Some young people have been living an online lifestyle for years. This means that while some kids are thriving without the pressures of attending school, others are unravelling & facing mental health concerns during challenging times.

Teachers have been asking about the signs that might indicate they should be more concerned about a young person’s mental health. While I have written about this in my books, here is a brief guide.

Teachers should keep a look out for young people (and one another) at this time & consider getting help from a mental health professional if available. Being sensitive to possible warning signs is especially important when most contact happens online or remotely.

If you feel concerned about someone, it is always better to be proactive. Saying something along the lines of, ‘You seem a bit (insert what you’ve observed) & I’ve been feeling a bit worried about you. Do you think I should be worried about you?” usually starts the conversation.

Anxiety

What’s fairly normal

Some worries are common in times of uncertainty. Everyone is on heightened alert. People often feel exhausted. This is why lessening the emphasis on assessment for school students is recommended.

Signs that might give you more concern

In each of these areas it is important to compare the signs with the person’s usual level of functioning.

  • Looping worries that don’t get anywhere towards an action or solution
  • Increased restlessness & agitation such as pacing, trembling, shaking, rapid speech, tics or hair pulling or twisting
  • Feelings of being completely overwhelmed, dread & disempowered.

Sadness and Depression

What’s fairly normal

Some glum & sad times are expected. Missing friends & missing freedoms is a process of partial grieving for them and for a lifestyle.

Signs that might give you more concern

  • Not doing some things they would usually enjoy
  • Changes in appetite or weight
  • Feeling that life is pointless
  • More sullen and morose
  • Talking about themselves in denigrating ways
  • Crying
  • Talking about death or loss more readily.

Sleep

What’s fairly normal

Some disturbance of sleep is usual at these times. Some may have more vivid dreams & may feel disturbed by them (talking to them about their dreams will help).

Signs that might give you more concern

  • Alterations in their usual pattern
  • Waking up after brief sleeps & not being able to get back to sleep
  • Over-sleeping & avoidance
  • Not being able to relax or sleep at the end of the day
  • Children coming into parent’s beds in the middle of the night more often.

Obsessions

What’s fairly normal

People are hearing a lot more than usual about threats, infections and illness so some wariness as well as a focus on physical health is expected.

Signs that might give you more concern

  • Repetitive activities that seem not to make sense
  • Excessive handwashing or disinfecting that seems excessive or obsessive
  • Fears of contamination or a sense of impending illness or death that seems out of order with their current level of risk
  • Unrealistic fears that they may contaminate others
  • A sense that they are either ‘immune’ from viruses or that they are responsible for them.

Fears

What’s fairly normal

Covid-19 takes ‘stranger-danger’ to an entirely different level. At these times small events can trigger major responses.

Signs that might give you more concern

  • Dramatically increased startle response
  • Total avoidance of interactions with family members despite low or no risk.
  • Feeling terrified or overwhelmed by circumstances
  • Having an unshakable & unrealistic dread of the future.

Anger

What’s fairly normal

Grumpiness & some snappiness is usual. Young people often express their fears & stresses behaviourally & tend to do so towards those they know and love best of all.

Signs that might give you more concern

  • Self–directed anger or self- harm
  • Temper outbursts that occur erratically and persist for long periods of time
  • Violent acts
  • Smouldering resentments, vendettas or stand-over tactics aimed at controlling others
  • No remorse or insight into others’ feelings after they have had an outburst
  • Outbursts where they lash out, hit or hurt others or damage valuable items
  • Anger is escalating or they seem unable to control or contain their level of anger.

Conflict

What’s fairly normal

Being cooped up together for extended periods can heighten tensions in the best of families & relationships. Flare-ups & heated exchanges could occur. Some households may be on edge & yelling & stressful inter-changes may intensify.

Signs that might give you more concern

  • Fearfulness or trepidation about specific people
  • Appearing more guarded or unwilling to speak in case they could be
  • You feel worried or uncomfortable on their behalf
  • You feel they are keeping a secret.
  • Increased rate of pacifying behaviours – rubbing of neck, biting nails, playing with hair, rubbing temples or covering their mouth.
  • Art works or writings that contain uncharacteristically aggressive or death- focused imagery (be especially alert to drawings that show armless figures, disproportionate sizes of people in drawings, jagged teeth or distorted mouths)
  • Signs of injuries
  • Bruising especially on the inner sides of arms
  • Unusual use of sexual terms or imagery

Assessment Summary

Any assessment needs to occur in the context of a baseline. I use three general rules of thumb in making an assessment of risk:

  • Is the person substantially different from how they usually present to me?
  • Is there change apparent in different settings or contexts? For example a child who glum at home but cheers up when with friends is usually less concerning than none who is sad across both settings.
  • How worried do I feel? While we need to careful not to project our fears onto others, you are attuned to people. If you are worried on someone’s behalf it is almost always wise to assume that there is something to worry about.

Andrew is the author of Tricky Teens, Your Best life at Any Ageand Tricky Kids.

Downloadable PDF: Mental health what to look for