||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 you did.
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
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
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 this.
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 just laziness.
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
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 next.
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 strain
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
- 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
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
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 happens once.
If a parent doesn't feel that breaking the law is particularly
important, it is more likely that their children will offend.
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
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 thin.
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 alcohol
- 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
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 satisfying.
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 taken seriously.
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 constant trouble.
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 must be:
- 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 them.
Don't use corporal (physical) punishment
Although it is now viewed as unhelpful, many people still
occasionally smack younger children. If you do this with adolescent
- 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 your GP.
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 the issue.
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 circumstances.
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.
Lives - Parentline offers help and
advice to parents bringing up children and teenagers: 0808 800
Frank - Free confidential drugs information and
advice line. Tel: 0800 776600.
Minds - Free advice and support for parents
worried about their children’s behaviour, emotional problems and
mental health. Parents Helpline: 0808 802 5544.
Teenager - Website which focuses on how to handle
teenage behaviour and build a positive parent/teem
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
Revised by the Royal College of Psychiatrists’ Child and Family
Public Engagement Editorial Board (CAFPEB).
With grateful thanks to Professor Richard
Williams, Dr Professor Ann Le Couteur, Dr Virginia
Davies, Dr Vasu Balaguru, and Thomas Kennedy.
This resource reflects the best possible evidence at the time of
© Royal College of Psychiatrists March 2017
Due for review March 2020