Common Mental Health Conditions in Youth

Depressive Disorder

Emotional Changes

  • Feelings of sadness, which can include crying spells for no apparent reason

  • Frustration or feelings of anger, even over small matters

  • Feeling hopeless or empty

  • Irritable or annoyed mood

  • Loss of interest or pleasure in usual activities

  • Loss of interest in, or conflict with, family and friends

  • Low self-esteem

  • Feelings of worthlessness or guilt

  • Fixation on past failures or exaggerated self-blame or self-criticism

  • Extreme sensitivity to rejection or failure, and the need for excessive reassurance

  • Trouble thinking, concentrating, making decisions, and remembering things

  • Ongoing sense that life and the future are grim and bleak

  • Frequent thoughts of death, dying, or suicide

 

Behavioral Changes

  • Tiredness and loss of energy

  • Insomnia or sleeping too much

  • Changes in appetite — decreased appetite and weight loss, or increased cravings for food and weight gain

  • Use of alcohol or drugs

  • Agitation or restlessness — for example, pacing, hand-wringing, or an inability to sit still

  • Slowed thinking, speaking, or body movements

  • Frequent complaints of unexplained body aches and headaches, which may include frequent visits to the school nurse

  • Social isolation

  • Poor school performance or frequent absences from school

  • Less attention to personal hygiene or appearance

  • Angry outbursts, disruptive or risky behavior, or other acting-out behaviors

  • Self-harm — for example, cutting, burning, or excessive piercing or tattooing

  • Making a suicide plan or a suicide attempt

 

Generalized Anxiety Disorder

Behavioral/Cognitive Symptoms:

  • Feeling nervous, restless or tense

  • Expecting the worst, even when there is no apparent reason for concern.

  • Having difficulty controlling worry

  • Having the urge to avoid things that trigger anxiety

  • Problems concentrating, or the mind going blank

  • Irritability

  • Problems falling or staying asleep, or sleep that is restless and unsatisfying

  • Restlessness when awake

  • Not eating enough or overeating

  • Outbursts of anger

  • A pattern of being disobedient, hostile, and defiant behaviors

Physical Symptoms:

  • Muscle tension

  • Upset stomach

  • Sweating

  • Difficulty breathing

  • Headaches 

  • Fatigue 

 

Other Anxiety Disorders

 Separation Anxiety

  • Excessive distress when separated from the primary caregiver

  • Nightmares

  • Reluctance to go to school or other places because of fear of separation

  • Reluctance to go to sleep without the primary caregiver nearby

  • Repeated physical complaints

  • Worry about bad things happening to their parents or caregivers

  • Have a general sense of something terrible occurring while being apart from their parents or caregivers

Social Anxiety

  • Avoiding or refusing to initiate conversations, invite friends to get together, order food in restaurants, or call text, or e-mail peers 

  • Frequently avoiding eye contact with adults or peers

  • Speaking very softly or mumbling

  • Appearing isolated or on the fringes of the group 

  • Sitting alone in the library or cafeteria, or hanging back from a group in team meetings 

  • Overly concerned with negative evaluation, humiliation, or embarrassment 

  • Difficulty with public speaking, reading aloud, or being called on in class

Bipolar Disorder

Important to note: Although uncommon, young kids can be diagnosed with Bipolar Disorder, however, most common age range of first diagnosis is late teens to early twenties.

Symptoms a child or teen may display during a manic episode:  

A manic episode happens when a person’s state of mind is characterized by high energy, excitement, and euphoria over a sustained time. It's an extreme change in mood and cognition that can interfere with school, work, or home life.

  • Show intense happiness or silliness for long periods. 

  • Have a very short temper or seem extremely irritable.

  • Talk fast about a lot of different things. 

  • Have trouble sleeping but not feel tired. 

  • Have trouble staying focused, and experience racing thoughts. 

  • Seem overly interested or involved in pleasurable but risky activities. 

  • Use/Misuse of alcohol, drugs, and nicotine, high-risk sexual behaviors

  • Do risky or reckless things that show poor judgment.

  • Shoplift, vandalism, skipping school, any risk-taking behavior that could lead to harm/potential to harm the individual and/or other people

Symptoms a child or teen may display during a depressive episode:

A depressive episode is a period characterized by symptoms of depression Those affected primarily exhibit a depressive mood for at least two weeks or more and a loss of interest or pleasure in everyday activities.

  • Feel frequent and unprovoked sadness. 

  • Show increased irritability, anger, or hostility. 

  • Complain a lot about pain, such as stomachaches and headaches. 

  • Have a noticeable increase in the amount of sleep. 

  • Have difficulty concentrating. 

  • Feel hopeless and worthless. 

  • Have difficulty communicating or maintaining relationships. 

  • Eat too much or too little. 

  • Have little energy and no interest in activities they usually enjoy. 

