Mental health experts are highlighting the importance of recognizing when a teenager’s mood shifts from typical adolescent behavior to more serious concerns like anxiety or depression. Signs such as a decline in school performance, withdrawal from social activities, or a loss of interest in previously enjoyed hobbies can indicate underlying issues.
Research indicates that many teenagers are struggling with mental health challenges. According to the National Alliance on Mental Illness, approximately one in six adolescents in the United States experiences a major depressive episode each year. In New Hampshire, the 2023 Youth Risk Behavior Survey revealed that 40% of students reported feeling persistently sad or hopeless, with about one-third stating that their mental health was poor most or all of the time.
Dr. Sarah Rocha, a child and adolescent psychiatrist at Elliot Behavioral Health, emphasizes the need for parents to be vigilant. “Emotions and emotional range are part of the normal human experience,” she noted. “But if you’re seeing a consistent change in your child’s behavior or mood for two weeks or more, that’s when I would really recommend calling your health care provider.”
Signs of distress can manifest differently among teenagers. Dr. Jennifer McLaren, a pediatric psychiatrist with Dartmouth Health Children’s, explains that if behaviors interfere with daily life, this may signal more than typical teenage angst. “Indicators can include changes in sleep patterns, withdrawal from enjoyable activities, or a decline in academic performance,” she said. “Risky behaviors, such as substance use or self-harm, are also concerning.”
The presentation of depression can differ significantly between adolescents and adults. William Charmak, a board-certified psychologist at Foundation Counseling and Wellness, points out that while adults often exhibit signs of guilt or persistent sadness, adolescents may not. “Guilt is not often common in adolescent depression,” he said. Instead, teens may experience feelings of numbness or disconnection from activities or people they once enjoyed.
Gender differences also play a role in how anxiety and depression are expressed. Dr. Alexandra Kuftinec, a psychiatrist at Concord Hospital, notes that girls often internalize their feelings and may present with physical symptoms like headaches or stomachaches. In contrast, boys might exhibit aggression or anger, which can manifest in confrontational behavior.
Anxiety disorders are among the most prevalent mental health issues facing teenagers today. Dr. Rocha explains that untreated anxiety can trigger depressive episodes. Many teens experience multiple diagnoses, including generalized anxiety, social anxiety, and even post-traumatic stress disorder (PTSD) stemming from various life experiences.
Prompt intervention is crucial; experts warn that delaying care can lead to a crisis situation. “If we see a behavior change and think it’s just a phase, we may delay seeking help until it escalates,” Rocha cautioned.
Primary care providers often serve as the first line of defense in identifying mental health issues during routine checkups. Kuftinec’s practice employs the PHQ-9 Personal Health Questionnaire for Adolescents, which assesses symptoms of depression over a two-week period. If symptoms appear more than half the days, it may indicate a serious problem.
In response to the growing demand for mental health services, Dartmouth Children’s and the University of New Hampshire have established the New Hampshire Mental Health Care Access and Pediatrics line. This initiative connects primary care providers with mental health specialists for timely assessments and recommendations.
In cases where immediate intervention is necessary—such as when a teenager poses a danger to themselves or others—access to inpatient psychiatric care can be limited. In an effort to address these challenges, New Hampshire has increased access to psychiatric services over the past two years. In 2022, Dartmouth Health expanded its capacity by adding more than 40 inpatient beds for children aged 5 to 15, and in April 2025, a new six-bed adolescent medical psychiatry unit will open for youths aged 12 to 17.
Observing changes in a teenager’s mood or behavior warrants proactive communication from parents. Dr. Rocha advises against asking closed questions that do not elicit detailed responses. Instead, she suggests open-ended inquiries, such as, “I noticed you don’t want to go to practice anymore. Can you tell me more about that?”
Parents are encouraged to engage in shared experiences with their children, whether through activities they both enjoy or simply spending time discussing everyday matters. Creating an environment of open communication can help adolescents feel more comfortable sharing their thoughts and struggles.
Navigating the mental health system can be daunting for families. Melissa Brule, director of Behavioral Health and Specialty Services at Elliot Hospital, emphasizes that resources are available. Families who do not have a trusted pediatrician can access evaluations at community mental health centers during open hours.
At Elliot, behavioral health navigators are available to assist families in finding appropriate care. Most screenings are conducted via telehealth, which has proven beneficial for families seeking convenience.
Recognizing and addressing mental health concerns early can significantly impact a teenager’s well-being. Parents play a crucial role in this process by staying informed and engaged in their child’s emotional health.
