Teen Angst or Dangerous Anger?

6 Signs
How to tell if it's normal adolescent moodiness -- or a symptom of more serious
trouble.
By Rob Baedeker

WebMD the Magazine - Feature

Reviewed by Brunilda Nazario, MD

When Angela's 15-year-old son, Mark, started hanging out exclusively with the "death metal"
crowd, wearing only dark clothes and dying his hair, she fretted. Was this run-of-the-mill teen
angst, or something more troubling? Then Mark quit the school play, and one day Angela got a
call from the principal, saying Mark had vandalized computers in the school's library. Now she
became really worried.
Erratic teenage behavior is an age-old concern for parents. But in the wake of violent events such
as Colorado's 1999 Columbine High School massacre and the recent mass shooting at Virginia
Tech -- even though such incidents are extremely rare -- many adults find themselves taking their
kids' moods seriously. Are they wrestling with "normal" teenage emotions or showing signs of a
problem with depression or anger, perhaps even one that could spiral out of control?
Parents are right to pay attention. Serious mental health problems are a real issue for some
teens. According to recent research reported in American Family Physician, "At any given time,
up to 15% of children and adolescents have some symptoms of depression. Five percent of those
9 to 17 years of age meet the criteria for major depressive disorder."
But not every instance of a teen acting out is a red flag. Jeffrey Bostic, MD, director of the School
Psychiatry Program at Massachusetts General Hospital and assistant clinical professor of
psychiatry at Harvard Medical School, says a certain amount of rebellion and experimental
behavior is normal for teenagers. "Everybody goes through a phase," he says, "where they will
pick more fights or get more piercings or tattoos or whatever is in vogue for their generation."
However, Bostic explains, when a teen starts to show signs of feeling "isolated from the herd,"
bad things can happen. While he notes it's dangerous to believe that you can add up the risk
factors and conclude a violent event will result, Bostic has identified several signs that may
indicate something more serious than normal teen angst is going on.
6 Signs of Dangerous Teen Anger

• Cry for help. "When a kid tells you, 'I'm going to do some kind of harm,'" says Bostic,
"they're seeking an intervention."
• Extreme identification. Teens who start to identify exclusively with one clique or
subculture and "want to go to war with all the other groups" have crossed the line into
dangerous thinking.
• Communication blackout. When teens stop talking to other adults and peers altogether,
they are likely feeling an extreme degree of social isolation.
• Violence. It may seem obvious, but too many parents miss this cue, says Bostic. A
pattern of violent activities such as hitting or vandalism can foreshadow future harmful
acts.
• Dropping out. A sudden disengagement from activities such as music, sports, or theater
or an overnight drop in grades can lead to involvement in more risky behavior. A teen
who stops identifying with others may have no qualms about doing them harm.
• Substance abuse: Especially combined with the above behaviors, drug and alcohol use
may relax mental barriers and lead teens to harmful activities they otherwise might avoid.
Keep in mind that street drugs aren't the only hazard; teens also can abuse household
cleaning products, aerosol sprays, adult prescription drugs, and over-the-counter cold
medications.

Originally published in the September/October 2007 issue of WebMD the Magazine

http://www.webmd.com/parenting/features/teen-angst-dangerous-anger-6-signs