||What changes occur in adolescence?
The teenage years can be an emotional assault
course for all concerned. A gulf can grow between parents and their
children during adolescence. One of the reasons many of us find it
so hard is because it's a time of rapid physical development and
deep emotional changes. These are exciting, but can also be
confusing and uncomfortable for child and parent alike.
Rapid changes can occur physically and
emotionally. There are also changes socially (attending secondary
school, spending more time with peers) which can present with new
challenges like using drugs/alcohol and sexual relationships.
Physical - Hormones, timing and
||The psychological and emotional changes
The process of rapid physical changes in
adolescence is called puberty. It starts gradually, from around
eleven years for girls and thirteen for boys. The age at which
puberty starts has been dropping in most countries, probably due to
better nutrition. So, your children may hit puberty earlier than
The hormone changes responsible actually begin
some years earlier and may produce periods of moodiness and
restlessness. Girls start these changes before boys and will, for
the first three or four years, appear to be maturing much faster.
After this, boys catch up.
These changes include:
- For girls: menstrual periods, growth of
under-arm, body and pubic hair.
- For boys: voice breaks (becomes deeper),
growth of body and pubic hair, facial hair, erections and wet
dreams. For both: Rapid physical growth.
By the age of 17, they'll be young men and
women who may be bigger than their parents and capable of having
children themselves. In spite of this, they often still need
support from you.
It is not surprising that, with the speed of
these changes, some adolescents become very concerned about their
appearance. They may feel worried, especially if these changes
happen earlier or later than their peers. It’s important to
remember that there’s a lot of difference in the ages at which
these changes occur and adolescents need to be reassured about
Growth and development uses a lot of energy,
and this may be why teenagers often seem to need so much sleep.
Their getting-up late may be irritating, but it may well not be
As well as growing taller, starting to shave
or having periods, people of this age start to think and feel
differently. They make close relationships outside the family, with
friends of their own age. Relationships within the family also
change. Parents become less important in their children's eyes as
their life outside the family develops.
Real disagreements emerge for the first time
as young people develop views of their own that are often not
shared by their parents. As everybody knows, adolescents spend a
lot of time in each other's company, or on the telephone or
internet to each other. Although this can be irritating to parents,
it is an important way of becoming more independent. These
friendships are part of learning how to get on with other people
and gaining a sense of identity that is distinct from that of the
family. Clothes and appearance are a way of expressing solidarity
with friends, although teenage children are still more likely to
get their values from the family.
Parents often feel rejected, and in a sense
they are. But this is often necessary for young people to develop
their own identity. Even if you have rows and arguments, your
children will usually think a lot of you. The rejections and
conflicts are often not to do with your personalities, but simply
with the fact that you are parents, from whom your children must
become independent if they are to have their own life.
As they become more independent, young people
want to try out new things, but often recognise that they have
little experience to fall back on when things get difficult. This
may produce rapid changes in self-confidence and behaviour -
feeling very adult one minute, very young and inexperienced the
Being upset, feeling ill or lacking confidence
can make them feel vulnerable. They may show this with sulky
behaviour rather than obvious distress. Parents have to be pretty
flexible to deal with all this, and may feel under considerable
Adolescence is the time when people first
start in earnest to learn about the world and to find their place
in it. This involves trying out new experiences, some of which may
be risky or even dangerous.
- Young people can crave excitement in a way that most adults
find difficult to understand - and exciting activities may be
dangerous. Fortunately, most people manage to find their excitement
in music, sport, or other activities that involve a lot of energy,
but little real physical risk.
- When they do experiment - with drink or drugs or smoking - it
is usually with friends. If a young person does this alone, they
are in much greater danger. Warnings from older adolescents will
usually be taken more seriously than those from parents.
What kind of difficulties can a
young person have?
|The young person can
present with an array of difficulties. Some of these are described
below. If any of these seem to be severe or persistent, please
refer to our leaflets on these conditions (www.rcpsych.ac.uk/info).
It’s important to note that despite the
popular myth of ‘difficult teenager’, the majority of adolescents
do not have significant or severe difficulties.
