Teenage Angst: 3 Typical Issues and When to seek Professional Help for an Adolescent

This post is the 4th in a series of 6 about adolescence. You can read the first post here: 5 Ways to Support Preteen Girls so they can be Strong and Confident during and after Puberty

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During adolescence teens can mature and grow into healthy adults, the can fail to progress in some aspect, or, rarely, they can fail to successfully navigate all of the emotional developmental milestones. To complicate matters more, many mental illnesses begin to make themselves known between the ages of 14-25. Determining if a mental health issue is simply a product of difficulty coping with the developmental tasks of adolescence, or if the child is actually developing symptoms that meet criteria for a sustained mental health diagnosis, can be challenging. Even normal teenage behavior can spark concern. When do behaviors go beyond what is considered to be typical and when should a teen get treatment? In three of the developmentally specific aspects of adolescence, there are certain behavioral reactions that raise a red flag.

The Imaginary Audience


The teen experience of feeling like everyone is watching you is due to body and hormonal changes. Feeling self-conscious in adolescence is absolutely typical. Paying close attention to what a teen does to manage their uneasiness can provide clues as to how the teen is progressing through adolescence. Many teens will learn to accept the fleeting feeling of self-consciousness without allowing their lives to be disrupted. However, some teens may feel uncomfortable to the point that they start engaging in negative behaviors to ease their uncomfortableness. The behaviors do help the child feel better, but they can also adversely affect the child’s functioning and maturation. The teen may engage in obsessive compulsive behaviors, restrict food, or hurt themselves in some manner (cutting, burning, etc.). The teen may refuse to try new things, may isolate themselves, and may even stop going to school. If after two weeks, or shorter for dire behaviors, the teen continues to resort to extreme counteractive behaviors to soothe self-consciousness, a mental health professional should be consulted.

 Fitting In

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Teens have a strong need to feel part of a group and they often believe that if they are different in any way they will be rejected by their peers. Difficulties arise if the teen becomes overly concerned about their differences, or if the teen adopts negative behaviors so that they can have a sense of belonging. A teen who is excessively worried because their peers have deemed them “too short”, “too tall”, “too fat”, “too nerdy”, etc. will develop low self-confidence and low self-acceptance. Depressed feelings can start, and the child may even think of suicide. In this case professional help should be arranged as soon as an adult becomes aware of the teen’s struggles. An external expression of difficulty with managing the strong desire to fit in, is gang membership and/or illegal substance use. A therapist can help the teen address and resolve the reasons that the need to fit in is so important to them.

 Identity Development


Developing a sense of identity is the most important and complex task of adolescence. Without completing this developmental milestone, a child will struggle to successfully mature into adulthood. Every teen eventually asks themselves the “who am I?” question. A teen who tries out different styles in search of finding their identity, like one week being Goth, the next week being a hippie, and the next week being an intellectual, is behaving in a manner that is to be expected. However, a teen really struggling to find a sense of self may go as far as trying to take on another person’s identity. The teen may mimic a person’s mannerisms, may get their hair-cut just like the other person, dress just like the other person, and make the exact same decisions (such as what to eat) as the other person. Identity searching behavior that goes to these lengths needs to be addressed by a mental health professional.

 In a nutshell, if a teen’s coping methods are damaging to the child and/or the people around him/her, then a mental health professional who specializes in adolescence should be consulted. Teens will often be more open regarding their concerns and struggles with adults who aren’t their parents. A therapist can validate the child’s need to feel like they belong and can help the child begin to think about their own values and beliefs in the context of belonging. Therapists also teach positive coping skills to help teens learn to manage their strong emotions. If there is a teen in your life that you are worried about in the least, speaking with a mental health professional directly is the best way to understand whether or not the teen needs therapy. Determining if a longer lasting mental illness is developing can really only be determined in hindsight, although extremes in behaviors do offer clues as to the severity of any issue. Either way, if the teen is in the beginning stages of a mental illness or if the teen only needs therapy to help them navigate adolescence better, if they do not get needed therapy they can suffer severe consequences down the road.

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Sara Culpepper, Licensed Professional Counselor, loves helping women and teens improve their relationships with themselves, internalize that their worth is not connected to their appearance, and express their genuine nature. Sara helps women understand that eating disorders and emotional dysregulation can be due to societal pressures. She enjoys providing education regarding intuitive eating, health at every size, and feminism. To talk with her regarding treatment in the state of North Carolina, please schedule a free consultation.