Teens’ mental health

In the teen years, fitting in and being accepted can feel like everything. Teens may take more risks when the social reward seems bigger than the possible cost. Some risks are healthy, like trying out for a team or joining a new club.

How adults can help

• Agree on a code word they can text you to get picked up, no questions asked
• Get to know their friends, and make your home welcoming
• Help them find healthy “risks”: a new sport, a performance, a job
• Talk through situations ahead of time: “What would you do if…?”

Because the teen brain is still changing, it can be shaped by what teens do. Challenging classes, exercise and creative activities can strengthen brain circuits.

Brain-building activities

• Art, writing, coding or making things
• Learning a musical instrument or a language
• Sports, dance or any regular movement
• Volunteering and helping others

During the teen years, the body’s natural sleep signal shifts later in the evening. So teens often can’t fall asleep early, and find it hard to wake up for school. Many teens don’t get enough sleep, which affects attention, mood, impulse control and schoolwork.

Sleep helpers

• Cut back on caffeine, especially later in the day
• Keep a regular bedtime and wake time, even on weekends where possible
• Keep phones and screens out of the bedroom at night
• Turn off screens about an hour before bed

Teens may handle stress differently than adults, which can raise the risk of anxiety and low mood. Many mental health challenges first show up in the teen years, when brain, body and social changes all overlap.

Skills to learn

• Break big tasks into small steps
• Name the feeling: “I’m overwhelmed”, “I’m nervous”
• Notice what triggers stress
• Use a calming tool: slow breathing, a walk, music, talking to someone

Many teens feel intense pressure to succeed in school, sports and activities, and to fit in. Social media can turn up that pressure. Losing sleep makes everyday stress harder to cope with.

Healthy reminders

• Asking for help and staying close to people are part of being well
• Comparing yourself to people online can hurt your self-esteem
• Negative self-talk can be questioned: “Is that really true?”
• No one is perfect
• Practicing before a stressful task helps
• Rest is part of success, not the opposite of it

For families

• Make stress a normal thing to talk about at home
• Listen without judging, and ask questions that need more than yes or no
• Share healthy routines: sleep, meals together, movement and a family media plan

Lasting low mood looks different for everyone. Some people have many signs, and some only a few. If you have felt sad most of the time for a few weeks or longer, and can’t concentrate or enjoy things you used to, it’s time to talk to a trusted adult.

Signs to watch for

• Changes in eating or sleeping
• Dropping grades
• Feeling sad, anxious, worthless or “empty”
• Feeling tired, or having trouble remembering things
• Getting easily frustrated, irritable or angry
• Losing interest in things you used to enjoy
• Pulling away from friends and family
• Thoughts of suicide or self-harm

What helps

• Asking a doctor about talk therapy
• Keeping a regular sleep schedule and eating well
• Spending time with friends or family, even when you don’t feel like it
• Staying active, even with a short walk
• Talking to a parent, teacher or school counselor

Teens need more privacy as they grow, and that is healthy. But pulling away from everyone and everything they used to enjoy can be a sign they are struggling with low mood, worry, bullying or something they feel unable to share.

Gentle ways to reach in

• Keep inviting them, even if they say no
• Let them know they can tell you anything, and you’ll work it out together
• Say what you’ve noticed without guessing: “I’ve been worried about you. You don’t seem yourself.”
• Talk side by side: in the car, on a walk, while cooking

Some risk-taking is part of the teen years. But risky choices can also be a way of coping with pain, fitting in, or feeling something when they feel numb.

What helps

• Agree on safety plans, like a no-questions-asked ride home
• Ask directly and calmly, and say you want to help
• Be curious about why, rather than only punishing
• Talk through consequences together

In 2023, 1 in 5 U.S. high school students seriously considered suicide in the past year, and 9% made an attempt. Help works, and young people do get better.

If you are having these thoughts

• Call or text 988, or chat at 988lifeline.org, any time
• Tell one person you trust today: a parent, relative, teacher, coach or counselor

If a teen tells you

• Thank them for telling you, and stay calm
• Take it seriously, even if they say it was a joke
• Stay with them and get help together: call or text 988
• If a life is in danger, call 911

In early adolescence, some young people begin to question their gender identity. In the middle teen years, many explore their sexual identity. This can be stressful without support from friends, family or community.

