Teenage mental health: a guide for parents
Some moodiness, arguments and wanting privacy are normal in teenagers. Warning signs are changes that last two weeks or more and affect daily life: persistent sadness or irritability, withdrawing from friends and family, falling grades, sleeping or eating much more or less, unexplained cuts or burns, talk of hopelessness or death, or intense fear about weight. About one in seven 10- to 19-year-olds worldwide has a mental health condition; most are treatable. Talk calmly and without judgement, ask directly about self-harm and suicide, and get help early. If a teenager is in immediate danger, call 1122 or go to an emergency department.
Health writers · Aslam Clinic
Some moodiness, arguments, slammed doors and a wish for privacy are a normal part of being a teenager. What is not normal is a change that lasts for weeks and takes over daily life: persistent sadness or irritability, pulling away from friends and family, falling grades, sleeping or eating much more or less, unexplained injuries, or talk of hopelessness. Those are signs to act on, early and calmly.
The World Health Organization estimates that one in seven young people aged 10 to 19 worldwide has a mental health condition, most often , or behaviour problems, and most are never recognised or treated. Suicide is the third leading cause of death in people aged 15 to 29. These conditions respond well to help, and parents are usually the first to notice.
Normal teenage changes, and warning signs
| Usually normal | Warning signs — especially if they last two weeks or more |
|---|---|
| Moody, then fine a few hours later | Low, irritable or tearful most days, for weeks |
| Wants more privacy and time with friends | Withdraws from friends as well as family; stops doing things they used to enjoy |
| Sleeps late at weekends | Cannot sleep, or sleeps most of the day; exhausted all the time |
| Argues about rules | Aggression, dangerous risk-taking, or drug or alcohol use |
| Worries before an exam | Fear that stops them going to school or leaving the house |
| Interested in appearance | Skipping meals, rapid weight loss, making themselves sick, or saying they are fat at a normal weight |
| Some drop in grades during a hard term | A sharp, sustained fall in school performance |
Depression and anxiety
Depression in teenagers often looks like irritability and anger rather than sadness. Other signs include losing interest in everything (), tiredness, poor concentration, changes in appetite and sleep, and saying things like 'what's the point' or 'everyone would be better off without me'.
Anxiety often shows up in the body — stomach aches, headaches, nausea before school — and as avoidance: refusing to go to school, to tuition or to family events. Many anxious teenagers look calm on the outside. Both conditions respond well to talking therapy such as , and sometimes medicine prescribed by a specialist.
Self-harm and suicidal thoughts
— cutting, burning, scratching or hitting oneself — is usually a way of coping with overwhelming feelings, not attention-seeking. Signs include unexplained cuts, bruises or burns on the arms, thighs or chest, and long sleeves in hot weather. Some teenagers who self-harm also have .
Asking directly — 'Are you having thoughts of hurting yourself or ending your life?' — does not put the idea in their head. It tells them they can talk to you.
Eating problems
such as anorexia and bulimia usually begin in adolescence and young adulthood, and girls are more commonly affected, though boys are too. Watch for skipping meals, secretive eating, going to the bathroom straight after meals, excessive exercise, rapid weight loss, and distress about weight or shape. Pressure about appearance before marriage proposals, and comments from relatives about a girl's weight or colour, can make these worse. Eating disorders are serious and need early professional help; do not wait for severe weight loss.
Bullying and cyberbullying
Bullying — at school, in the neighbourhood or online — is one of the strongest risks to a young person's mental health. Cyberbullying follows a child home. In a 2024 WHO survey across Europe, Central Asia and Canada, about one in six adolescents reported being cyberbullied. Watch for a teenager who suddenly avoids their phone or seems anxious when it buzzes, does not want to go to school, or loses friends.
- Listen and believe them. Do not blame them or take their phone away as punishment — that teaches them not to tell you.
- Save evidence: screenshots, messages, usernames.
- Use blocking and reporting tools on the platform.
- Talk to the school; bullying is the school's responsibility too.
- Threats, blackmail with photos, or sexual messages to a child are crimes. Report them to the police, and get support for your child.
Screens and social media: a balanced view
Screens are neither poison nor harmless. A large 2019 analysis of more than 350,000 adolescents found that the average link between digital technology use and wellbeing was negative but very small — explaining at most 0.4% of the difference in wellbeing between teenagers. What matters more is what a teenager is doing online and what it is replacing.
- Sleep — phones in bed are one of the commonest causes of poor sleep in teenagers. Charging phones outside the bedroom helps more than most rules.
- Content — pro-self-harm and extreme dieting content, gambling and pornography are genuinely harmful.
- Comparison — endless images of other people's lives can drive low mood and poor .
- Connection — for isolated teenagers, especially girls who cannot go out freely, online friendships can be a real support.
Agree screen rules together rather than imposing them, and follow them yourself — including at the dinner table.
Pressures particular to young people in Pakistan
- Career choice. Many teenagers feel they must become a doctor or engineer to satisfy their family, whatever their interests or abilities. Repeated MDCAT attempts under pressure are a common trigger for depression.
- Comparison and 'log kya kahenge'. Being compared with cousins and neighbours, and worrying about what the family will say, keeps problems hidden.
- Marriage pressure for girls. Early engagements, proposals and pressure to marry before finishing education can cause intense distress, particularly when a girl has no say. Being forced into marriage is harmful, and in many cases illegal.
- Restrictions on girls. Limited freedom to go out, study or see friends increases isolation.
- Pressure on boys to earn early, not show emotion and 'be a man' makes them less likely to ask for help.
- Violence at home. Witnessing or experiencing violence is a major risk for teenagers' mental health. The Punjab Women's Helpline 1043 and the child protection helpline 1121 can help.
Faith can be a strong support for young people, and prayer and professional help are not in conflict. But a teenager who is severely low, not eating or hurting themselves needs a doctor as well as dua.
How to talk with your teenager
- Choose a side-by-side moment — in the car, on a walk, cooking together. Face-to-face 'we need to talk' feels like an interrogation.
- Say what you have noticed, without blame. 'You've seemed really low lately, and I'm worried about you.'
- Ask open questions — 'How are things really going?' — and then listen more than you talk.
- Assume they have a reason for what they are doing, even if you disagree with it.
- Do not rush to fix or lecture. Being heard is often the help they need first.
- Stay calm if they say something frightening. If they see you panic or get angry, they will stop telling you.
- Pick your battles. Letting small things go keeps the relationship open for the big things.
- Offer a choice of support — you, a trusted relative or teacher, a school counsellor or a doctor.
When to get help
Start with your family doctor, who can refer to a child and adolescent psychiatrist or . Psychiatry departments at government DHQ and teaching hospitals see young people, and online therapy has made psychologists accessible outside big cities. Teenagers are more likely to engage if they are involved in choosing where to go and have some private time with the professional.
What you can do this week
- Spend some one-to-one time with your teenager doing something they choose.
- Ask one open question about how they are really doing, and listen.
- Move phones and chargers out of bedrooms at night — for the whole family.
- Stop comparisons with siblings and cousins, out loud and in front of relatives.
- Lock away medicines and pesticides at home; this saves lives.
- Save the emergency number 1122 and the Rozan helpline number in your phone.
Common questions
Still not sure what to do?
Reading about a symptom only goes so far. A doctor who can ask you questions and examine you will get further in ten minutes than any article can.
