Recognizing When Teens Aren't Okay
It can be difficult to tell the difference between “normal teenage behavior” versus depression, anxiety, or other indications that your teen may not be OK. Side by Side's Director of Sonoma/Marin Community Services, Denisse Mendoza, recommends looking for a change in normal behaviors. “If their concentration, performance, focus, appetite, speech, sleep patterns, etc. are different, it could be a sign that something is wrong.”

The second thing to look for is avoidance. “It’s normal to avoid stressful or difficult things such as homework,” Mendoza says. “But take note when youth start avoiding the things that used to bring them joy, such as leaving the house, going to a birthday party, or playing sports.”

Laura Taylor, TAY Space Program Director, adds that it’s important to look for these silent cues because youth often hide their challenges. “It's not that I don’t worry about the kids who are acting out,” she says, “it’s just that I can see it so I can do something about it. Throwing a fit, throwing things, defying adults -- those can all be cries for help. But when youth are quiet and everything goes internal, we need to make sure they are not falling through the cracks.” 
Five Signs Your Teen or Youth May Not Be OK

1. Appearance and hygiene. You can tell a lot about a teen's mental state by how they look. Dirty clothes, unkempt appearance and body odor due to poor hygiene are often a sign of mental distress.
2. Changes in appetite or sleep. When youth stop wanting to eat, it could be a sign that something is wrong. Trouble with sleep is another indicator to look for.
3. Body language, facial expressions and eye contact. If a youth is slouched over, closed off, or has no eye contact, it could be a sign that they are internalizing their challenges.
4. Isolating and/or avoidance. Avoidance of activities they used to enjoy and isolating from others is often a sign that youth are internalizing their challenges.
5. Physical symptoms such as headaches and stomach aches. Mental stress often manifests in our bodies. Youth may not understand their mental distress, but they can tell us that their stomach is hurting, they have butterflies, or their head hurts. 
As noted above, when we are triggered, we often feel it in our body. “Anxiety attacks happen when we are flooded with feelings,” Mendoza says. “We can’t think our way out of an anxiety attack because our thinking has become dysregulated.” So she has her clients focus on their senses and on soothing techniques, but is quick to point out that “soothing” doesn’t necessarily mean gentle. Some techniques are to get an ice pack and press it to your chest, splash very cold water on your face, or drink ice water. 
Self-Care Techniques

Self-care techniques can also go a long way towards relieving symptoms and regulating upset. Some options suggested by Side by Side staff include:
1. Engage in something creative. Activities such as drawing, bead work/jewelry making can help soothe the system.
2. Make a plan to change behaviors. Go on daily walks, make a meal, or have someone go grocery shopping with you.
3. Connect with loved ones. Many youth with past trauma benefit from reminders to do simple things like calling their parents or siblings to check in.
4. Pause and breathe. If your youth looks like they could use a break, they might benefit from a reminder to have a “pause” and breathe. You can take a break and do it with them!
5. Don’t take it personally. When someone does or says something that triggers anxiety, remember that the other person might be going through something as well, and that it probably doesn’t have anything to do with you.
6. Mindfulness and grounding. Anxiety attacks happen when we are worried about something in the past or the future. Coming back to the present can help. Taking your shoes off and putting your feet in the grass is a simple grounding technique that is quite effective.
7. Name objects out loud. Find five things that are blue and name them, or touch five square objects. This calms down the parasympathetic nervous system.
8. Massage, acupuncture and group therapy can all be helpful as well. Check with your primary care physician and ask what is covered by insurance if you have it. 
Additional Resources for Support

  • National Crisis Text: text HELLO to 741741
  • National Suicide Prevention: 800-273-8255
  • NAMI-National Alliance on Mental Illness: 415-444-0480
  • Buckelew Programs Grief Support: 415-499-1195 
  • Sonoma County Crisis Stabilization Unit: 707-576-8181
  • InRESPONSE Mental Health Support Team (Santa Rosa): 707-575-HELP (4357)  
  • Crisis Support Services of Alameda County: 800-309-2131