As a professional who has worked with adolescents and families for the past 30 years, I have heard this question a lot. We all worry about our children. When a child is struggling, or her behavior worries you, it can be hard to know whether or not you need to reach out to a professional.

It is common for teens to exhibit unusual behavior such as isolation, aggression, and/or exhibiting risky behaviors and making bad choices. Their hormones are changing, you’ll notice moodiness and the pushing of boundaries, and there is a reason for that.

Teenagers are preparing to discover who they are cognitively. Their brains are preparing for adulthood and there is a mismatch between their emotional brain and their logical brain. This is important to know because what we should be doing as parents is letting them grow up so that they don’t need us to parent them anymore. Emotional outbursts, getting tearful over seemingly nothing, grumpiness, being more isolated and some risk-taking behavior is all par for the course. It may not be pleasant for parents but it is well within the normal range.

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However, these years are also a time when symptoms of depression, anxiety and other mental health symptoms can begin to emerge. According to the National Alliance on Mental Illness, half of all long-term mental illness begins by age 14, suicide is the third leading cause of death for people age 10-14, and second for those aged 15-24. About one in five between ages 13 and 18 experience a severe mental disorder.

Many types of mental illness first emerge in adolescence such as depression, anxiety, and even ADHD. Schizophrenia often first appears in young adulthood or the late teen years. Like adults, teens can be exposed to many forms of trauma, so PTSD is another common mental illness in teens.

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Many parents don’t realize that teenage depression and anxiety don’t look the same as adult depression and anxiety.

Adults look sad when depressed, and anxious when they are suffering from anxiety. But teens don’t look that way. They tend to be more withdrawn or angry. In fact, problems with anger is one of the biggest signs of depression in teens, especially teenage boys.That anger is something to look at, definitely.

If you also see them having problems with sleep or the way they are eating has changed drastically, or they are gaining or losing a lot of weight, or they are isolating and you can’t get them out of their room, or their socializing has changed, all of these behaviors signal that it may be time to take a closer look.

Here are some more symptoms to watch for:

• Loss of interest in activities

• No motivation for fun or interesting activities

• Sleep disturbances including insomnia and nightmares

• Can’t sit still or focus on a task

• Seems chronically anxious or worried

• Lack of energy or oversleeping

• Bounces between moods of no-energy and hyperactivity

• Self-harm including cutting, picking, burning, biting, or hairpulling

• Suicidal thoughts or actions

• Constantly irritable or always reacts in an unreasonable manner

• Smoking, taking drugs, or drinking.

Addressing the need for adolescent mental health treatment is difficult for any family. Every parent wants their children to be healthy and happy. Parenting a teen isn’t easy, and it can be difficult to determine whether annoying, troubling, or frustrating behaviors are normal or a red flag. One tip for deciphering signs of mental illness from normal teenage behavior is to to keep communication open. With an open line of communication, your teen will feel comfortable opening up to you about what’s going on in their life and how they are feeling.

Lisa Barker, LMFT, is a therapist at A Balanced Life, Inc. who specializes in trauma resolution, life transition, behavior issues, depression, anxiety, stress, grief and loss, and family conflict.