Signs a Teen May Need Support, and Who to Call First

In crisis or thinking about suicide? Call or text 988 now (in Colorado it reaches the 988 Colorado Mental Health Line). If you are in immediate danger, call 911.

Moody, or something more

Maybe your teen has been snapping at everyone, sleeping until noon, or spending every evening alone in their room. You wonder whether this is just being sixteen or something that needs attention. That question is hard, and NIMH says plainly that telling the difference can be hard.

NIMH notes that all children are sad, anxious, irritable or aggressive at times, and that in most cases these are typical developmental phases. It also says such behaviors may point to a more serious problem in some children. You are not overreacting by paying attention. SAMHSA notes that many conditions, including serious mental illnesses, can start showing signs in the tween and teen years. This guide can help you decide whether to look closer and who to call. It cannot tell you what is going on for your teen. Only an evaluation by a qualified clinician can do that.

Struggles are common. In CDC's 2025 Youth Risk Behavior Survey, 33.3% of U.S. high school students reported persistent feelings of sadness or hopelessness, and among those students, 29.6% reported receiving counseling or therapy. In that survey, persistent meant feeling so sad or hopeless almost every day for two weeks or more in a row that they stopped some usual activities.

Look at length, distress and impact

Compare your teen with their own usual self, not with other teens or a sibling. A quiet teen who has always liked time alone is different from a social teen who has suddenly stopped answering friends. Change from their normal is often the first clue.

Then look at the pattern instead of a single bad day. NIMH suggests seeking help when behaviors or emotions:

• Last for weeks or longer, rather than passing in a day or two after a bad grade or a breakup.
• Cause distress for your teen or for the family.
• Interfere with functioning at school, at home or with friends, such as falling grades, dropping activities or pulling away from people.

Signs NIMH and CDC describe

These are signs agencies list as worth noticing. They are not a checklist for a diagnosis, and a teen can be struggling without showing many of them. For older children and teens, NIMH lists signs including:

• Losing interest in things they used to enjoy, or having low energy.
• Sleeping too much or too little, or seeming sleepy all day.
• Spending more and more time alone and avoiding friends or family.
• Dieting or exercising excessively, or fearing weight gain.
• Smoking, drinking or using drugs, or risky or destructive behavior.
• Periods of very high energy while needing much less sleep than usual.
• Saying someone is trying to control their mind, or hearing things others cannot hear.
• Self-harm, such as cutting or burning their skin, or thoughts of suicide.

Signs that are easy to miss

Some struggles do not look like sadness or fear. CDC notes that anxiety can make children irritable and angry, not only worried, and that some children may not talk about hopeless thoughts and may not appear sad. CDC lists ongoing irritability, trouble concentrating, and feelings of worthlessness or guilt among the signs of depression. A teen who seems mostly angry or checked out may still be hurting.

School is another place signs show up early. Stomachaches on school mornings, rising late arrivals and repeated nurse visits can point to school avoidance, which signs of school refusal covers in detail.

Warning signs that need help now

If your teen talks about wanting to die, has a plan, or you think they are in danger, call or text 988 now, or call 911 if there is immediate danger. Do not leave them alone. NIMH lists warning signs including talking about wanting to die, feeling hopeless or trapped, being a burden to others, giving away important possessions, saying goodbye, and looking for ways to end their life.

NIMH also advises asking directly, "Are you thinking about suicide?" Studies show asking does not increase suicidal thoughts or behavior. NIMH says reducing access to highly lethal items can help keep someone safe, and that you should not promise to keep suicidal thoughts secret.

NIMH's other steps are to be there and listen without judgment, help the person connect with 988 or a trusted professional, and follow up after a crisis. You can also contact 988 yourself when you are worried about someone you care about and want guidance on what to do next.

Who to call first

For signs that are worrying but not an emergency, you have a few good first calls. CDC says the first step to treatment is to talk with a health care provider, such as your child's primary care provider, about an evaluation. A doctor can also check for medical causes of tiredness, sleep changes or weight changes. NIMH suggests talking with teachers and others who see your child often, and a school counselor can share what staff notice during the day. SAMHSA also suggests asking whether your teen's school has a school-based health center.

Bring notes to that first visit or call. NIMH's tips for talking with a provider suggest describing when symptoms started, how severe they are and how often they happen, and mentioning any family history of mental health conditions. A few weeks of short notes on a phone or calendar is usually enough to show the pattern.

You can also contact a therapist directly. Mountainside works with teens and adults and offers a free 15-minute consultation, by secure video across Colorado or in Greenwood Village. The teen therapy page explains how sessions and parent involvement work, and CBT for teens describes one common approach.

If you cannot tell how urgent things are, you can call or text 988 for guidance. SAMHSA notes that 988 offers support for mental health, drug and alcohol concerns, not just emergencies.

Before you call anyone, it can help to talk with your teen. How to talk to your teen about therapy has words to use, and what validation is explains how to respond to big feelings without arguing. When you are ready to choose a type of help, teen therapy vs family therapy vs parent training compares the options.

Frequently asked questions