How adults can help

• Keep conversations positive: point out strengths and celebrate successes
• Let them grow into their own person, and remind them you are there to help
• Listen to their ideas, even when you disagree

Signs a teen may be feeling bad about themselves

• Being easily swayed by negative friends
• Dropping things they used to care about, or making excuses
• Mood changes: sadness, tears, anger or pulling away
• Saying harsh things about themselves
• Struggling to accept praise or criticism

What helps

• Encourage volunteering or groups that give a sense of purpose
• Let them make decisions and take on responsibility
• Listen without judging, and treat them with respect
• Tell them you love them, with no conditions

LGBTQ+ young people are not more likely to struggle because of who they are. They often face more bullying, rejection and stress from others. In 2023, 65% of LGBTQ+ U.S. high school students felt persistently sad or hopeless, compared with 31% of their cisgender, heterosexual classmates.

LGBTQ+ students were also more likely to be bullied at school (29% vs. 16%) and to have seriously considered suicide (41% vs. 13%). These numbers show why support from family, school and community matters so much.

Ways to support

• Help them find supportive groups and safe online communities
• Learn more, so they don’t have to teach you everything
• Listen and thank them for trusting you
• Make sure their school takes bullying seriously
• Stand up against hurtful jokes and comments
• Tell them you love them, and nothing changes that
• Use the name and pronouns they ask you to use

Teens may feel pushed to play a certain role in their group, or to go along with risky plans. Having a ready-made, face-saving reason to say no makes it much easier.

For parents

• Connect with other parents and agree on shared expectations, so your teen isn’t singled out
• Give your teen face-saving reasons to skip risky situations, like a poorly supervised sleepover
• Help them rehearse what they would say or do
• Learn about their crowd, and any role they feel pressure to play

For teens: ways to say no

• “I can’t, my parents would kill me.” Blaming your parents is allowed.
• “Nah, I’m good.” Short and calm works.
• Text a code word to a parent for a no-questions pickup
• Suggest something else to do

Bullying is unwanted, aggressive behavior where there is a real or perceived power imbalance, and it happens again and again, or is likely to. It raises the risk of low mood, anxiety, sleep problems, lower grades and dropping out of school.

If it’s happening to you

• Save screenshots and write down dates and what happened
• Tell a trusted adult, and keep telling until someone helps
• You don’t have to face it alone, and it is not your fault

If you see it

• Be kind to the person being targeted: sit with them, check in
• Don’t like, share or comment on hurtful posts
• Tell a trusted adult

Online bullying can follow a young person home, at any hour. More than 1 in 6 U.S. high school students said they were bullied electronically in the past year.

What to do

• Block the person
• Don’t reply to or forward the messages
• Report it to the app or platform; it often breaks their rules
• Report it to the school if a classmate is involved
• Take screenshots and record dates and times

Trust is key. Young people need to feel they can come to an adult when something goes wrong online, without getting in trouble.

Ideas

• Agree on family rules about what is OK to share
• Check privacy and security settings together
• Keep talking about their online life, not just the risks
• Notice if mood changes around device use
• Talk about which apps are and aren’t OK for their age

Social media can help teens stay close to friends and family far away, and join groups around sports, music, theater or LGBTQ+ support. They can learn from museums, parks and hobby creators, and share their own art.

Healthy uses to encourage

• Chatting with real friends
• Creating and sharing their own work
• Finding supportive communities
• Learning a new skill

Heavy use can crowd out sleep and time with friends and family. Feeds can show violent, dangerous or false content, and edited images that can hurt body image and self-esteem.

Warning signs

• Comparing themselves harshly to others
• Pulling away from friends and hobbies
• Screen time getting in the way of sleep, activity or meals
• Seeming upset, anxious or low after being online

Studies found that teens who mostly scroll without engaging were more likely to have symptoms of low mood. More active use, like commenting, posting or chatting, did not show the same negative effects. Research so far mostly shows small links, and can’t say what causes what.

Questions to ask yourself

• How do I feel after I’ve been online?
• Which accounts make me feel good? Which make me feel worse?
• Have I seen anything that worried me?

The American Academy of Pediatrics suggests a Family Media Plan: rules for screens that fit your family’s routines and values, made together and reviewed as kids grow.

