracks suspiciously well with the rise of smartphones and social platforms. A 2024 Pew Research survey found that forty-eight percent of teenagers now believe social media has a mostly negative effect on people their age—a sharp increase from thirty-two percent just two years earlier. Teenagers themselves seem to be developing a more critical view of their digital lives.
The research, however, remains more complicated than headlines suggest. Studies consistently show correlations between heavy social media use and symptoms of depression and anxiety, particularly among girls. A study cited by the U.S. Surgeon General found that adolescents who used social media more than three hours daily faced twice the risk of negative mental health outcomes. The World Health Organization reported in 2024 that problematic social media use among adolescents has increased from seven to eleven percent since 2018, with girls more affected than boys.
But correlation and causation remain difficult to untangle. "Research is showing that those who are more depressed tend to use social media more, and vice versa," notes Dr. Carol Vidal, a child and adolescent psychiatrist at Johns Hopkins. "It is not clear that the cause of depression is social media use." What does seem clear is that excessive social media use is associated with a cluster of behaviors that can worsen mental health: poor sleep, increased social comparison, exposure to cyberbullying, and displacement of face-to-face interaction.
The sleep disruption piece may be particularly significant. Dr. Paul Weigle, a child and adolescent psychiatrist at UConn School of Medicine, argues that sleep deprivation from nighttime screen use may be "the most important single cause of the adolescent mental health crisis." The mechanism is straightforward: screens emit blue light that suppresses melatonin production, and engaging with social media activates the brain in ways that make falling asleep difficult. Only one in five high schoolers gets the recommended eight to ten hours of sleep. Chronic sleep deprivation worsens depression and anxiety, impairs academic performance, and increases risk-taking behavior—which in turn can deepen the mental health struggles that disrupted sleep in the first place.
For parents, this suggests that blanket panic about screens may be less useful than targeted attention to how and when devices are used. Researchers at Johns Hopkins have found that there appears to be a "sweet spot" of social media use—too little and too much both correlate with worse outcomes. The American Academy of Pediatrics recommends avoiding screens for at least an hour before bed and not sleeping with devices in the bedroom, advice that proves easier to give than to enforce.
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When parents recognize that their teenager needs help, the first question is often where to find it. Schools, for all their limitations, have become a critical access point. In the 2021-22 academic year, ninety-six percent of public schools offered at least one type of mental health service. This doesn't mean every student has easy access to robust support—resources vary enormously by district—but it does mean that schools are often a logical starting point.
Most schools employ some combination of school counselors, school psychologists, school social workers, and nurses who can provide initial assessment and short-term support. School counselors typically focus on academic planning and can screen for mental health concerns, though their role varies by state and district. School psychologists are trained to conduct evaluations, including for special education accommodations, and can provide some counseling services. School social workers often coordinate with families and outside providers, helping connect students to community resources.
Parents seeking to access these services should start by contacting their child's guidance counselor, homeroom teacher, or principal. Teachers can share observations about how a student is functioning in class, while parents share what they're seeing at home. Together, this information can help determine what level of support might be needed. Many schools also have crisis response teams trained to intervene when a student appears to be in immediate danger.
Beyond individual support, many schools have implemented broader mental health programming. Some districts offer telehealth counseling, classroom-based social-emotional learning curricula, and peer support programs. California now requires mental health instruction as part of health education in middle and high schools. New York City provides free online therapy for teenagers through a partnership with Hazel Health. These programs can help normalize conversations about mental health and reduce the stigma that often prevents teenagers from seeking help.
Still, significant gaps remain. A 2024 National Survey of Children's Health found that among adolescents who needed mental health treatment, sixty-one percent had difficulty getting it—a thirty-five percent increase since 2018. School mental health professionals are typically stretched thin, and some communities lack accessible options beyond what schools provide. Parents may need to advocate persistently to get their children the services they need.
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Perhaps the most important thing parents can do—and often the most difficult—is create conditions where teenagers feel able to talk about their mental health. This is harder than it sounds. Adolescence is defined partly by the drive toward independence and privacy. Many teenagers would rather endure considerable suffering than admit vulnerability to their parents. Boys, in particular, are often conditioned to hide emotional struggles.
Clinicians offer several principles for navigating these conversations. First, avoid making it a formal event. "Sometimes the most honest conversations happen in casual, everyday moments—like a car ride or while sharing a chore," suggests Dr. Heather Felton, a pediatrician at Norton Children's Medical Group. The physical arrangement of driving—sitting side by side, eyes forward—can make difficult topics feel less confrontational. Second, lead with curiosity rather than alarm. Open-ended questions like "How have things been going for you lately?" invite more honest responses than "Are you depressed?" Third, listen without immediately trying to fix. The instinct to solve problems can shut down conversations before they really begin.
It also helps to examine your own attitudes about mental health. Have you ever dismissed someone's struggles as weakness, or used derogatory language about people with mental illness? Teenagers are exquisitely attuned to the messages adults send about what topics are acceptable to discuss. When parents frame mental health concerns as treatable conditions—no different, really, from asthma or diabetes—teenagers may feel less shame about seeking help.
