What to Watch out for with Your Teen’s Health

In this age group, new issues related to behavioral and mental health emerge. Parents are faced with looking for signs of unhealthy behaviors like eating disorders, smoking and drug use, as well as signs of mental distress like depression and anxiety. Here are some common questions of parents of teens
What concerns and comments are you hearing from teens about marijuana use? Do you think many teens have a good grasp of the risks?
Marijuana use has become more common in teens. Recent surveys of 12th-graders show that approximately 45 percent have used marijuana and about 20 percent are current users, meaning they have used at least once in the past month; close to six percent use marijuana daily. (See www.monitoringthefuture.org.)
Perceptions of harm resulting from marijuana use have meanwhile decreased among teens, even though research shows that regular or heavy use in teens can have numerous adverse outcomes, including less success in school or a job.
Many teens are interested in medical marijuana. “Medical marijuana” is a misnomer, as it is the active ingredients in the Cannabis plant, the cannabinoids, which may have medical benefit. A typical marijuana plant may contain over 200 cannabinoids, and only a few have been studied for use in adults. There have been no clinical trials on possible benefits of cannabinoids in youth.
Until cannabinoids are studied rigorously, as with all other Food and Drug Administration-approved medications, cannabinoids cannot be recommended for teens as a routine medical treatment.
What are “normal” signs of stress versus indications my teen may need to see a doctor for anxiety?
Stress is a common condition among teens, and is due to what are felt to be the demands of doing well in everyday life, such as school, relationships and work. A little stress can be good, as it can be motivating to do one’s best. Symptoms of “routine stress” are short-lived and include feeling nervous, anxious, worried, upset, irritable or angry. Looking from the outside, most would agree that we, too, would feel stress in a similar situation.
However, if symptoms persist, and are not necessarily related to particular situations, then an anxiety disorder may be the problem, and a doctor should be consulted. The usual stress symptoms noted above are exaggerated. Other symptoms can include difficulty sleeping, forgetfulness and problems concentrating. Physical symptoms are also common and can include feeling tired a lot, chest tightness, stomach pain and muscle aches and pains.
Helpful treatments for anxiety include counseling and anti-anxiety medications. Anxiety and depression are believed to involve similar brain and body pathways, and some medications are helpful for both problems.&pagebreaking&How common is it for teens to suffer from depression? If depression is not severe, but recurring, how can I best help my teen cope?
Teens normally have mood swings, feeling happy or sad related to day-to-day life circumstances. However, depression is a more persistent emotional state, and serious depression occurs in about 10 percent of teens. Symptoms can include loss of interest or pleasure in doing things that the teen used to enjoy, feeling down or hopeless, sleep disturbances, fatigue, irritability, body aches and pains, social withdrawal, trouble concentrating, eating too little or much and using drugs to feel better (“self-medicating”).
Parents can help their teen by acknowledging that the teen is having a hard time and by being there for him or her and available to listen nonjudgmentally. Untreated depression, whether intermittent or persistent, can become debilitating, so getting professional help is important. Both counseling and antidepressant medications can help.
What kind of behaviors indicate an eating disorder? Where is the line between being healthy and unhealthy?
Eating disorders such as anorexia nervosa, bulimia nervosa and binge eating disorder occur in about two percent of teen females and one percent of teen males. However, problem eating behavior is more common: a recent survey revealed that to lose weight, roughly 10 percent of teens did not eat for more than 24 hours; five percent took pills, powders or liquids; and four percent vomited or took laxatives. These behaviors were more common in teen girls than teen boys, although both engaged in them.
Healthy means eating a wide variety of foods and getting enough fat, carbohydrate and protein to maintain normal body function. Usually weight and height are in a similar healthy range, which is measured by body mass index (BMI). BMI’s that are too high (overweight, obese) or too low (underweight, malnourished) are both unhealthy.
Higher risk populations for eating disorders include girls 15 to 19 years of age (although eating disorders are increasing in minorities and younger groups), people who are obese, are athletes or are diabetic. Warning signs can include restricting intake, vomiting after eating, over-exercising, over-involvement in food fads and using caffeine, stimulants, diet pills and laxatives to lose weight. Other signs include excessive weight change over the last six to 12 months and persistent body-image complaints. Symptoms of malnutrition include irregular periods or loss of periods in girls, cold intolerance, constipation, hair loss, fainting and fatigue. It should be noted that a low heart rate, less than 50 beats per minute during daytime, is abnormal even in athletes and could result in serious heart problems if not treated.
If you suspect your teen has disordered eating, have him or her evaluated right away by a health care provider. Eating disorders are serious conditions that can result in life-long medical and emotional problems if not treated early and appropriately.&pagebreaking&What is Mono? What’s the difference between symptoms of Mono versus those of the common cold or flu? How long should I keep my teen out of school?
Mono, also called infectious mononucleosis, is a viral infection caused by the Epstein-Barr virus. Common symptoms are sore throat, fever, swollen glands and pronounced fatigue. Mono is sometimes called the “Kissing Disease,” as kissing is one way in which the virus can be spread; an infected person has the virus in their saliva. If you suspect your teen has mono, there are blood tests to help make the diagnosis.
Like many other viral infections, there is no specific treatment or cure for mono. Treatment of symptoms such as sore throat or fever with a medication such as ibuprofen can help your teen feel better. Resting and drinking plenty of fluids are important, too. Typically, your teen will feel better in a week or two, though sometimes it takes a month for complete return to normal. Your teen can return to school when he or she feels better. However, if your teen plays sports, he or she should get clearance first from your health care provider, as rarely mono can cause an enlarged spleen, which could rupture with vigorous sports contact.
The common cold and flu are also viral illnesses. The cold typically causes a stuffy or runny nose, while flu has those symptoms along with fever and/or chills and body aches. Both the cold and the flu also can result in a sore throat, headache and cough. Colds usually last a few days, while flu symptoms last about a week. Getting the flu shot every year minimizes the likelihood of getting the flu.
Seth Ammerman, M.D. is a clinical professor in pediatrics and adolescent medicine at Stanford University. He is also medical director of the Teen Health Van, a community outreach program of Lucile Packard Children’s Hospital Stanford, which provides free health care to underserved teens. Advice is not intended to take the place of an exam or diagnosis by a physician.