What to Do When You Think Something's Wrong: A Parent's Guide

As a parent, you know your teen better than anyone. That gut feeling when something's off? Trust it—but also know the difference between normal teen ups and downs and signs that might need more attention. 

STEP 1: UNDERSTAND NORMAL TEEN STRUGGLES 

Is this normal teenage behavior or something more? 

First, a reality check: being a teenager is hard. Bad days, stress and mood swings come with the territory. As Dr. Lisa Damour, prominent psychologist and expert on teen development, notes, "Parents need to make clear to their children that they will have lousy days and all that matters are the choices you make around coping." 

This is key: what matters isn't whether your teen feels great all the time—it's how they handle difficult emotions. Do they: 

• Reach out to friends? 

• Get moving with sports or exercise? 

• Use creative outlets like music or art? 

• Talk things through with someone they trust? 

• Take healthy mental breaks? 

Or do they turn to concerning alternatives like isolation, self-harm or substance use to numb the pain? 

Why this matters more than ever: This distinction between healthy and unhealthy coping is critical in today's world. When teens seek quick relief from emotional pain, they face unprecedented dangers that didn't exist when we were young. Fake prescription pills containing deadly fentanyl now look identical to real Percocet, Xanax or Adderall—the very medications some teens might seek to self-treat anxiety, stress or difficulty focusing. Just 2 milligrams of fentanyl—a few grains of salt—can be lethal. These counterfeits are sold through social media and can be found anywhere, including in schools. 

What might have been "just experimenting" in the past can now be fatal with a single pill. That's why recognizing early warning signs of mental health struggles is a critical step in preventing substance use tragedies. 

STEP 2: RECOGNIZE WARNING SIGNS 

What changes should concern you? 

It’s normal for teens to go through ups and downs. But when changes are persistent, show up in more than one area of life, or seem to come out of nowhere, they may be signs of something deeper—especially if your teen is also dealing with other risk factors like stress, trauma or pre-existing mental health conditions.  

Look for patterns, not just isolated moments. One or two skipped assignment or moody afternoon might not mean much. But if you’re noticing multiple changes that last more than a couple weeks, it’s worth paying attention.   

Remember: Even high-achieving teens and athletes can struggle beneath the surface. The pressure to maintain perfect grades or peak athletic performance often creates hidden stress that can lead teens to seek relief through risky behaviors. According to recent studies, one in five teens aged 12-17 have had a major depressive episode within the past last year. Some teens face additional challenges that make them more vulnerable to both mental health struggles and risky coping behaviors. Those with ADHD, anxiety or depression may need extra support developing healthy ways to cope with stress.  

STEP 3: STRENGTHEN YOUR CONNECTION 

Your relationship is their best protection 

Fortunately, your relationship with your teen is their strongest protection against both mental health struggles and substance use risks. When teens feel safe, valued and heard at home, they're more likely to share their challenges and less likely to seek relief through risky behaviors like substance use. 

Try these connection-building approaches:  

• Be curious about your teen's world—ask open questions about what's going well and what's challenging 

• Create regular, relaxed opportunities to talk without pressure 

• Validate their feelings without immediately trying to solve their problems 

• Share family meals whenever possible 

• Stay involved in their activities without adding performance pressure 

• Model healthy ways to handle your own stress 

• Maintain clear family rules and boundaries 

• Help them build connections with other trusted adults 

This protective connection is especially important in today's environment where teens face unprecedented risks from counterfeit pills and other dangerous substances. 

STEP 4: START WITH CONVERSATION 

How to approach difficult topics When you notice concerning changes, conversations are your most powerful tool. Teens often open up more during casual moments than formal "talks." Look for natural opportunities during drives, walks or while cooking together. Try starting with: 

• "Things seem a little different lately to me—want to talk about what's going on?" 

• "I've noticed you seem stressed. What's feeling hard right now?" 

• "I'm here to listen, not to lecture or judge." 

Then really listen. Let them share without interruption or judgment. Focus on understanding rather than solving or lecturing. 

These conversations create space for teens to talk about what they're experiencing emotionally, which can help prevent them from turning to substances as a way to self-medicate or cope with stress, anxiety or other challenges. 

STEP 5: USE AVAILABLE RESOURCES 

Tools to help you and your teen 

STEP 6: KNOW WHEN TO GET PROFESSIONAL HELP 

You don't have to handle serious concerns alone 

If warning signs continue despite your best efforts at connection, you don't have to handle this alone. When concerns persist for more than two weeks—especially changes in sleep, mood or social withdrawal—it's time to reach out for additional support. 

References: Scott Hadland, MD, Chief of Adolescent Medicine, Mass General for Children/Harvard Medical School; Lisa Damour, PhD, Teen Parenting Expert, Best Selling Author, Co-Host of Ask Lisa Podcast; Fred Muench, PhD, CEO, Clear 30