Overview of Psychosocial Problems in Adolescents

Psychologic and social (psychosocial) problems, particularly involving behavioral and school issues, are more common during adolescence than at any other time during childhood. Adolescents are much more independent and mobile and are often out of the direct control of adults. When misbehavior becomes severe and frequent, adolescents should be evaluated for a psychosocial disorder by a mental health professional. In particular, depression, anxiety, and eating disorders are common during adolescence. Adolescents who have anxiety or mood disorders may have physical symptoms such as fatigue or chronic fatigue, dizziness, headache, and abdominal or chest pain.

Depression is common among adolescents, and doctors actively screen for it during examinations.

Suicide is uncommon, but thoughts about suicide (called suicidal ideation) are common. Adolescents with suicidal ideation require an immediate mental health evaluation, and parents should not try to determine how serious the problem is on their own.

Anxiety often manifests during adolescence, as do mood disorders and disruptive behavioral disorders such as oppositional defiant disorder and conduct disorder.

The COVID-19 pandemic and the global response to it, including changes in daily routines and school schedules, have impacted the rates of depression and anxiety among many adolescents.

Thought disorders, in which a person has difficulty distinguishing between fantasy and reality (also called psychosis), most commonly begin during adolescence or early adulthood. The first episode of psychosis is called a psychotic break. Schizophrenia and schizoaffective disorder are examples of thought disorders. Periods of psychosis may be related to drug use. In these cases, psychosis may resolve after a period of time. Psychotic episodes may occur with cannabis (marijuana) use, particularly edible products. Some adolescents who have a psychotic episode caused by cannabis use go on to develop a chronic psychotic disorder.

Eating disorders, especially in girls, are common and can be life threatening. Some adolescents go to extraordinary lengths to hide symptoms of an eating disorder, which may include substantial reductions in food intake, purging after eating, use of laxatives, or extensive, vigorous exercise.

Doctors can often identify these problems. They can offer adolescents practical advice and, when appropriate, encourage adolescents to accept treatment provided by specialists.

(See also Introduction to Problems in Adolescents.)