Key Takeaways
- Back-to-school stress does not automatically mean a teenager has a mental health condition.
- A useful question for parents is whether a behavior is typical for their teen or represents a meaningful change from their normal personality, habits, or functioning.
- Changes that continue for weeks, including withdrawal, mood changes, unusual sleep patterns, difficulty organizing daily life, or struggling to attend school, may be worth discussing with a mental health professional.
- Parents do not need to force a teenager to talk. The first goal is to make it safe for them to talk when they are ready.
- When choosing a therapist for a teenager, look for someone with specific experience working with adolescents.
Watch Dr. Stacey Krauss's full Healthy in Houston segment:
Watch the TV segment on Vimeo
Back-to-school season brings new classes, schedules, friendships, expectations, and routines. For teenagers, all of those changes can create stress even when things are generally going well.
For parents, the difficult question is figuring out when what they are seeing is part of an ordinary rough patch and when it might signal that their teenager needs more support.
Dr. Stacey Krauss, Psy.D., ABPP, CEO of Transitions Counseling and Consulting, recently joined Healthy in Houston to discuss exactly that question.
She described it as learning to distinguish between a teen who is having a hard day and a teen who is having a hard time.
Is This Normal for Your Teen?
There is no single checklist that tells every parent whether their teenager is struggling.
Teenagers have different personalities, habits, energy levels, social lives, and ways of expressing emotion. A behavior that would be unusual for one teenager may be completely normal for another.
That is why Dr. Krauss recommends starting with a simple question:
Does this seem typical for my teen?
Imagine a teenager who is normally confident and outgoing suddenly becoming withdrawn. Or a teen who is usually organized begins having persistent difficulty keeping up with daily activities. Those changes may deserve more attention than the same behaviors in a teenager for whom they have always been typical.
The key is looking for a meaningful change from your teenager's baseline, particularly when that change does not resolve after a short period of time.
What Changes Should Parents Pay Attention To?
Teenagers often communicate through their behavior before they are ready or able to describe what they are experiencing.
During the television segment, Dr. Krauss encouraged parents to notice changes such as:
- A normally outgoing teenager becoming unusually withdrawn
- Mood changes that persist rather than resolving after a difficult day
- Sleeping significantly more or less than usual
- New difficulty organizing everyday activities
- Trouble getting through the school day or even through the front door
- Changes that remain noticeable after several weeks
These signs do not automatically mean that a teenager has anxiety, depression, or another mental health condition. They are signals that something may have changed and that it is worth paying attention.
Transitions has more comprehensive resources on teen mental health treatment, including the Teen Intensive Outpatient Program.
For parents specifically concerned about anxiety, the existing guide to anxiety in children and teenagers goes deeper into symptoms, causes, treatment, and coping strategies.
How Should You Talk to a Teen You Are Worried About?
This was one of the most useful parts of Dr. Krauss's conversation.
Parents often become so concerned about saying the wrong thing that they put enormous pressure on themselves to create the perfect conversation.
You do not need a perfect opening.
Dr. Krauss suggested simply describing what you have noticed:
“You don't seem like yourself lately. How are you doing?”
Then remember that your goal is not necessarily to get your teen to talk immediately. As Dr. Krauss put it, the goal is to make it safe for them to talk.
That distinction matters.
A teenager may shrug. They may say they are fine. They may change the subject. That does not mean the conversation failed.
Dr. Krauss noted that it may take the fifth or sixth time a parent creates an opening before a teenager is ready to engage. Staying available and continuing to communicate that you are willing to listen can be more useful than trying to force everything into one conversation.
What If Your Teen Doesn't Want to See a Therapist?
Parents often worry about how they will convince a reluctant teenager to talk with a mental health professional.
Dr. Krauss's first recommendation is straightforward: do not overthink it.
Start by finding a therapist who actually has experience working with teenagers. Adolescents are not simply younger adults. A clinician who regularly works with teens understands adolescent development, communication styles, family dynamics, and the fact that building trust may happen at a different pace.
The first few sessions may involve simply getting comfortable with each other.
The goal is to make therapy feel increasingly normal and safe, rather than expecting a teenager to walk into a first appointment and immediately discuss everything that is bothering them.
Transitions provides different types of mental health treatment for teenagers, including a Teen Partial Hospitalization Program at select locations,depending on what a teen and family need.
Are Parents Involved in a Teen's Therapy?
Teen therapy does not necessarily mean handing your child to a therapist and being completely excluded from what happens next.
As Dr. Krauss explained during the interview, the family is often involved in some form. Exactly what that involvement looks like can vary based on the teenager's needs, treatment plan, age, clinical situation, and appropriate privacy considerations.
Some treatment may take place individually with the teen. Other conversations or sessions may involve parents or the family together.
The goal is for everyone to understand the broader plan and how the family can help support progress outside of therapy.
This aligns with Transitions' broader approach to teen care, which includes parent involvement and family support when appropriate.
How Long Should Parents Wait Before Seeking Help?
Every situation is different, so there is no single number of days that applies to every teenager.
Dr. Krauss's advice in the segment was to pay particular attention when an unusual change is not resolving after a few weeks.
A single difficult school day is different from a normally social teenager remaining withdrawn for weeks. One bad night's sleep is different from a persistent change in sleep. Feeling nervous about the first day of school is different from repeatedly struggling to walk through the school doors.
Duration, severity, and how much the change is affecting everyday life all matter.
If you are unsure, you do not have to decide on your own whether the situation is “serious enough.” Talking with a mental health professional can help you understand what you are seeing.
If your teen is in crisis or talks about suicide or self-harm, call or text 988 to reach the 988 Suicide & Crisis Lifeline, or call 911 in an emergency.
Frequently Asked Questions About Teen Mental Health and Back-to-School Stress
How can I tell normal teenage behavior from a mental health concern?
Start by comparing your teen's current behavior with what is normal for them. A meaningful change in mood, sleep, social behavior, organization, school functioning, or daily activities that continues over time may be worth discussing with a professional.
What should I say if I think my teenager is struggling?
Keep it simple and describe what you have noticed. For example: “You don't seem like yourself lately. How are you doing?” Try to create a safe opening rather than pressuring your teen to immediately explain everything.
What if my teenager says they're fine?
Do not assume that means you should never ask again. Continue to let them know that you are available. Dr. Krauss notes that teenagers sometimes need parents to open the door to a conversation several times before they are ready to walk through it.
Should my teenager see a therapist who specializes in teens?
Experience working with adolescents can be important. Teenagers have different developmental, emotional, social, and family needs than younger children or adults, and treatment should reflect those differences.
Does the whole family need therapy if my teenager is struggling?
Not necessarily. Every family and treatment plan is different. However, parents and caregivers often play an important role in supporting a teen's treatment, and family or parent involvement may be recommended.
You Know Your Teen Better Than Anyone
Parents do not need to diagnose their teenager.
One of the most useful things you can do is notice changes, remain curious about what is happening, and keep making it safe for your teen to tell you when something does not feel right.
Back-to-school stress can be temporary. But when a teen seems fundamentally different from themselves and that change continues, it is reasonable to ask whether they may need additional support.
The difference between a hard day and a hard time is not always obvious. Paying attention to your teenager's patterns, staying available, and reaching out when you are concerned can help you make that distinction together.
Find Mental Health Support for Your Teen
Transitions Counseling and Consulting offers mental health services for children, teens, adults, couples and families in Arizona and Texas, including an office in Houston, with telehealth available when appropriate. Contact Transitions or call (602) 363-0629 to schedule an appointment or ask which services fit your needs.