  • Think about death or have thoughts of suicide.

 

Eating Disorders

Anorexia Nervosa: People with anorexia nervosa avoid food, severely restrict food, or eat very small quantities of only certain foods. Even when they are dangerously underweight, they may see themselves as overweight. They may also weigh themselves repeatedly. Anorexia can be fatal. Anorexia nervosa has the highest mortality (death) rate of any mental disorder. People with anorexia may die from medical conditions and complications associated with starvation; by comparison, people with other eating disorders die of suicide. 

Bulimia Nervosa: People with bulimia nervosa have recurrent episodes of eating unusually large amounts of food and feeling a lack of control over these episodes. This binge eating is followed by behaviors that compensate for the overeating, such as forced vomiting, excessive use of laxatives or diuretics, fasting, excessive exercise, or a combination of these behaviors. Unlike those with anorexia nervosa, people with bulimia nervosa may maintain a normal weight or be overweight.

Binge-Eating Disorder: People with binge-eating disorder lose control over their eating. Unlike bulimia nervosa, periods of binge eating are not followed by purging, excessive exercise, or fasting. As a result, people with binge-eating disorder are often overweight or obese.

Symptoms of Anorexia Nervosa

  • Extremely restricted eating and/or intensive and excessive exercise 

  • Extreme thinness (emaciation) 

  • A relentless pursuit of thinness and unwillingness to maintain a normal or healthy weight 

  • Intense fear of gaining weight 

  • Distorted body image, a self-esteem that is heavily influenced by perceptions of body weight and shape, or a denial of the seriousness of low body weight

Over time, these symptoms may also develop:  

  • Thinning of the bones (osteopenia or osteoporosis) 

  • Mild anemia and muscle wasting and weakness

  • Brittle hair and nails 

  • Dry and yellowish skin 

  • Growth of fine hair all over the body (lanugo) 

  • Severe constipation 

  • Low blood pressure, slowed breathing and pulse 

  • Damage to the structure and function of the heart 

  • Drop in internal body temperature, causing a person to feel cold all the time 

  • Lethargy, sluggishness, or feeling tired all the time 

  • Infertility 

  • Brain damage

  • Multi-organ failure

Symptoms of Bulimia Nervosa

  • Chronically inflamed and sore throat 

  • Swollen salivary glands in the neck and jaw area 

  • Worn tooth enamel and increasingly sensitive and decaying teeth (a result of exposure to stomach acid) 

  • Cuts/scars on joints/knuckles on hands from self-induced vomiting

  • Acid reflux disorder and other gastrointestinal problems 

  • Intestinal distress and irritation from laxative abuse 

  • Severe dehydration from purging

  • Electrolyte imbalance (too low or too high levels of sodium, calcium, potassium and other minerals), which can lead to stroke or heart attack

 Symptoms of Binge Eating Disorder

  • Eating unusually large amounts of food in a specific amount of time, such as a 2-hour period 

  • Eating fast during binge episodes

  • Eating even when full or not hungry 

  • Eating until uncomfortably full 

  • Eating alone or in secret to avoid embarrassment 

  • Feeling distressed, ashamed, or guilty about eating 

  • Frequently dieting, possibly without weight loss

 

Obsessive Compulsive Disorder (OCD)

Symptoms of OCD: People with OCD may have obsessions, compulsions, or both. Some people with OCD also have a tic disorder. Motor tics are sudden, brief, repetitive movements, such as eye blinking, facial grimacing, shoulder shrugging, or head or shoulder jerking. Common vocal tics include repetitive throat clearing, sniffing, or grunting sounds.

Obsessions may include:

  • Constant, irrational worry about dirt, germs, or contamination 

  • Excessive concern with order, arrangement, or symmetry 

  • Fear of harm or danger to a loved one or self

  • Religious rules or rituals

  • Intrusive words or sounds

  • Fear of losing something valuable

Compulsions may include:

  • Excessively cleaning or washing a body part 

  • Keeping or hoarding unnecessary objects 

  • Ordering or arranging items in a particular, precise way

  • Repeatedly checking on things, such as making sure that the door is locked or the oven is off

  • Repeating a name, phrase, tune, activity, or prayer

  • Repeatedly counting items 

  • Constantly seeking reassurance

 

Conduct Disorder

Symptoms of Conduct Disorder: Children who have conduct disorder are often hard to control and unwilling to follow rules. They act impulsively without considering the consequences of their actions. They also don’t take other people’s feelings into consideration. Boys who have conduct disorder are more likely to display aggressive and destructive than girls. Girls are more prone to deceitful and rule-violating behavior.

