Tween mental health: What are the pressures and challenges?

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As a caregiver, it can be difficult to identify signs a tween may need mental health support.

Tweens are navigating new social environments and handling puberty-related changes that can cause mood and attitude shifts. Many of these experiences are typical of the transition into adulthood.

However, tweens can and do experience mental health challenges.

According to the National Alliance on Mental Illness (NAMI), 17% of children between 6 and 17 live with a mental health disorder.

Signs a tween may need mental health support include:

• intense irritability
• frequent physical complaints related to emotional distress, such as stomachaches or headaches
• sleeping too much or too little
• nightmares
• a decline in academic performance
• fatigue or low energy
• loss of interest in favorite hobbies or activities
• social withdrawal
• change in friends
• excessive dieting or exercising
• preoccupation with weight or appearance
• engaging in harmful or impulsive behaviors
• self-harm
• regular negative self-talk
• suicide ideation

Tweens may deal with pressures resulting from bodily changes, personal growth, learning, and interpersonal relationships.

Cognitive

Many cognitive changes take place during the tween years as the brain continues to remodel itself based on experiences. Children develop more complex thought processes and a deeper sense of “right” and “wrong.”

In school, they may be asked to engage more academically and work independently on projects.

At home, parents may expect children to take up a portion of household chores.

Emotional

Tweens may also experience emotional challenges due to fluctuating hormones, but other factors can also cause emotional distress.

Emotional pressures during tweenhood can come from:

• academic and parental expectations
• a heightened focus on self-image
• peers
• a general desire to be included and accepted

Social

Emotional pressures often coincide with social pressures for tweens. As independence grows and reliance on caregivers decreases, children turn to their peers for companionship and support.

Social pressure during the tween years can come from:

• a desire to be accepted or to fit in
• growing awareness of sexuality
• self-consciousness and body awareness
• feeling a need to “go with the crowd”
• social media

Physical

Many tweens are entering puberty and may face challenges related to:

• acne
• growth spurts
• voice changes
• body hair
• breast development
• menstruation
• body odor

Both young men and women may feel judged by their peers for being too developed or underdeveloped.

Not all tweens develop a mental health disorder due to the pressures they face during preadolescence, but certain mental health challenges are common for this age group.

Depression and anxiety

Mood disorders, such as depression and anxiety disorders, are common mental health challenges for tweens.

According to the World Health Organization (WHO), approximately 3.6% of 10- to 14-year-olds live with an anxiety disorder, and depression affects 1.1% of children in the same age group.

Behavioral disorders

Behavioral disorders are those featuring patterns of behavior that cause distress or impairment in everyday life.

Attention deficit hyperactivity disorder (ADHD), for example, is a behavioral disorder that affects approximately 2.4 million children between 6 and 11 years of age in the United States alone, with a global prevalence of 3.1% among children ages 10–14 years.

Other common tweenhood behavioral disorders include conduct disorder (CD) and oppositional defiant disorder (ODD).

Eating disorders

Tweens can also develop mental health challenges related to body image, such as eating disorders.

Eating disorders include diagnoses such as anorexia nervosa and bulimia nervosa, conditions that share symptoms such as fixation on body weight, excessive food rituals, and extreme body image concerns.

According to the Centers for Disease Control (CDC), body image challenges and disordered eating can start between the ages of 9 and 11 years as children become more aware of their bodies.

Caregivers can make a difference in tween mental health. Ways to promote positive mental health and support a child’s resiliency include:

• providing quality nutrition
• offering plenty of opportunities for exercise, sleep, and relaxation
• actively listening and being available for open conversation
• avoiding criticism and judgment during communication
• engaging in a tween’s hobbies and interests
• checking-in regularly
• being involved in a child’s school and academic events
• supporting a child’s efforts to complete chores and responsibilities
• helping with and encouraging goal-setting
• meeting and becoming familiar with a tween’s friend group
• respecting personal space
• asking for a tween’s opinions and involving them in decision-making processes
• leading by example through healthy lifestyle choices and self-care

A mental health professional can offer guidance any time there is concern about a tween’s mental health — even if what they are experiencing seems typical for their age group.

A mental health professional can assess a tween’s current level of stressors and their available coping strategies. Even if there is no current mental health diagnosis, tweens can discuss their concerns and learn new, effective ways to handle preadolescent pressures.

Help is available 24/7 for tweens and caregivers via the SAMHSA National Helpline at 1-800-662-4357.

Tweens, or preadolescents, are children between 9 and 12 years of age. They are in the phase of development where a variety of cognitive, social, emotional, and physical pressures exist.

Not all tweens experience mental health challenges, but mood disorders, behavioral disorders, and eating disorders are often seen in this age group.

Engaging with children, being present in their lives, and encouraging open communication are ways caregivers can help support tween mental health and resiliency.