Why Is My Teen so Mean to Me? Part 3: Mental Health Issues

Every teen behaves in ways that are frustrating at least on occasion, and perhaps even numerous times. While some measure of defiance in teens is normal as they strive to assert their burgeoning independence, very frequent occurrences of noncompliant, blatantly defiant or angry behavior can indicate a mental health disorder.

As we mentioned in the previous articles of our series, an invalidating environment is one factor that can lead to teen behavioral problems. It can also, simultaneously, lead to mental health issues. As a rule, mental health and behavioral challenges often go hand-in-hand.

For example, a child raised by chronic instability or parental conflict can grow up to develop borderline personality disorder. Teens with BPD have conflicted relationships, lack of sensitivity towards others, and high reactivity. An abused child can develop post-traumatic stress disorder (PTSD), which can involve anger outbursts, anxiety, and acting out at home or school. Oppositional Defiant Disorder and Disruptive Mood Dysregulation Disorder, both of which involve severe defiance against authority, negative attitude, and temper tantrums, are often the result of an invalidating childhood.

Let’s summarize these diagnoses in more detail.

Oppositional Defiant Disorder (ODD)

Oppositional defiant disorder is one of the most commonly diagnosed behavioral disorders in children and adolescents. If your teen has ODD, they often have angry outbursts. They get upset by the seemingly smallest things and defy rules you set when they’re angry. They are spiteful, irritable, and make hurtful remarks on a consistent basis. A teen with ODD can be verbally aggressive and physically aggressive, too.

Disruptive Mood Dysregulation Disorder (DMDD)

It feels like your teen is persistently irritable or angry—all the time, every day. Adolescents with DMDD commonly explode in rage or anger, physically and/or verbally, at home and at school. Additionally, other family members, friends, and teachers notice these displays of anger. You always feel like you need to walk on eggshells in order to prevent setting them off. DMDD and ODD are very similar, but DMDD is more severe.

Borderline Personality Disorder (BPD)

Your teen might have BPD if they’ve always had rocky relationships with parents and friends. In addition to a chronic pattern of unstable relationships, teens with BPD often have intense irritability or anxiety, difficulty controlling their anger, and problems with impulsivity. They might get very attached to certain people, but then retreat completely if the person does something that hurts them. Teens with BPD are very emotionally sensitive and emotionally reactive. Think adolescents can’t have BPD? This article will show you why we disagree.

Other mental health issues that could be the source of your teen’s behavioral problems include Conduct Disorder, PTSD, and Attention Deficit Hyperactivity Disorder (ADHD). ADHD in particular can significantly interfere in many areas of a teen’s life, including social life, family life, and school/academic performance.

Teen Diagnoses: Mental Health and Behavioral Issues

First, a disclaimer: not all teens who fight with their parents or are intensely rude to them have a diagnosable mental health issue. Teens could be just going through a phase or struggling with a crisis in another area of their lives (such as school or friends). Look back to our first article to see some examples of other factors that could be impacting your teen’s challenging behavior. (e.g. substance use, developmental or cognitive delays).

In any case, even if your teen is in fact struggling with one of the aforementioned mental health issues, the point of our blog is not to diagnose your teen. Only a mental health professional can do that. If you suspect your teen might be suffering from one of these disorders, visit a licensed therapist, social worker, or other mental health professional and ask them to conduct an assessment of your teen.

Let us reassure you, though: Even if your teen ultimately receives a diagnosis for their mental health or behavioral challenges, a diagnosis is just a starting point. A name for the challenge. A diagnosis’ sole purpose is to help choose a course of treatment. (And of course, to help insurance help cover the costs of said treatment.) So while a diagnosis might help you understand more fully the struggles and symptoms of your teen, it’s important not to get too caught up in the label and lose sight of the main focus: treatment.

In the next article of this series, we’ll discuss what types of treatment are available for teens with behavioral issues – and their parents, too. When it comes to behavioral concerns and relationship conflict, the entire family needs to get help: not just the teen.