- Over-eating, excessive sleepiness and a persistent over-concern
with appearance may be signs of emotional distress.
- Anxiety may produce phobias and panic attacks. Research
suggests that emotional disorders are often not recognised, even by
family and friends.
- At some time, 4 out of 10 adolescents have felt so miserable
that they have cried and have wanted to get away from everyone and
- During their adolescence, more than 1 in 5 teenagers think so
little of themselves that life does not seem worth living. In spite
of these powerful feelings, depression may not be obvious to other
- The dramatic physical changes of adolescence can be very
worrying to some teenagers, especially to those who are shy and who
don't like to ask questions. At the other end of the scale, some
express their concern with excessive bragging about sexual ability
- More than half of young people in the UK will have had their
first experience of sex before the age of 16 and so the risk of
pregnancy is a significant part of adolescent life.
- The age of consent for both heterosexual and homosexual
intercourse is 16 in England, Scotland and Wales, 17 in N. Ireland.
It is illegal to have sex if either partner is under this age, even
if they give consent.
- Those who start having sex early are at greater risk of early
pregnancy and health problems. Sexually transmitted diseases are
common, and HIV infection and AIDS are becoming more common.
- Crushes on someone of the same sex are common in adolescence.
Some young people go on to be gay.
- Some young people (and their parents) will not be sure whether
they are gay or straight.
- Sensitive support, clear guidance and accurate information
about these different aspects of sex are essential - from parents,
schools, GPs, and family planning clinics.
- Most adolescents choose their partners quite carefully.
Sleeping around and risky unprotected intercourse are often signs
of underlying emotional problems. They may also be the signs of a
risk-taking lifestyle - adolescents who take risks in one way tend
to take risks in other ways as well.
- Recent research suggests that girls who are close to their
parents are less likely to become pregnant in their teenage
- Teenagers can get confidential advice on contraception from
their GP, who does not have to inform their parents. Emergency
contraception from pharmacies is only available to those aged 16 or
Parental shock ……
It can be surprisingly upsetting when your child has their first
serious relationship, or you find out that they have started to
have sex. For the first time in your life together, you are not the
most important person to them. The sense of shock will pass, but
you may need a while to adjust to the new state of affairs.
- Teenagers and their parents complain about each other's
behaviour. Parents often feel they have lost any sort of control or
influence over their child. Adolescents want their parents to be
clear and consistent about rules and boundaries, but at the same
time may resent any restrictions on their growing freedom and
ability to decide for themselves.
- If disagreements are common and normal, when should you worry?
Experience suggests that children are at greater risk of getting
into trouble if their parents don't know where they are. So, try to
make sure that you know where they are going and what they are up
to. If you really don't know, you need to find out.
Refusal to go to school can be due to:
- difficulties in separating from parents
- being perfectionist, and becoming depressed because they can't
do as well as they would want to
- disturbed family life, with early separation from or death of
- an established pattern which may have started at primary
school. These children often have physical symptoms, such as
headache or stomach-ache.
Those who go to school, but then play truant,
are usually unhappy at home and frustrated at school. They prefer
to spend their days with others who feel the same way.
Emotional problems will often affect school
work - worrying about yourself or about what is going on at home
makes it difficult to concentrate. Pressure to do well and to pass
exams may come from parents or teachers, but adolescents usually
want to do well and will push themselves. Excessive nagging can be
counter-productive. Exams are important, but they should not be
allowed to dominate life or to cause unhappiness.
Bullying can cause all of the above. Around 1
in 10 secondary school children is bullied at some point; about 1
in 20 is bullied every week. Short children are more likely to be
bullied. If you are worried that this is happening, talk to the
school to make sure that they enforce their bullying policy.
Trouble with the law
Most young people do not break the law, but
those who do are usually boys. When they do, it usually only
If a parent doesn't feel that breaking the law
is particularly important, it is more likely that their children
Unhappiness or distress can also lead to
behaviour that will get them into trouble with the police. It is
always worth asking about their feelings if an adolescent is
repeatedly getting into trouble.
