Is It a Mental Health Problem? Or Just Puberty?

MAY. 30, 2018

By Dona Matthews, Ph.D.


We’re seeing epidemic levels of stress in children and teenagers, with increasing rates of clinical depression, anxiety and other coping problems. Fear, uncertainty and lack of control—factors that power stress—are ramped up in times of rapid, unpredictable change. And puberty is a time of massive change: hormonal, physical, sexual, social, cognitive and neurological.

Puberty brings a level of volatility in attitudes, behavior, responsibility and moods that can look and feel like mental illness. Most parents experience at least some moments of concern for their children’s mental health during the puberty ages of 11 to 14. But, should you? Or is your child experiencing a normal transition into adulthood?

It isn’t always easy to distinguish between the typical moodiness of puberty and mental health conditions that require professional attention. If you’re wondering about your child’s behaviors, here are some questions to ask yourself. They provide a good starting point for understanding how serious the problems might be, and whether you should seek professional help:

  • Does your child have at least one good friend? Although most young teens prefer popularity, one close friend is enough to get through puberty with resilience. If your child has no friends, that’s often a sign of isolation, and a strong reason to consider professional help.
  • Does your child have at least one adult they can talk to? This might be a parent, another relative, a teacher, or someone else—someone who can provide wisdom and support.
  • Does your child have at least one activity that engages them? One productive area of interest can sustain a young person through tough times. It might be a sport, the arts, a school subject, gardening, anything that involves thinking, learning and developing competence.
  • Is your child ever happy? It’s normal for pre-teens and early-teens to express more irritability, annoyance and anger (especially with their parents). But if your child never seems happy or contented, that is cause for concern.
  • Is your child engaging in self-harm? This includes alcohol, drugs and other toxic substances; cutting; sexual promiscuity; and self-sabotage like skipping school. It’s normal for a child to be curious about these things, but it’s time to seek help if you think your child’s well-being is threatened by dependence on any of these activities.

If your child does have an effective network of social support—including at least one friend and one adult they can talk to—is happily engaged in one or more productive activity and is not engaging in self-harming activities, you’re likely dealing with “normal” puberty. However, that doesn’t mean your child doesn’t need your help.

How to Support Resilience in Your Early Adolescent

There has been considerable research done showing that parents can make a difference in their children’s ability to handle stress, thereby minimizing the likelihood of mental health difficulties. Here are some ideas for supporting resilience in your child, whether or not they’re experiencing a mental health condition:


Being available when your children need you can make the difference between a good decision and a dangerous one. Be fully present when your teen wants to talk and be fully positive. Tweens are painfully aware of others’ perceptions and believe that everyone is looking at them with critical or even mocking eyes. Make sure your teen feels your positive gaze. No criticism, no judgement, no distractions.

Strive for Balance

We all need balance in our lives, but that’s especially true for early adolescents. Make sure your young teenager has opportunities for quiet reflection, ample sleep, regular outdoor exercise and good nutrition. Practice breathing techniques, and other mindfulness skills. You’ll be better at managing your own stress, and you’ll provide your teenager with a good model of coping with their ups-and-downs.

Welcome Conflict

Respect your child’s need to create their own unique blend of mainstream values with your family’s values. If you’re an immigrant, single parent, member of a cultural or religious minority or in a same-sex relationship, your child may feel a conflict between their home values and their peers’ values. A friendly debate is a great way for your teenager to discover what you care about, and why it’s worth caring about. You’re likely doing a good job of parenting if you and your teenager can argue, but there’s still love and warmth in your home.

Own the Parenting Space

Tweens and teens can appear to take pleasure from pushing your buttons. But on a deeper level, they need you to stay strong and calm. Just like a toddler who challenges the rules, teens feel safest when they know they can trust you to be solid no matter what grief they give you. That applies whether or not your child is dealing with a diagnosed mental health condition.

The years from 11 to 14 can be highly stressful for children as well as their parents. Unfortunately, there isn’t an easy or simple template for parents to determine whether or not their child has a diagnosable problem—that’s something only a mental health professional can do. You can, however, support your child’s resilience, and help them get through adolescence as smoothly as possible.



Dona Matthews, PhD, has been working with children, adolescents, families, and schools since 1990. In addition to running a busy private practice, she was the Executive Director of the Millennium Dialogue on Early Child Development at the University of Toronto, and the founding Director of the Hunter College Center for Gifted Studies and Education, City University of New York. She writes a regular column for, has published dozens of articles and book chapters, and is the co-author of these books: Beyond Intelligence: Secrets of Raising Happily Productive Kids; Being Smart about Gifted Education; The Development of Giftedness and Talent across the Life Span; and The Routledge International Companion to Gifted Education.


We’re always accepting submissions to the NAMI Blog! We feature the latest research, stories of recovery, ways to end stigma and strategies for living well with mental illness. Most importantly: We feature your voices

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JUN, 15, 2018 05:29:13 PM
Gary Childress
I had my first very severe psychosis (of many) when I was 24. I had virtually no friends growing up and the only activity that engaged me was plastic model kits, which I played with entirely in isolation from the company of peers. I was almost always morbidly depressed and felt like I couldn't confide with adults around me other than school counselors. I am diagnosed with mental illness but coping.

I therefore believe that Dr. Matthew's account of 'early warning signs' presented above is probably a very good set of indicators that something may be wrong, that parents should be on the lookout for and have their child screened so that possible intervention and preventive measures can be pursued.

JUN, 05, 2018 02:22:24 AM
Thank you for sharing this. It helps a parent like me discern what is puberty vs a deeper issue.

JUN, 01, 2018 02:41:38 AM
Lucesita Lombillo
This article was not only informative but very positive.

Submit to the NAMI Blog

We’re always accepting submissions to the NAMI Blog! We feature the latest research, stories of recovery, ways to end stigma and strategies for living well with mental illness. Most importantly: We feature your voices.

Check out our Submission Guidelines for more information.