Ideas to include

• Check privacy settings and talk about ads and influencers
• Make room for offline fun: reading, hobbies, time outdoors
• One screen at a time
• Screen-free zones: the dinner table, homework time and bedtime
• Turn off autoplay and notifications

In a healthy relationship

• You both have privacy
• You can disagree without fear
• You can say no, and it is accepted
• You can spend time with friends and family
• You feel safe and respected
• It’s good to spend time together, and OK to spend time apart

It can include

• Emotional: insults, threats, humiliation, controlling who they see
• Physical: hitting, pushing, kicking or any physical harm
• Sexual: forcing or pressuring sexual acts, or sharing sexual images without consent
• Stalking: repeated, unwanted contact or attention that causes fear

Teens may see teasing and name-calling as normal in relationships, but these can grow into abuse.

Signs a partner may be abusive

• Any physical harm
• Checking their phone, email or social media without permission
• Explosive temper or mood swings
• Extreme jealousy or insecurity
• Keeping them from friends or family
• Possessive or controlling behavior
• Pressuring or forcing them into sex
• Putting them down, especially in front of others

Changes adults might notice

• Constantly checking their phone, or anxious when away from it
• Dropping friends or activities
• Seeming nervous, low or on edge
• Unexplained injuries

Young people who experience dating violence are more likely to feel low and anxious, use tobacco, alcohol or drugs, act out, and think about suicide. It can also raise the risk of abuse in later relationships.

Do

• Connect them with trusted help
• Focus on their safety and feelings, not on the partner
• Help them save threatening messages
• Listen calmly and believe them
• Make a safety plan together
• Tell them it is not their fault

Try not to

• Blame or shame them
• Contact the partner yourself in anger
• Give ultimatums, which can push them closer to the partner

Growth speeds up and puberty begins, usually a year or two earlier for girls than boys. Thinking tends to be black-and-white. Young teens can feel self-conscious and constantly judged by peers. They want more privacy, and may push limits or react strongly to rules.

Teens can think in more abstract ways, but the brain areas for impulse control and weighing consequences are still maturing, so strong emotions can win in the moment. Arguments with parents often increase as teens push for independence and spend more time with friends.

Impulse control usually improves, and older teens can weigh risks and rewards more accurately. They have a stronger sense of who they are and what they value, and focus more on the future. Many relationships with parents shift toward a more adult footing.

Pediatricians suggest clear, reasonable limits on things like curfews, school, media and behavior, with more independence as teens show responsibility. This balance is linked with lower rates of low mood and drug use.

Ideas

• Agree on the rules together, and explain the “why”
• Model the decision-making you want to see
• Rehearse tricky choices ahead of time
• Review the rules every few months, and add freedom when trust is kept

Pediatricians suggest talking about healthy relationships, sex, consent, pregnancy and infection prevention, and substance use before they become urgent.

Tips

• Answer the question they asked, then check if they want more
• Listen more than you talk
• Say you’d rather they come to you than guess
• Use shows, news or friends’ stories as a way in

Pediatricians encourage teens to build a personal set of calming strategies. Many are free or low-cost and can be learned from online videos.

Ideas to try

• Art or music
• Deep breathing
• Exercise, which can ease tension, lift mood and improve sleep
• Journaling
• Time in nature
• Yoga or meditation

Try not to pre-judge their choices as “stupid” or “wrong”. Assume they had a reason. Their explanation may make sense from where they are standing.

Try

• “Tell me more about that.”
• “What made you decide to…?”
• “How did that feel?”

Open questions like “How has your day been?” invite conversation. Instead of guessing what’s wrong, say what you’ve noticed: “I’ve been worried about you. You don’t seem your usual self.”

If teens only ever hear nagging, they stop listening. Let small things go, so you have their ear for the big ones, like safety.

Ask yourself

• Is this about safety or health?
• Is this my preference, or a real problem?
• Will this matter in a week?

Outbursts often come from confusion or distress, not real hatred. Staying calm shows them that big feelings can be survived.

Try

• “I can see you’re really upset. Let’s talk when we’re both calmer.”
• Come back to it later, without holding a grudge
• Model what you expect: teens notice when adults don’t follow their own advice

If you’ve been feeling low, stressed or not like yourself, share how you’ve been feeling with someone you trust. That could be a parent or guardian, a teacher or a school counselor.

Ways to start

• “Can we talk? I haven’t been feeling like myself.”
• Pick a calm moment, like a car ride or a walk
• Text it, or write it down, if saying it out loud feels too hard
• Bring a friend with you to see the school counselor