When a Teen Is Struggling: The Grandparent Advantage

You have something the parents do not always have. A little distance. A little perspective. And years of patience that did not come easily; they were earned.

That combination puts you in a rare position when a teenager in your life seems off. You are often the first to notice. And you may be the first one they actually talk to.

There is a reason for that. The parent-child relationship carries its own friction, even in the best families. Without that friction, grandchildren sometimes say things to a grandparent they would never say at home.

That is not a small thing. It is a real opening.

And plenty of teens could use one. In a 2023 national CDC survey of high school students, about 4 in 10 said they had felt persistently sad or hopeless during the past year.

So what does “off” look like? Every teenager has rough days. The signs worth watching are the ones that stick around for a few weeks or longer. The National Institute of Mental Health lists sadness that will not lift, losing interest in favorite activities, irritability or anger, pulling away from friends and family, slipping grades, and changes in sleep or appetite.

You may spot these sooner than anyone. Parents see change a day at a time, so slow shifts can blend in. You often see the before and the after. The grandson who used to talk your ear off about baseball and now answers in single words. The granddaughter who keeps finding reasons to skip Sunday dinner.

When they do open up, give them your full attention. Some of the best talks happen shoulder to shoulder: on a drive, on a walk, over a jigsaw puzzle or a fishing line. Sometimes it is easier to talk when nobody has to hold eye contact. The holidays ahead will bring plenty of those moments.

Keep your questions simple. “You’ve seemed a little quiet lately. Want to tell me about it?” Then let the silence do some of the work. You have had plenty of practice at that.

If you worry that asking will make things worse, take heart. MedlinePlus, the federal health information site, notes that talking about depression does not make it worse and may help a teen get help sooner.

There is one promise to avoid making: keeping a secret that involves their safety. You can tell them, gently, that you love them too much to sit on something that serious. Then encourage them to talk with their parents, and offer to be there when they do.

When it comes to teen mental health, being informed helps. Knowing what treatment options actually look like means that if the conversation with the parents turns toward getting help, you can take part in that discussion, not as someone guessing, but as someone who understands the landscape.

Here is that landscape, in brief.

For many families, the first call is to the teen’s doctor, who can screen for depression and suggest next steps. A school counselor can also help point the way. Treatment usually begins with talk therapy, sometimes combined with medication. The National Institute of Mental Health notes that depression can be treated with either one or both together.

Care also comes in levels. Outpatient therapy means regular sessions, often weekly. Intensive outpatient programs typically meet several times a week while the teen lives at home. Partial hospitalization, sometimes called day treatment, provides structured care during the day, with nights at home. Residential programs offer round-the-clock care in a live-in setting. A hospital stay is for an immediate crisis.