Weight can be a real problem. If an adolescent
is overweight and is criticised or made fun of, they are more
likely to dislike themselves and to become depressed. This can lead
to inactivity and comfort eating, which worsens the weight problem
- dieting can actually aggravate the situation. It is more
important to ensure that they feel happy with themselves, fat or
Many adolescents diet. Fortunately, few will
develop serious eating disorders - only around 1 in 100 teenagers
develop anorexia, 1 in 50 have bulimia. However, these are more
likely to occur in those who take up serious dieting, think very
little of themselves, are under stress and who has been over-weight
as a child.
Drugs, solvents and
- Many teenagers experiment with alcohol and illegal drugs.
Around 1 in 3 15- year-olds in England has used drugs at some
- Regular use of drugs or alcohol is much less common. Less than
1 in 100 of 11-12-year-olds are regular users, but this increases
to 1 in 6 of 15-year-olds.
- Although cannabis has been widely felt to be relatively
harmless, there is now good evidence that it can make mental health
problems worse in adolescence, and can double the risk of
- Despite publicity about other drugs, alcohol is the most common
drug to cause problems for adolescents.
- You should consider the possibility of drug or alcohol use when
you notice sudden or dramatic changes in behaviour.
- Find out about any drugs your children may be using - see the
telephone and web resources at the end of the leaflet.
What if they ask about the drugs you used to use in your
Honesty is generally the best
policy, although it is probably worth stressing the differences in
drugs available now. For example, much of the cannabis available
today is many times stronger than was available 20 years ago, and
we now know a lot more about its risks to both physical and mental
- Physical, emotional and sexual abuse may occur in adolescence
and may cause many of the problems mentioned above.
- Children or teenagers who are being abused can find someone to
talk to at ChildLine.
- Families with these problems need expert advice and should seek
help. The list of organisations at the end of this leaflet may be
able to point you in the right direction.
Much less often, changes in behaviour and mood
can mark the beginning of more serious psychiatric disorders.
Although uncommon, bipolar disorder (manic depression) and
schizophrenia may emerge for the first time during adolescence.
Extreme withdrawal may indicate schizophrenia,
though there are usually other explanations for such behaviour.
Parents who are concerned about these possibilities should ask to
see their GP.
The good news for parents
Adolescence has had a bad press. However, recent studies have
shown that most teenagers actually like their parents and feel that
they get on well with them. It is a time when the process of
growing up can help people to make positive changes, and to put the
problems of the past behind them.
It is not just a difficult stage, although it
can feel very much like it at times. The anxiety experienced by
parents is more than matched by the periods of uncertainty, turmoil
and unhappiness experienced by the adolescent.
Difficult times come and go, but most
adolescents don't develop serious problems. It's worth remembering
this when things are difficult.
Parents may sometimes start to feel that they
have failed. However, whatever may be said in the heat of the
moment, they play a crucial part in their children's lives. Helping
your children grow through adolescence can be profoundly
Don't be jealous
The good times and opportunities that
adolescent children have may well make you feel very middle-aged.
Their physical strength is increasing at a time that yours may well
be waning. Jealousy can be the hidden fuel for all sorts of
arguments and trouble.
Make your home a safe base
Adolescent children are exploring life, but
need a base to come back to. Home should be somewhere they feel
safe to come back to, where they will be protected, cared for and
Parents need to:
- agree between themselves about their basic values and
- support each other in applying them.
It's difficult for a teenager to respect
parents who are always at each other's throats or undermining each
other. A common trap is for one parent to ally themselves with
their child against the other parent. This usually leads to
Adults need to be a source of advice, sympathy
and comfort. A teenager needs to know that his or her parents will
not automatically jump down their throat with a judgement, a
criticism or routine advice. Listening comes first
However fast they may be growing up, you are
your children's providers and it is reasonable that you should
decide what the ground rules are. Whilst adolescents may protest,
sensible rules can be the basis for security and agreement. They
- clear, so everybody knows where they stand
- where possible, they should be agreed with the children
- consistent, so everyone sticks to them
- less restrictive as children become more responsible.
You can't (and shouldn't) have
rules for everything. While some issues will not be negotiable,
there should be room for bargaining on others.
Sanctions, such as grounding or loss of pocket
money, will only work if they are established in advance. Don't
threaten these if you are not willing to carry them out.
