Recognizing when teenage mood changes signal serious mental health issues rather than normal adolescent behavior can be challenging for parents. According to the National Alliance on Mental Illness, one in six U.S. adolescents has a major depressive episode each year. In New Hampshire specifically, the 2023 Youth Risk Behavior Survey found that 40% of students felt persistently sad or hopeless, and about a third said their mental health was not good most or all of the time.
Distinguishing Normal from Serious
Child and adolescent psychiatrist Dr. Sarah Rocha notes that “emotions and emotional range are part of the normal human experience. People have a bad day; but if you’re seeing a consistent change in your child’s behavior or mood for two weeks or more that seems to be a pattern, that’s when I would really recommend calling your health care provider.” Changes that interfere with activities of daily life—such as when behaviors prevent teens from doing things they usually enjoy—indicate it may be time to seek help. Warning signs include sleeping too much or too little, withdrawing from things previously enjoyed or people they typically socialize with, declining school functioning like grades or attendance, or riskier behaviors such as substance use or self-harm.
Different Presentations by Gender
Depression presents differently in teens than adults. Adult depression typically shows low self-worth, persistent sadness, and guilt—symptoms less common in adolescent depression. Girls tend to internalize feelings and complain of headaches, stomachaches, or develop disordered eating patterns. In boys, anxiety and depression can look like aggression or anger, including getting into fights. Anxiety disorders are among the most prevalent mental health disorders in teens, though most teens have more than one diagnosis.
Seeking and Receiving Care
Primary care providers often identify potential mental health issues during yearly checkups using screening tools like the PHQ9 Personal Health Questionnaire for Adolescents. New Hampshire’s Mental Health Care Access and Pediatrics line helps connect primary care providers with experienced mental health professionals to answer questions about assessment, diagnosis, treatment planning, and medication. To reduce wait times for psychiatric inpatient care, New Hampshire has expanded access over the past two years. Dartmouth Health opened a new six-bed adolescent medical psychiatry unit in April 2025 for children ages 12 to 17, with a single point of access helping place children in appropriate beds quickly.
This article is an AI-assisted summary. All facts and figures are drawn from the original report: https://www.unionleader.com/news/health/nh_medical/when-mood-swings-signal-something-more-serious/article_2169a5e6-e513-41a4-9973-03f34fe06616.html