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Adolescence: What's Normal and What's Not
by Robert Needlman, M.D., F.A.A.P.
reviewed by Robert Needlman, M.D., F.A.A.P.
There is an old myth that all adolescents rebel, feel miserable much of the time, and engage in dangerous behaviors. However, studies show that many adolescents accept their parents' core values and value their parents' advice. They work hard at school and avoid foolish risks.
Still, even the easiest teenager can try his parents' patience. One minute, he is happy and cooperative; the next minute, he is angry and stubborn. He may refuse to talk about his feelings, then complain that no one understands how he feels.
Some amount of friction is to be expected as adolescents struggle to become more emotionally independent. But the teen years are also a time when serious problems can arise, including alcohol and drug addiction, eating disorders, depression, and even suicide. As the parent of an adolescent, how can you tell if your child is "just being a teenager" or if he really needs help? The list below describes some common adolescent behaviors and gives some danger signs to look out for:
- Moodiness: Quick changes of mood, from happy to miserable and back, are normal during adolescence. Overall, however, your teenager should remain upbeat and optimistic. An adolescent who is sad, bored, unenthusiastic, detached, or down most of the time (not just when forced to participate in family activities) might be experiencing depression. Extreme mood shifts, from deepest misery or emptiness to overflowing and uncontrollable energy can be a sign of bipolar disorder, which often first appears during the teen years.
- Irritability: Adolescents often have a short fuse, particularly when dealing with their parents. However, if every little disappointment or delay provokes an angry comment or outburst, it can be a sign of depression, not just normal teen crankiness.
- Clamming up: Teens often refuse to talk about their deepest feelings with their parents. They may claim to have nothing whatever to say about anything. This behavior could be part of the normal process of emotional separation. Clamming up only becomes worrisome when a teen doesn't have anyone with whom to share his feelings--neither a nonparental adult nor peers. Emotional isolation makes it hard for a teen to handle the usual tensions and problems that arise in adolescence. It also can be a sign of various mental health problems, including depression or, in extreme cases, schizophrenia.
- Sleepiness: Many teens need more sleep than they did as preteens. They often get too little sleep during the week and try to catch up on weekends. This is normal behavior, even though inadequate sleep can contribute to school problems and behavioral issues. Extreme sleepiness, even when the teen seems to be spending plenty of time in bed, might signal depression or a physical problem such as a sluggish thyroid or sleep apnea.
- Preoccupation with sex: Sexual fantasies and experimentation are normal, especially during the middle adolescent years (roughly 14 through 16). Irresponsible, promiscuous, risky sexual behaviors are dangerous and may be a sign of low self-esteem or other problems. Adolescents who feel hopeful about their futures--for example, who plan to go to college--are more likely to avoid very risky sexual behaviors; they have too much to lose.
- Overconcern with looks: If your teen seems to spend hours each day in efforts to get the "right" look, can't walk past a mirror without checking her appearance, and often feels unattractive, that's all probably normal teen behavior. But if your already-thin teen engages in diets or exercise programs to lose weight, or alternates dieting with binge eating, that's more concerning. Eating disorders are very common among teenage girls. Because the male body ideal is more muscular than thin, fewer boys have anorexia nervosa or bulimia. But they are more apt to use steroids or other dangerous substances in attempts to bulk up.
- Substance use: At some point during their teen years, most adolescents experiment with potentially dangerous substances such as cigarettes, alcohol, and other drugs. While any use of these substances carries some risk--for example, a single car ride with a drunken driver can be deadly--as a parent, you need to know how to tell when experimentation changes into regular use, abuse, or addiction. Most teens will not tell their parents about their substance use willingly, but it still is important to ask and to keep the lines of communication as open as possible. Another important strategy is to become familiar with your child's friends.
- The search for meaning: Expect your teen to struggle with the big questions: Who am I, and why am I here? The later adolescent years, in particular, are times of idealism. Teens often adopt political positions that counter their parents' and defend them with great enthusiasm. Don't be surprised if your adolescent questions your morals or ethics. What would be more cause for worry is a teen who is convinced of the meaninglessness of the world, and who feels that he has no role and no future. Suicide is the third most common killer of teens, after unintentional injuries and homicide.
So, if you find yourself locked in a heated debate about why your favorite politician is such a skunk, why your household rules are hypocritical, and why your values need a drastic overhaul, relax and enjoy your healthy adolescent.
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Created November 27, 2001
Reviewed August 15, 2004
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