When it comes to teenagers, there are many behaviors that parents might find troubling or confusing. In some cases, these behaviors are normal and simply a teen’s reaction to hormone surges and the emotional moodiness that often goes along with adolescence. Other times, however, these new or increasing behaviors and quirks can be warning signs of mental illness. If you’re curious about your teen’s behavior, read through this list of seven often overlooked warning signs of mental illness. Keep in mind that many of these can be a normal part of development and not something to worry about. However, if you have concerns about your teen’s behavior, be sure to check with your child’s primary care doctor or mental health counselor to find out if further evaluation is warranted.

#1. Worries

When children are young, they often worry about things like monsters and spiders. As they get older, their worries and fears change, and this is normal. Your teen might feel stressed when they have to give a report in front of the class. He or she might be worried on the first day of school or the first day of a new job. Many teens also have worries about their future or about their safety in certain situations.

Some amount of worry is normal and can keep your teen safe. Other times, however, it can be a sign of anxiety. If your teen’s worry is severe, if it keeps him or her from doing things that other teens their age take part in, or if it’s affecting them frequently, it’s a sign that should be evaluated by a professional, who can determine if it’s part of an anxiety disorder or other mental health condition.

#2. Alcohol Use

Many teens do eventually experiment with alcohol. Going to a party and trying a beer on an occasional or rare basis is often not a cause for great concern (though it does merit a consequence if it crosses boundaries imposed by the parent). Binge-drinking, however, or drinking regularly are issues that need to be investigated.

Some teens with mental health conditions use alcohol and other substances as a way to self-medicate. If your teen is finding that they can’t be social without drinking or they are drinking a lot in a short period of time, it’s possible that social anxiety, depression, or other types of mental health issues are at play.

#3. Headaches or Stomachaches

Of course everyone occasionally gets a headache or has stomach issues. Some teens will develop migraines or conditions like irritable bowel syndrome. Other teens, however, will have headaches, stomachaches, or other general pains when they are suffering with a mental health condition. Since headaches and stomachaches can be warning signs of mental illness, if your child experiences recurrent pain, it’s important to have a full physical evaluation done to rule out or diagnose physical problems. If nothing is helping and no problem has been found, however, a mental health checkup might be in order. In some cases, a teen can have physical manifestations of :

• anxiety
• depression
• drug addiction
• other mental health conditions

#4. Weight Loss

Many teens struggle with their weight. Some teens are a healthy weight and still think that they are overweight or obese. Any teen can develop an eating disorder, like anorexia or bulimia. One common symptom of these eating disorders is unexplained weight loss. Any overweight teen should be working with a doctor or a nutritionist to find a healthy way to lose weight without endangering their growth and development. If your teen is losing weight without a doctor-approved diet, a physical examination is in order to find out whether there is a physical or mental cause for the weight loss.

#5. Fighting

Some teens, particularly boys, will get into physical altercations with other teens. If it happens once or twice over the course of several years, it’s not necessarily a major problem. Frequent fighting, however, or any fighting that includes the use of weapons, is a big red flag when it comes to a mental health condition. Such teens could be dealing with depression or even psychotic delusions.

#6. Problems With Friends

Similarly, teens will often have minor scuffles and spats with their friends during the teen years. Girls, in particular, might get into the he-said, she-said cycle of gossiping, deciding not to be friends anymore, and making up. This could be normal growing pains, but if it’s happening frequently and with more than one or two friends, it could indicate a problem such as:

• bipolar disorder
• social anxiety
• depression
• or other issues

In some cases, it could mean that a teen is using or abusing drugs or alcohol and having a hard time fitting in with friends who will not participate in or enable that behavior. Other times, it’s a case of a teen being a bully or being the victim of a bully, both of which are risk factors for various mental health issues.

#7. Poor Performance in School

Warning signs of mental illness can also include poor performance at school. Some teens do struggle more than others and poor grades might not be unusual for your own teenager. If the problem is with just one or two classes or subjects, this could be due to problems understanding the material. If your teen’s grades are all plummeting, however, or if your child usually gets all As and is now getting all Cs, it’s worth looking into to see if something more serious is going on.

Substance abuse, an anxiety disorder, depression, and many other mental health conditions can cause a student to stop caring about grades. Also, teens with undiagnosed learning disabilities and ADHD often find it difficult to hide their symptoms once they get into high school, so this is another possibility worth looking into.

Parenting a teen can be a challenge, especially when it comes to knowing whether their often strange behavior is simply teenage angst or warning signs of mental illness. Having a good relationship with your child’s doctor is one way to have someone to bounce ideas off of. Another good idea is to get to know a counselor, who can walk you and your teen through the rigors of getting through the adolescent years with less stress and worry. Don’t be afraid to seek help for you or for your teen during these potentially rocky years.