A high percentage of teenagers go through a rebellious or ‘crazy’ phase that is normal for their age and brain development. The difference between normal teen-crazy and truly troubled behavior is when the teenager falls behind his or her peers in critical areas. At a bare minimum, a normal teen will be able to do the following:
- Attend school and do most school work if they want to;
- Have and keep a friend or friends their own age who also attend school;
- Develop a maturity level roughly the same as his or her peers;
- Exercise self-control when he or she wants to;
- Demonstrate basic survival instincts and avoid doing serious harm to themselves, others, or property.
- Enjoy activities that interest them.
It is normal for many teens to be inconsistent, irrational, insensitive to others, self-centered, and childish. Screaming or swearing is normal–regard this the same as a toddler temper tantrum. Outlandish imagination and ideas are normal in the adolescent phase too. These are behaviors that crazy teens grow out of unless something else is holding them back.
This is your challenge: How do you tell the difference? Troubled teens with mental disorders have the same challenging behaviors as ‘normal’ crazy teens… How do you know if they need serious mental health treatment? Look for pervasive patterns of social and behavioral problems that stand out against their peers, patterns which persist or occur in different settings. The patterns repeat themselves and are increasingly worse. You suspect your troubled teen is slipping behind and won’t grow out of it.
A sudden change in behavior.
- An abrupt change in friends and interests, and loss of interest in things your teenager used to enjoy. This might indicate the onset of a serious mental illness or drug use or both.
- Unusual ideas, or obsessive beliefs, or unrealistic plans, see: “Unsettling: what psychosis looks like in children and young people.”
- Others think there is something abnormal about your child. (e.g., your child’s friend comes forward, their teacher calls, other parents keep their children from your child, or someone checks to see if you’re aware of the nature of his or her behaviors).
Unsafe behaviors (“Unsafe” means there’s a danger of harm to themselves or others, property loss or damage, running away, seeking experiences with significant risk (or easily lured into them), abusing substances, and physical or emotional abuse of others.)
- If a troubled teenager does something unsafe to themselves or others, it is not an accident, but something impulsive, intentional, and planned.
- They have a history of intentional unsafe activities.
- They have or seek the means to do unsafe activities.
- They talk about or threaten unsafe behavior.
How psychologists measure the severity of a child’s behavior
“Normal” is defined with textual descriptions of behaviors, and these are placed on a spectrum from normal to abnormal (or “severe emotional disturbance” – SED). Below are a few examples of a range of behaviors in different settings. These descriptions are generalizations and should not be used to predict your child’s treatment needs, but they do offer insight into severity and the need for mental health treatment.
Not serious – This child has occasional problems with a teacher or classmate that are eventually worked out, and usually don’t happen again.
Mildly serious – This child often disobeys school rules but doesn’t harm anyone or property. Compared to their classmates, they are troublesome or concerning, but not unusually badly behaved. They are intelligent, but don’t work hard enough or focus enough to have better grades. They could use help from a school counselor, teachers, and possibly a therapist for themselves or the family.
Serious – This child disobeys rules repeatedly, or skips school, or is known to disobey rules outside of school. They stand out in the crowd as having chronic behavior problems compared to other students and their grades are poor even if they’re very intelligent. This child needs mental health or substance abuse treatment.
Very serious – This child cannot be in school or they are dangerous in school. They cannot follow rules or function, even in a special classroom, or they may threaten or hurt others or damage property. It is feared they will have a difficult future, perhaps ending up in jail or having lifetime problems. If they cooperate, this child requires intensive mental health and or substance abuse treatment.
Not serious – This child is well-behaved most of the time but has occasional problems, which are usually worked out.
Mildly serious – This child has to be watched and reminded often, and needs pushing to follow rules or do chores or homework. They don’t seem to learn their lessons and are endlessly frustrating. They can be defiant or manipulative, but their actions aren’t serious enough to merit intensive treatment, though a school counselor or private counselor would be very beneficial.
Serious – This child cannot follow rules, even reasonable ones. They can’t explain or take no responsibility for their behavior, which can include damage to the home or property, or harm to themselves or others. They need mental health treatment or substance abuse treatment.
Very serious – The stress caused by this child means the family cannot manage normally at home even if they work together. Running away, damaging property, threats of suicide or violence to others, and other behaviors require daily sacrifices from all. Police are commonly called. This child needs intense psychiatric treatment and/or substance abuse treatment, and likely residential treatment.
Mildly serious – This child may seem extra immature. They will argue, tease, bully or harass others, and most schoolmates avoid them. They are quick to have temper tantrums and childish responses to stress that always require extra attention from parents and caregivers.
Serious – The child has no friends their age, or risky friends, and can be manipulative or threatening. They can have violent tendencies, poor judgment, and take dangerous risks with themselves and others. They don’t care about others’ feelings, or may readily harm others physically or emotionally. This child needs therapy and psychiatric mental health treatment or substance abuse treatment.
Very serious – The child’s behavior is so aggressive verbally or physically that they are almost always overwhelming to be around. The behaviors are repeated and deliberate, and can lead to verbal or physical violence against others or themselves. This child needs intensive psychiatric and/or substance abuse treatment.
If you’ve been searching for answers and selected this article to read, your suspicions are probably true. Most parents have good intuition about their child. If you’re looking for ways to “fix” or change your child, they’re aren’t any easy answers nor medications or therapies which do this. Treatment means multiple life changes in addition to medication and therapy, and these can include help for insomnia, a change in diet, treatment for digestive system problems, and household changes to reduce stress.
Mental illness is serious and recovery is a long slow process. It is understandable if you want them to recover quickly–your stress can be intolerable. Avoid pushing for recovery because it will only stress your child and lead you to disappointment. Instead, cooperate with professionals (teachers, treatment providers), and prepare yourself for a parenting marathon. What’s the best way to prepare? Work hard on your own mental health and wellbeing. This advice and wisdom from other parents may help you face this daunting task.
Early treatment, while your troubled teenager is young, can prevent a lifetime of problems. Find a professional who will take time to get to know your child and you and the situation, and who will listen to what you have to say–a teacher, doctor, therapist, psychiatrist or other mental health practitioner.
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