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  • Writer's pictureJerzy Grzebieluch, MD

Adolescent Behaviors that May Indicate Underlying Mental Health Issues

Adolescence is a time of significant physical, emotional, and social development. It's common for adolescents to display various behaviors as they navigate the challenges of this stage. While many behaviors are part of normal development, some may raise concerns and warrant psychiatric evaluation.

It's essential for parents, caregivers, and educators to be attentive to changes in behavior that may indicate underlying mental health issues. Here are some adolescent behaviors that might require psychiatric evaluation:

  1. Extreme Mood Swings:

  • Rapid and intense mood swings that interfere with daily functioning.

  • Persistent irritability, anger, or sadness that seems disproportionate to the situation.

  1. Isolation and Withdrawal:

  • Drastic social withdrawal and isolation from friends, family, and activities once enjoyed.

  • A sudden decline in social interactions and reluctance to participate in group activities.

  1. Changes in Sleep Patterns:

  • Significant disruptions in sleep patterns, such as insomnia or excessive sleeping.

  • Frequent nightmares or night terrors that affect the adolescent's overall well-being.

  1. Changes in Academic Performance:

  • A sudden decline in academic performance despite previous success.

  • Frequent absences, lack of interest in school, or difficulty concentrating.

  1. Risk-Taking Behavior:

  • Engaging in dangerous activities without consideration of consequences.

  • Reckless behaviors like substance abuse, unsafe sexual practices, or involvement in criminal activities.

  1. Drastic Changes in Eating Habits:

  • Significant changes in eating habits, such as extreme dieting, overeating, or developing unhealthy relationships with food.

  • Obsession with body image, leading to potentially harmful behaviors.

  1. Self-Harm or Suicidal Thoughts:

  • Expressing thoughts of self-harm or suicide, even if not acted upon.

  • Evidence of self-injury, such as cutting or burning, indicating emotional distress.

  1. Intense Anxiety or Panic Attacks:

  • Frequent and intense anxiety, panic attacks, or phobias that interfere with daily life.

  • Avoidance of situations that trigger anxiety or panic.

  1. Excessive Obsessions or Compulsions:

  • Displaying obsessive thoughts or engaging in compulsive behaviors that disrupt daily routines.

  • Demonstrating signs of obsessive-compulsive disorder (OCD).

  1. Difficulty Coping with Stress:

  • Inability to cope with normal stressors, leading to emotional breakdowns or maladaptive coping mechanisms.

  • Persistent feelings of overwhelm and an inability to problem-solve effectively.

  1. Extreme Perfectionism:

  • Setting unrealistic standards for oneself and experiencing intense distress when unable to meet them.

  • Perfectionism that interferes with daily functioning and relationships.

  1. Substance Abuse Issues:

  • Experimentation with drugs or alcohol that escalates to problematic use.

  • Visible signs of substance abuse, such as changes in appearance, behavior, or school performance.

  1. Difficulty in Relationships:

  • Struggling with forming and maintaining healthy relationships with peers, family, or romantic partners.

  • Frequent conflicts and difficulty communicating effectively.

  1. Unexplained Physical Complaints:

  • Frequent physical complaints (headaches, stomachaches) with no apparent medical cause.

  • Physical symptoms that may be manifestations of underlying emotional distress.

  1. Evidence of Trauma:

  • Behaviors indicative of past traumatic experiences, such as flashbacks, nightmares, or avoidance of trauma-related triggers.

  • Changes in behavior following exposure to traumatic events.

It's crucial to note that individual differences exist, and some behaviors may be part of normal adolescent development. However, when these behaviors persist, intensify, or significantly impact an adolescent's functioning and well-being, seeking a psychiatric evaluation is advisable. Early intervention and appropriate mental health support can make a significant difference in addressing and managing mental health challenges in adolescents.

If concerned about a young person's mental health, it's essential to consult with mental health professionals or healthcare providers for a thorough assessment and guidance on the next steps.


Dr. Jerzy Grzebieluch is a board-certified psychiatrist providing evaluations and treatment to child, adolescent, and adult patients. He's currently accepting new patients covered by TRICARE insurance. A primary care manager referral is not required to book your appointment.


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