 Some of the symptoms include:  

Aggressive Conduct:

  • Intimidating or bullying others

  • Physically harming people or animals on purpose

  • Forcing someone to perform an activity they are not comfortable with (e.g., sexual activity)

  • Using a weapon

Destructive Behavior:  

  • Arson

  • Other intentional destruction of property

Deceitful Behavior:

  • Lying

  • Breaking and entering

  • Stealing

  • Forgery

Violation of Rules:

  • Skipping school

  • Running away from home

  • Drug and alcohol use

  • Sexual behavior at a very young age

 

Oppositional Defiant Disorder (ODD)

Symptoms of ODD: Signs of ODD generally begin during preschool years. Sometimes ODD may develop later, but almost always before the early teen years. These behaviors cause significant impairment with family, social activities, school and work.  

Many children & teens with ODD also have other mental health disorders such as Attention-Deficit/Hyperactivity Disorder (ADHD), Conduct Disorder, Depression, Anxiety, and Learning/Communication Disorders

These symptoms may include:

Angry and Irritable Mood

  • Often and easily loses temper

  • Is frequently touchy and easily annoyed by others; easily agitated

  • Is often angry and resentful

  • Vindictiveness

  • Is often spiteful or vindictive

  • Has shown spiteful or vindictive behavior at least twice in the past six months

Argumentative and Defiant Behaviors

  • Often argues with adults or people in authority

  • Often actively defies or refuses to comply with adults' requests or rules

  • Often deliberately annoys or upsets people

  • Often blames others for his or her mistakes or misbehavior

 

Post-Traumatic Stress Disorder (PTSD)

PTSD is a disorder that some people develop after experiencing a shocking, scary, or dangerous event. It is natural to feel afraid during and after a traumatic situation. This fear triggers many split-second changes in the body to respond to danger and help a person avoid danger in the future. Anyone can develop PTSD at any age.

Symptoms of PTSD

Re-experiencing symptoms

  • Flashbacks—reliving the trauma over and over, including physical symptoms like a racing heart or sweating 

  • Bad dreams 

  • Frightening thoughts

 Avoidance Symptoms

  • Staying away from places, events, or objects that are reminders of the experience

  • Avoiding thoughts or feelings related to the traumatic event

 Arousal and Reactivity Symptoms

  • Being easily startled 

  • Feeling tense or “on edge” 

  • Having difficulty sleeping, and/or having angry outbursts

 Cognitive and Mood Symptoms

  • Trouble remembering key features of the traumatic event 

  • Negative thoughts about oneself or the world 

  • Distorted feelings like guilt or blame 

  • Loss of interest in enjoyable activities

  • Impulsive and aggressive behaviors (seen more in teens)

Addressing Youth Mental Health

Know the Warning Signs

It can be difficult to tell whether or not your youth has a mental disorder, but there are certain nonverbal cues and signs you can watch out for. 

  • Have lost interest in things that they used to enjoy

  • Have low energy

  • Sleep too much or too little, or seem sleepy throughout the day

  • Are spending more and more time alone, and avoid social activities with friends or family

  • Fear gaining weight, or diet or exercise excessively

  • Engage in self-harm behaviors (e.g., cutting or burning their skin)

  • Smoke, drink alcohol, or use drugs

  • Engage in risky or destructive behavior alone or with friends

  • Have thoughts of suicide

  • Have periods of highly elevated energy and activity, and require much less sleep than usual

  • Say that they think someone is trying to control their mind or that they hear things that other people cannot hear.

Mental Health Crisis Resources

Crisis Text Line: https//www.crisistextline.org

  • Provides free, 24/7 support for those in crisis by trained volunteers. Crisis doesn’t just mean thinking about ending your own life. It’s any painful emotion and anytime you need support. 

  • Text “HOME” to 741741

National Suicide Prevention Lifeline: https://988lifeline.org 

  • The National Suicide Prevention Lifeline is a national network of local crisis centers that provides free and confidential support to people in suicidal crisis or emotional distress. These services are offered 24 hours a day, 7 days a week. 

  • Phone number: 988

Trevor Project: https://www.thetrevorproject.org

  • Provides suicide prevention and crisis intervention to LGBTQ young people

  • Free, 24/7, confidential counseling through the following:

  • Trevor Lifeline: 1-866-488-7386

  • Trevor Text: Text “START” to 678-678

West Virginia Child Abuse Hotline: https://www.wvdhhr.org 

  • Report child abuse and/or neglect. Available to make reports 24 hours a day, 7 days a week.

  • 1-800-352-6513

National Human Trafficking Hotline

  • Report human trafficking. Available to make reports 24 hours a day, 7 days a week

  • National Human Trafficking Hotline: 1-888-373-7888

  • Text Line: Text “BeFree” to 233733

National Sexual Assault Hotline: https://www.rainn.org 

  • Operated by RAINN (Rape, Abuse, Incest National Network). Available to make reports 24 hours a day, 7 days a week. 

  • 1-800-656-HOPE (4673)

Rebecca White