Rewards for behaving well are just as
important - probably more important, in fact.
||When all else fails get help
Involve your children in making family rules - like all of us,
they are more likely to stick to rules if they can see some logic
to them and have helped to make them. If a teenager is reluctant to
discuss rules for him or herself, they may still do this if they
can see that it might be helpful for younger brothers or sisters.
If they don't want to get involved, they will just have to put up
with the rules you decide on.
Parents should pick their battles. A lot of
things adolescents do are irritating (as you probably irritate
them), but not all are worth an argument. It's usually better to
spend time on praising good decisions or behaviour. Most annoying
habits will burn themselves out once parents stop reacting to
Don't use corporal (physical)
Although it is now viewed as unhelpful, many
people still occasionally smack younger children. If you do this
with adolescent children:
- You create the impression that violence is an acceptable way to
solve difficulties. This means that they are more likely to grow up
to use violence as adults.
- You can get stuck in a cycle of violence - you hit them, they
hit you back (because they are now big enough), you hit them again
and so on.
Set the example
Although they are becoming more independent,
your children will still learn a lot about how to behave from you.
If you don't want them to swear, don't swear yourself. If you don't
want them to get drunk, don't get drunk yourself. If you don't want
them to be violent, don't use violence yourself. If you want them
to be kind and generous to other people ….. try to be like this
yourself. “Do as I say, not as I do” just won't work.
Don't worry if your children aren't as
grateful as you would like. It's great if they are, but they may
not be until they have children of their own and realise how
demanding it can be.
Sometimes, all of this may not be enough and
you (or your child) may be unable to cope. Worries about the
physical changes of adolescence - are they too early, too late or
ever going to happen - or about relationships can be discussed with
If there is violence in your family - parents
hitting one another, children hitting each other, parents hitting
children or children hitting parents - ask for help.
When problems arise at school, obviously
teachers may be a useful source of information. The teacher may
suggest that an educational psychologist becomes involved.
Psychologists can find out if there are any particular problems
with learning, but can also offer counselling if relationships are
Adolescents who experience turmoil or distress
for more than a few months - persistent depression, anxiety,
serious eating disorders or difficult behaviour - generally require
outside help. Counselling agencies may be suitable if things have
not gone too far. They exist for young people and for parents and
some contact addresses are listed below.
However, specialist help may be needed from
the Child and Adolescent Mental Health Services (see our factsheet
‘Who’s who in CAMHS). They mainly offer out-patient treatment and
can be contacted through your GP.
As they grow older, your children will want
more privacy. Adolescents may, quite naturally, wish to see the
doctor on their own. The law allows them to agree their own
treatment from the age of 16, or younger under certain
Provides a free and confidential sexual, health advice and
contraception by young people up to the age of 25. Helpline: 0808
Provides a free and confidential service for children. Helpline
Kidscape - Provides
advice, run training course and produce helpful booklets and
information about bullying.
Family Lives -
help and advice to parents bringing up children and teenagers: 0808
Talk to Frank -
Free confidential drugs information and advice line. Tel: 0800
Minds - Free advice and support for parents
worried about their children’s behaviour, emotional problems and
mental health. Parents Helpline: 0808 802 5544.
Your Teenager -
Website which focuses on how to handle teenage behaviour and build
a positive parent/teem relationship.
The Young Mind: an essential guide to mental health for young
adults, parents and teachers. Edited by Bailey, S. and Shooter,
M. (2009). ). This is an accessible, user-friendly handbook
produced by the Royal College of Psychiatrists
- Gutman Leslie Morrison; et al (2010); Change
in wellbeing from childhood to adolescence: risk and resilience.
Department for Children, Schools and Families, Great Britain.
- Rutter, M. & Taylor, E. (eds) (2008)
'Rutter’s Child and Adolescent Psychiatry' (5th edn).
London: Blackwell Publishing.
Original author: Professor Richard Williams
Revised by the Royal College of Psychiatrists’
Child and Family Public Education Editorial Board. With grateful
thanks to Professor Ann Le Couteur.
© January 2012. Due for review January 2014.