5 Signs Your Teen Might Not Be Okay—And What You Can Do

By: Edie Stark, LCSW

As a therapist who specializes in eating disorders and teen mental health, I’ve witnessed firsthand how challenging it can be for parents to discern when their teen is struggling. Adolescence is a tumultuous period marked by physical changes, social pressures, and emotional highs and lows. While some level of moodiness and withdrawal is totally developmentally normal and to be expected, there are critical signs that may signal deeper issues requiring your attention and more specialized care.

Teen girl is walking in San Diego and appears to be struggling with a low mood.

In this blog, I’ll walk you through five signs your teen might not be okay and offer practical steps to take if you notice these red flags.

1. Changes in Eating Habits or Body Image Concerns

Adolescence is a time when teens may naturally become more self-conscious about their appearance. However, significant changes in eating habits or an intense focus on weight, food, or exercise can indicate an underlying problem. Warning signs include:

  • Skipping meals regularly or adopting overly restrictive eating habits.

  • Preoccupation with dieting, “clean eating,” or cutting out entire food groups.

  • Increased secrecy around food or refusal to eat with the family.

  • Rapid weight changes (loss or gain).

  • Changes in clothing choices IE wearing very baggy clothes

These behaviors may be early indicators of an eating disorder like anorexia nervosa, bulimia nervosa, or binge eating disorder. Teens are particularly vulnerable to the cultural messaging that equates thinness with worthiness, so it’s crucial to address these behaviors early. It is very important to note that ANY body, gender and person can experience eating disorders. A teen does not need to be in a thin body or female for these concerning symptoms to be taking seriously. 

What to do:

Approach your teen with compassion, not judgment. Instead of focusing on their food choices or weight, express concern for their overall well-being. For example, say, “I’ve noticed you’ve been skipping meals lately, and I’m worried about how you’re feeling. Can we talk about it?” Seek support from a pediatrician or therapist with expertise in eating disorders. Early intervention can make all the difference.

2. Persistent Mood Changes

Teens are known for being moody, but persistent or extreme changes in mood could signal anxiety, depression, or other mental health challenges. Look for signs such as:

  • Irritability or anger that seems out of proportion.

  • Withdrawal from friends, family, or previously enjoyed activities.

  • Frequent crying or expressing feelings of hopelessness.

  • Difficulty concentrating or noticeable drops in academic performance.

Teen depression often presents differently than adult depression; it may appear more as irritability or anger rather than sadness.

What to do:

Start by creating a safe space for your teen to open up. Avoid blaming or dismissing their feelings. You might say, “I’ve noticed you’ve seemed down lately, and I want to understand what’s going on. I’m here to listen.” If your teen struggles to articulate their emotions, that’s okay—many do. Encourage them to meet with a therapist who specializes in teen mental health to explore their feelings in a supportive environment.

3. Sudden Isolation or Changes in Social Behavior

teen girl sits outside therapist office

Friendships are critical during adolescence, and changes in social behavior can provide valuable clues about a teen’s mental health. Warning signs include:

  • Withdrawing from social activities or isolating themselves in their room.

  • Sudden conflict with close friends or abrupt changes in their friend group.

  • Avoiding school or extracurricular activities.

While it’s normal for teens to seek more independence, isolation or avoidance often reflects underlying struggles such as social anxiety, depression, or bullying.

What to do:

Ask open-ended questions like, “I’ve noticed you’ve been spending more time alone lately. Is everything okay with your friends?” Listen attentively without interrupting or offering solutions right away. If they seem unwilling to talk, reassure them that you’re there whenever they’re ready. A therapist can also help uncover the root causes of their isolation and teach them strategies to navigate social challenges.

4. Risky or Self-Destructive Behaviors

Risky behaviors, such as experimenting with substances, self-harm, or reckless decision-making, are often signs that a teen is struggling to cope with intense emotions. Specific examples include:

  • Increased use of alcohol or drugs.

  • Engaging in self-harm behaviors like cutting or burning.

  • Reckless actions such as dangerous driving or skipping school frequently.

  • Talking about or making comments that suggest suicidal thoughts.

These behaviors often indicate underlying pain or feelings of hopelessness. It’s important not to dismiss them as attention-seeking or a “phase.”

What to do:

If you suspect self-harm or suicidal thoughts, seek professional help immediately. Safety is the top priority. Contact a crisis hotline, a school counselor, or a mental health professional trained in adolescent care. Let your teen know you’re taking these steps because you care deeply about their safety. While these conversations can feel uncomfortable, your openness and willingness to act could save their life.

5. Physical Symptoms Without a Clear Medical Cause

Mental health struggles often manifest physically. Teens may not always recognize or articulate their emotional distress, so their bodies may “speak” for them. Watch for signs like:

  • Frequent headaches or stomachaches.

  • Trouble sleeping or sleeping too much.

  • Changes in appetite unrelated to eating disorders.

  • Persistent fatigue or lack of energy.

These symptoms may indicate stress, anxiety, or depression, especially if a medical evaluation doesn’t reveal a clear cause.

What to do:

Validate your teen’s experience by saying something like, “I see you’ve been having a lot of headaches lately. That must be really tough for you.” Encourage them to meet with a doctor to rule out medical causes, but also consider therapy as part of their care plan. A therapist can help them explore whether emotional stress is contributing to their physical symptoms.

How to Support Your Teen

Recognizing the signs is only the first step. Your response as a parent can have a significant impact on their healing journey. Here are some general tips for supporting a teen who may be struggling:

Parent putting arm around teen on California beach
  1. Foster Open Communication:

    Make it clear that you’re always available to talk without judgment. Sometimes, simply being present and available can help a teen feel less alone.

  2. Seek Professional Help Early:

    If you’re concerned about your teen’s mental health, don’t wait to get them help. Many issues can be addressed effectively with early intervention.

  3. Be Patient:

    Change takes time, especially for teens navigating complex emotions. Avoid putting pressure on your teen to “snap out of it.”

  4. Educate Yourself:

    Learn about the challenges teens face today, including social media pressure, academic stress, and cultural expectations. Understanding their world helps you empathize with their struggles.

  5. Take Care of Yourself:

    Supporting a struggling teen can be emotionally draining. Don’t hesitate to seek your own support, whether through therapy, parent support groups, or trusted friends.

Final Thoughts…

Parenting a teen comes with unique challenges, but recognizing when your child is struggling is one of the most important ways you can show your love and care. If you notice signs that your teen isn’t okay, trust your instincts and act early. You don’t have to navigate this alone—therapists, school counselors, and healthcare providers are here to help you and your family through these difficult times.

Above all, remind your teen that it’s okay to struggle, and it’s even more okay to seek help. Your unwavering support and willingness to listen can make all the difference in their path to healing.

If you’re concerned about your teen’s mental health, consider reaching out to a qualified therapist in your area.

Early intervention saves lives.


Our Services:

Stark Therapy Group offers therapy for all types of eating disorders, including Anorexia, Binge Eating Disorder and Bulimia. We offer a 3-tiered family based support for teens in eating disorder recovery. We treat anxiety, depression and general mental health conditions. We offer 3-tiered family based support for teens with general mental health issues. We also offer couples therapy. We would love to help you on your mental health journey. Reach out today for a free consultation!

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