Is Your Teenager Angry, Withdrawn, and Struggling in School?
Beyond the "Typical Teen" Phase:
10 Warning Signs Parents Should Not Ignore
The "Paralysis" of Procrastination: What looks like laziness or "playing on their phone" is often executive dysfunction (ADHD) or an "avoidance" coping mechanism (Anxiety/Trauma) because the task feels physically impossible to start.
Explosive Irritability: While some teens are "withdrawn," many express depression or anxiety through anger. If small requests lead to massive blowouts, it’s a sign their nervous system is overwhelmed.
Academic Nosedive: A sudden drop in grades—or a bright student who "just isn't applying themselves"—is a hallmark of undiagnosed ADHD or the cognitive fog that comes with clinical depression.
Drastic Sleep Shift: This goes beyond staying up late. Watch for "revenge bedtime procrastination" (common in ADHD) or an inability to sleep due to racing thoughts (Anxiety) or nightmares (Trauma).
Social Withdrawal: Is your teen "ghosting" friends or losing interest in hobbies they used to love? This is a primary indicator of depression or social anxiety that requires professional intervention.
Physical "Mystery" Ailments: Mental health struggles in teens often manifest as physical pain—frequent headaches, stomachaches before school, or chronic fatigue are often somatic expressions of high stress.
Hyper-Vigilance or "Jumpiness": If your teen seems constantly on edge, startles easily, or is overly sensitive to their environment, it may be a sign of a trauma response or a sensory processing issue linked to ADHD.
Risky Impulsivity: Rapid-fire decision-making without considering consequences isn't just "being a teen"—it’s a clinical symptom of ADHD impulsivity or a dangerous attempt to "feel something" during a depressive episode.
Negative Self-Talk: Listen for phrases like "I’m just stupid," "I can't do anything right," or "It doesn't matter anyway." This internal narrative is a cry for help that spans across all four conditions.
Hyper-Focusing on Distractions: If they can spend six hours on a video game but can't focus for six minutes on a conversation, their brain is likely seeking the dopamine hit it's missing (ADHD) or escaping a painful reality (Trauma/Depression).
Why Your Pediatrician Might Not Be the Answer for Your Teen’s Mental Health
It is instinctive for parents to turn to their trusted pediatrician when a teen begins to struggle. However, while pediatricians are the heroes of physical health, the teenage years introduce a level of psychological and neurological complexity that often requires a different level of clinical expertise.
The "15-Minute" Diagnostic Gap: A pediatrician’s schedule is built for acute physical needs. A gold-standard mental health evaluation for a teenager requires 60 to 90 minutes of deep-dive clinical interviewing. In a rushed environment, subtle signs of trauma or "quiet" depression are often missed, leading to symptoms being labeled as "just a phase."
The "Band-Aid" Prescription: Pediatricians are often forced to treat the most visible symptom—like insomnia or lack of focus—without the time to uncover the root cause. If a teen is prescribed a sleep aid for "insomnia" that is actually caused by underlying trauma, the core issue remains untreated and may even worsen.
The Interplay of Biology and Mood: Teen bodies are in a state of hormonal upheaval. These shifts dramatically affect how psychiatric medications work and how emotions are regulated. Psychiatric provider at Skye have extensive experience to manage these complex interactions, whereas a general pediatric approach may be too "one-size-fits-all."
The Lack of Integrative Resources: Mental health in teens is rarely solved by a pill alone. Pediatric offices are seldom equipped to offer the integrative perspective—looking at gut health, nutritional deficiencies, and lifestyle triggers—that is often necessary to stabilize a struggling adolescent.
As a mother of high school teenagers myself, I don't believe that our children need to be overmedicated which is what unfortunately happens when worried parents rush to the doctor and only receive a bottle of pills.
Our kids need a detailed psychological evaluation, a treatment plan and then consistent careful monitoring, not just pills.
In our first 60 minute session with your child, I will dig deep to discover how I can help them. My subsequent follow-up sessions with your child will not be a 5 minute chat to get him a prescription refill but 20-30 minutes (or more if needed) sessions to really understand how they are interacting with medications and to make any adjustments as needed.
Your child deserves to feel better and I am looking forward to helping them.
Dr. Jennifer Sam
PMHNP-BC, DNP