Understanding Teens

What’s normal teen behavior? When is it time to get help?

Understanding Teens IParents often wonder how to tell the difference between typical teenage behaviors and warning signs of serious problems.

It’s wise to be alert. Three-quarters of mental illnesses begin by age 24. Although teens may look mature, their brains aren’t fully adult until sometime in their 20s. During this final development, they are more vulnerable to mental illness and addiction.

Teens have the best chance of enjoying a satisfying and productive life when mental health conditions are diagnosed and treated early.

The Developing Teen Brain

It’s normal for adolescents to have mood and behavior swings. Much of this can be attributed to the physical changes taking place in the brain.

Frontal cortex. Responsible for self-control, judgment, problem solving, emotional regulation, self-awareness and planning ahead, the frontal cortex is the last part of the brain to mature.

Teens are capable of amazing intellectual and creative accomplishments. It’s not that they have less control over their behavior, teens are just more likely to believe the benefits outweigh any potential harm or even that they are invulnerable.

Brain circuitry. At puberty, our brains experience a tremendous growth spurt of synapses which connect within and between various brain regions. As a teen grows into adulthood, the brain prunes away these synapses.

Because this rewiring of the brain is not complete until the 20s, teens are more prone to impulsive behavior and defience; not because they want to make bad decisions, but often because they can’t think before they act.

Studies also indicate teen brains have a heightened response to emotionally loaded images and situations compared to children and adults. This increases the urgency and intensity of their emotional reactions.

Sleep regulation. These brain changes could affect sleep regulation resulting in inadequate sleep or sleep deprivation which can contribute to irritability, depression and impulsive behavior.

Teens and Behavioral Health

Understanding Teens IIMental illnesses are disorders of brain function. They have many causes and result from complex interactions between a person’s genetics and environment. Some conditions that commonly start or intensify during the teen years are:

12.5% Anxiety disorders are the most common mental illness in the U.S. They include generalized anxiety disorder, panic attacks, social anxiety, school refusal and specific phobias which is an exaggerated fear of a specific object, activity or situation.1

11.4% Depression involves disturbances in mood, concentration, activity level, interests, appetite, social behavior and physical health. Girls experience depression at three times the rate as boys.2

11% Attention-deficit/hyperactivity disorder (ADHD) is commonly characterized by hyperactivity, inattention and impulsivity. Average age of diagnosis is seven years old.3

>8% Substance use disorder (SUD) is a dependence on any type of substance such as alcohol, opioids or prescription drugs.4

2.2% Bipolar disorder causes dramatic shifts in moods, energy level and thinking that can last days, weeks or months.2

<1% Schizophrenia is a serious brain disease affecting thinking, behavior and emotions. Average age of diagnosis is 16-30 years old.2


1. ADAA   2. National Institute of Mental Health (NAMI)   3. Center for Disease Control. 4. SAMHSA (Substance Abuse and Mental Health Services Administration).

How drugs affect the teen brain

Teens often turn to alcohol or drugs as a way to deal with problems, fit in, feel good or enhance performance. Ironically, repeated use of these substances can more easily “rewire” their brains and reduce their natural ability to feel good and perform as well as they could. Chronic drug use may alter key brain areas necessary for judgment and self control.

Although not all teens who use alcohol or drugs will develop an SUD, the majority of individuals who develop one started using before age 18. The risk increases if substance use began in the early teens or younger.

Warning signs

Seek help if you notice any of the following behaviors in your teen:

  • Withdraws from social activities
  • Seems “down” for two weeks or longer
  • Experiences severe mood swings
  • Exhibits drastic changes in behavior, personality or sleep habits
  • Seems very fearful for no apparent reason
  • Takes excessive risks
  • Stops normal eating or tries to lose weight with laxatives or vomiting
  • Extreme difficulty concentrating or sitting still
  • Repeatedly uses alcohol or drugs
  • Harms self
  • Threatens or talks about suicide

Tips for parents

Treatment works best when teens are willing to participate and want to get better.

Let your teen know you’re trying to understand – not “fix” – him or her. Begin by listening without judgment.

Don’t give up too quickly. Progress can be slow, and your teen may say “no” when you first suggest treatment. Try to understand his or her hesitation so you can respond appropriately.

Frame treatment differently. Present a therapist like a sports coach–someone to help them practice new skills to improve daily life.

Treat the whole family. Instead of singling out your teen, recognize that the whole family needs help.

Find the right therapist. Your teen will have better results when they find a provider who is a good fit.


How Pine Rest Can Help

Timely, appropriate treatment reduces the impact of teens’ mental and behavioral health conditions on their social and living skills, education, development, relationship and physical health.

In our outpatient clinics, teens can receive assessments, counseling, psychotherapy and psychiatry from clinicians specializing in the treatment of adolescents.

Counseling/Outpatient Services. To schedule a new outpatient appointment, call 866.852.4001.

For those teens who need more intensive treatment, we offer partial hospitalization–a short-term daily treatment that allows teens to return home in the evenings.

Adolescent Partial Hospitalization (Day) Program. For more information or admissions call 616.455.9200 or 800.678.5500

Our psychiatric hospital provides a safe environment for teens at risk or who have attempted or are threatening suicide or self-harm.

Inpatient Services for Adolescents.  For more information or admissions call 616.455.9200 or 800.678.5500.

We also provide longer-term, psychiatric residential services for adolescents who have psychiatric diagnoses and struggle with significant behavioral issues. Programming is designed to help with past trauma, psychiatric issues and develop positive coping skills.

Residential Program for Adolescents. For referral or access to services, call 616.281.0061.


Contact information

If you or a loved one are in crisis, please call our hospital’s contact center, which is staffed 24/7 by licensed clinicians.

616.281.6446 (TTY line) 

We have outpatient locations in Michigan and Iowa and also offer counseling and therapy via online video connection. To schedule an appointment at one of these locations or for more information, call 866.852.4001.

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