What if your teenager won't talk? This is common, and it doesn't mean you've failed. Keep showing up, keep asking, keep making clear that you're available. Teens may be more willing to talk to another trusted adult—a coach, a relative, a school counselor, a family friend. Offering these alternatives isn't giving up; it's acknowledging that sometimes teenagers need to establish some distance from parents to feel safe opening up. The goal isn't for you to be your child's therapist. The goal is for your child to get the support they need, wherever that comes from.
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If your teenager is expressing thoughts of suicide or self-harm, the situation requires immediate professional attention. The 988 Suicide and Crisis Lifeline provides free, confidential support twenty-four hours a day, seven days a week—by phone, text, or online chat. Trained crisis counselors can help talk through what's happening and connect you to local resources. If a teenager is in immediate danger, call 911 or go to the nearest emergency room. These are crisis responses, but they can be lifesaving.
For less acute but still concerning symptoms, the path forward usually involves consultation with a pediatrician or primary care provider, who can help assess the situation and make appropriate referrals. Treatment for adolescent depression and anxiety typically involves some form of talk therapy, often cognitive behavioral therapy, which has strong evidence supporting its effectiveness. This approach helps teenagers identify and change negative thought patterns that contribute to their symptoms. For more severe cases, medication may also be recommended, though decisions about antidepressants in teenagers require careful consideration of benefits and risks.
Finding a mental health provider can be frustratingly difficult. Wait times for child and adolescent psychiatrists often stretch to months. Insurance coverage remains complicated. Parents may need to make multiple calls, join waitlists, and advocate persistently. Many therapists now offer telehealth appointments, which can increase access for families in areas with limited local options. The SAMHSA National Helpline, at 1-800-662-4357, provides referrals to local treatment services and support groups.
While you're waiting for professional help, there are things that can make a difference. Encourage regular physical activity, which has documented effects on mood. Maintain consistent sleep routines as much as possible. Stay connected—eat meals together, find low-pressure activities you can share. Don't make school performance the center of your interactions during a mental health crisis. And take care of yourself. Parenting a struggling teenager is exhausting, and your own well-being matters both for its own sake and because your child needs you to be okay.
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There is, in all of this, a genuine reason for hope. The CDC's most recent data shows that rates of persistent sadness and hopelessness among teenagers have begun, ever so slightly, to improve. Experts attribute this partly to the unprecedented attention now being paid to youth mental health—the national conversation, the increased investment in school-based services, the willingness of families to seek help. Mental health challenges are treatable. Most teenagers who receive appropriate support go on to lead healthy, fulfilling lives.
The truth is that parenting through this moment requires holding two things simultaneously: the recognition that these are genuinely difficult times for young people, and the confidence that difficulty can be navigated with the right support. Your teenager needs to know that you're paying attention, that you're not scared off by hard conversations, and that you'll help them find what they need—even if you can't provide it yourself. That steadiness, that willingness to stay present and engaged through the hard parts, may be the most important thing any of us can offer.
You're standing in the hallway again, listening. Maybe it's nothing. Maybe it's something. Either way, the next step is the same: you knock on the door.
Sources
- Centers for Disease Control and Prevention. Youth Risk Behavior Survey Data Summary & Trends Report: 2013–2023. CDC, 2024.
- Annie E. Casey Foundation. Youth Mental Health Statistics in 2024. AECF, 2025.
- National Survey of Children's Health. Adolescent Mental and Behavioral Health, 2023. Health Resources and Services Administration, October 2024.
- Pew Research Center. Teens, Social Media, and Mental Health. Pew Research Center, April 2025.
- World Health Organization Regional Office for Europe. Health Behaviour in School-aged Children (HBSC) Study: Teens, Screens and Mental Health. WHO, September 2024.
- U.S. Surgeon General. Social Media and Youth Mental Health Advisory. U.S. Department of Health and Human Services, 2023.
- Murthy, V. Surgeon General's Call for Warning Labels on Social Media. U.S. Department of Health and Human Services, June 2024.
- American Academy of Pediatrics. Media Use in School-Aged Children and Adolescents. Pediatrics, 2016 (updated guidelines).
- SchoolSafety.gov. Mental Health Resources for Schools. U.S. Department of Education and Department of Homeland Security.
- American School Counselor Association. The School Counselor and Student Mental Health Position Statement. ASCA, 2022.
- SAMHSA. 988 Suicide & Crisis Lifeline. Substance Abuse and Mental Health Services Administration.
- Children's Hospital of Philadelphia. Tips for Talking to Your Child About Mental Health. CHOP Health Resources.
- National Alliance on Mental Illness. Mental Health by the Numbers. NAMI, 2024.
- Boston Children's Hospital. Teens, Anxiety, and Depression: How Worried Should Parents Be? Boston Children's Answers, 2021.
- The Conversation. Screen Time is Contributing to Chronic Sleep Deprivation in Tweens and Teens. August 2023.
- Johns Hopkins Medicine. Social Media and Mental Health in Children and Teens. Hopkins Health, 2025.