Is it Puberty or a Mental Health Issue?

Part 1

As young people begin to mature, and navigate puberty, they go through many changes – physical, emotional, and mental. These changes are all part of the normal and expected process of maturation, and will continue in some ways until their early- to mid-twenties. During this period of big changes, those around these rapidly-evolving humans may notice some new and different reactions to life. Responses to stress may be more emotional or aggressive; there may be more emotional volatility, and even signs of depression or anxiety. Some of these changes may be profound. But, is it “just puberty” or is it an emerging mental health issue?

According to the National Alliance on Mental Illness (NAMI), approximately 75% of mental illnesses manifest by age 24, with about 50% of all mental health conditions beginning by age 14. The question then is: If so many mental health issues emerge during puberty, is there a connection?

Does puberty cause mental health conditions?

Scientists are still researching all the effects that puberty has on the emotional health of young people but there are several theories as to why mental health issues seem to rear their heads during this important period. These can include:

  • Hormonal Changes
  • Brain Development
  • Physical Development
  • Early- Onset of Puberty
  • Social Changes

Each of these may be the cause of the behavioral changes in a given teen, or it may be a combination of factors that are affecting a particular person. It is important to consider them all, and understand that any given factor might be a more predominant cause at a particular time, but that this may change throughout the course of their pubescence.

Hormonal Changes

Hormone levels in an adolescent’s brain and body will fluctuate over the course of puberty, and these fluctuations can lead to things like anxiety, mood swings, low self-esteem, and even brain fog. In females, the dramatic increase in estrogen that occurs during puberty has been linked to depression. Estrogen levels affect the levels of serotonin in the brain, and lower serotonin levels can cause depression.

Brain Development

It is very important for parents and caregivers to remember that, on average, the adolescent brain is not fully developed until a person’s mid-twenties. The prefrontal cortex is particularly implicated here, and it is the part of the brain that is responsible for rational thinking, behavioral performance, and emotional control. This is why teens often experience and express such out-of-control emotions, and can also make choices or decisions without being fully cognizant of the possible consequences of their actions. This inability to fully cope with their emotions can be quite stressful, and can lead to feelings of anger or irritability. 

Physical Development

According to The Journal of Affective Diseases, the physical changes that adolescents experience – especially those in mid-puberty – can strongly affect rates of depression in both males and females. In fact, based on current research, these physical developments strongly impact incidences of depression more than any other single factor that was studied.

Early-Onset Puberty

Over the last fifty years, the age at onset of puberty has dropped drastically. According to a 202 research published in JAMA Pediatrics, in girls, the average age of onset is now 8 years of age, as compared to 13 years of age; in boys, the average onset now occurs at age 9, whereas it was age 14 five decades ago. Clinicians have found that boys and girls who begin to develop in advance of their peers can feel self-conscious, out of place, and isolated. Adolescents who do experience early-onset puberty are more likely to experience feelings of anxiety and/or  depression, develop substance abuse or eating disorders, and are at a higher risk of suicide than their peers.

Social Changes

As adolescents mature, they are navigating significant physical changes; likewise, they are going through tremendous social changes. During this time, teens begin to prioritize social relationships over family ones, which means that fitting in with their friends and peer groups is very important to them. They begin to place significant amounts of value on the judgments of their peers. They also begin to explore romantic and sexual relationships. All of this can be incredibly stressful as they begin to explore and develop their own individual identities, and these stressors can lead to anxiety.

So, How Do I Know?

Puberty, as previously discussed, can come with mood swings, resistance, anxiety, depression, and even irrational behaviors. But what indicates that these are not “run-of-the-mill” issues, and not signs of a possible mental health issue? Typically, it is a matter of excess. Some, or all, of these behaviors might be normal, but puberty should not cause:

  • Excessive defiance or troublemaking
  • Substance abuse issues
  • Excessive anger or violent behaviors
  • Persistent sadness or anxiety
  • Drastic changes in sleep habits, diet, or overall health

If you notice these signs in an adolescent, it might be prudent to check in with the young person and ask open-ended questions about their friends, how things are going at school, their peers and support networks, etc. The goal is to get a more well-rounded picture of what they are experiencing, and keep communication open. 

If you are a parent or caregiver and you feel that things have progressed beyond “normal” puberty-related issues, please seek the assistance of a mental health professional. Many mental health practitioners specialize in treating teens and pre-teens, and they can have significant benefits in helping adolescents address their mental health needs. Remember – you are not alone.

Center for Emotional Health provides mental health services to patients ages 4 and up. 

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