How your teen interacts with others can give you some clues about his or her mental health. While it’s not foolproof, a teenager who has a good number of friends, doesn’t have major friend-drama, and isn’t afraid to talk to new people is showing signs of having good mental health. While having few friends or having dramatic relationships isn’t necessarily a symptom of poor mental health, teens who find it hard to get along with others might have an underlying reason for it. Here is a list of five teen social behaviors that may indicate a mental health issue in your teen.

1. Feeling That No One Understands Them

If your teen says or conveys that they’re feeling misunderstood, it’s possible that he or she is just being a teenager. Many adolescents think at various times that they’re the only one going through a particular experience or emotion. Also, the teen brain and the adult brain are quite different, and adults sometimes forget that teens are not thinking the same way that they are. That’s normal, and as long as it’s not seriously impacting friendships or relationships, it’s not anything to worry about.

If your teen finds it hard to talk to people, however, because others truly do not seem to understand what your teen is talking about or how to relate to him or her, this could be a sign that something more is going on. The first sign on the list of teen social behaviors which indicate a mental health issue is your teen feeling as though nobody understands them. A lack of understanding social cues and graces could be a sign of being somewhere on the autism spectrum. Many people with mild autism are able to live normal, full lives once they learn how to read and respond to social cues, so don’t hesitate to get your child evaluated if you have a suspicion that this might be the case.

2. Often Feeling Too Sick or Too Anxious to Go Out

The second sign on the list of teen social behaviors which indicate a possible mental health problem is social anxiety, which can cause nervousness and physical symptoms. Your teen might be fine when around family members or a few close friends, but when it’s time to mingle in a larger group or meet new people, he or she might freeze up. Other teens with social anxiety can experience physical discomforts like a racing heartbeat, stomach pain, sweating, and muscle tension.

Social anxiety can look like separation anxiety, shyness, or disinterest in others. In reality, though, your teen might be legitimately anxious or frightened, even if he or she knows that the fear is irrational. Cognitive behavioral therapy and/or medications can be effective treatments for this type of anxiety disorder.

3. Dropping Friends

The third sign on the list of teen social behaviors which suggest a mental illness may be present is a change in friends. Teenagers often become and stay friends with people who share similar interests. So if your teen suddenly drops a good number of friends, particularly if he or she also drops some favorite interests or activities, it could be due to a mental health issue or an addiction.

Teens with depression might lose interest in activities and friends that they previously enjoyed. A teen with a substance addiction might switch to a new group of peers who validate and participate in the desire to use drugs or alcohol. Any teen also runs the risk of getting in with a group of peers who will be a poor influence encourage substance use and abuse.

If your teen is dropping friends, try to find out what’s going on. In some cases, that can be the first sign of a mental health or substance problem.

4. Defiant and Vindictive Toward Those in Authority

The fourth sign on the list of teen social behaviors which suggests a teen might have a mental health issue is rebelling against authority. Teens are often argumentative with and frustrated by their parents. This can be part of normal development; adolescents are going through the process of leaving childhood and dependence on their parents in order to find out about themselves as they enter adulthood. Sometimes, however, this type of defiance goes too far, and it can be a sign of a mental health disorder.

Oppositional defiant disorder (ODD) is a disruptive disorder that can wreak havoc in the home, at school, and anywhere else your teen deals with an authority figure. Often present in childhood, sometimes kids with ODD are assumed to be “difficult” or “contrary.” They tend to get in trouble in school and at home. Once undiagnosed and untreated children become teenagers and hormones are mixed in, the teen might become violent or scary to others in the home.

Aside from ODD, some teens who are defiant and very irritable all the time might be dealing with severe anxiety, a substance abuse problem, or some other type of mental health issue. Not being able to handle an authority figure is a symptom that should prompt you to visit your child’s PCP.

5. Feeling That Others Are Out to Get Them

The fifth sign on the list of teen social behaviors which indicate a mental health problem is paranoia. If your teen is displaying signs of paranoia, this is a mental health red flag that should be brought to his or her doctor’s attention right away. A teen who is isolating him- or herself and avoiding people and outings due to a fear that something bad could happen could be suffering from agoraphobia, schizoaffective disorder, or another mental health condition. There might be delusional thinking involved, and your teen might begin pushing away people who have been close to them.

Another time a teen might think that others are against him or her is when people are telling the person that their behavior does not seem right. Disturbing behaviors can be caused by a wide range of mental health issues, including substance use. If your teen is saying negative things about more than one friend, it is worth investigating whether there’s a mental illness on the part of your teen.

Worrying about whether your teen is getting along well with peers and others in the community can be stressful for you. Most of the time, arguments with friends and even broken-off friendships are a normal part of growing up, but occasionally, they can indicate something more serious. Try to talk to your teen so you can understand what’s going on.

If you notice your child displaying any of the teen social behaviors on this list and are concerned that there’s a mental health condition at play, make an appointment with your child’s doctor for an evaluation. From there, you might be referred to a mental health professional or a treatment center. Most teen mental health conditions can be treated very effectively, and catching them early can make treatments more effective and get your teen feeling better more quickly.