“Mental health is the overall wellness of how you think, regulate your feelings and behave. A mental illness, or mental health disorder, is defined as patterns or changes in thinking, feeling or behaving that cause distress or disrupt a person’s ability to function.” (The Mayo Clinic)
While the focus is often on teens and adults, preteens also experience mental health issues that affect their ability to function. Preteens are roughly between 9 and 12 years old. Some common disorders in this age group include:
- Depression – persistent sadness and loss of interest in activities.
- Anxiety disorders – persistent fears and worries that prevent social or academic participation.
- Bipolar disorder – extreme mood changes alternating between very “up” and very “down.” While bipolar disorder usually appears later in adolescence or adulthood, symptoms can appear earlier in some children.
- ADHD – hyperactivity and difficulty paying attention.
- Autism – difficulty communicating and interacting; autism usually appears in early childhood but must be managed through adulthood.
- Eating disorders – concern with weight and weight loss that includes unsafe eating habits.
- PTSD – emotional distress after trauma; anxiety, nightmares and triggered memories can continue for months or years.
Conditions may occur together; this is especially true of behavior problems, anxiety and depression. Rates of depression and anxiety in children have also been increasing over the last two decades.
Challenges for Preteens
No longer a child and not yet a teenager, preteens may feel uncomfortably in between, with their own age-related challenges.
- More responsibilities – From more homework to extracurricular activities to chores and increased expectations at home, preteens may struggle to balance the load. For some, the academic transition from elementary school to middle school can be difficult.
- Social pressure – Middle school can be more stressful than elementary school, with a new social pecking order and pressure to fit in, not to mention bullying.
- Peer pressure – Preteens may be exposed to drugs, alcohol and sex, or at least curious enough to seek and share information from each other.
- Physical changes – Approaching puberty can bring big changes to a preteen’s body, sometimes over several years. Reaching puberty earlier or later than peers can cause self-consciousness, worry and embarrassment.
- Emotional changes – Rapid changes in body, brain and hormones can mean frequent or intense mood swings.
Any additional stressors will add to existing challenges. These can include loss and grief, parents’ divorce or separation, natural disasters and moving. Pandemic-related stressors include isolation, navigating online school or altered schedules, and loss and grief over life as it was—social life and connections may have been severely limited.
Warning Signs
Preteens go through rapid development. Physical and hormonal changes can trigger unpredictable moodiness, making it difficult to identify serious mental and emotional distress. But the key is whether activities are affected in a significant way. If a preteen stops participating in school, activities or with friends for more than two weeks, it could be a sign of distress. Problems may be noticeable across settings such as home, school and social settings. Other warning signs include:
- Changes in academic performance or difficulty concentrating.
- Sleeping too much or too little; periods of manic activity.
- Noticeable weight loss or changes in eating habits.
- Outbursts, fighting, irritability, out-of-control moods that cause trouble with others.
- Destructive or risky behavior.
- Talking about hurting themselves or others, suicidal thoughts or self-harm.
- Persistent sadness, excessive worry, sudden or new fears.

Caring for Preteens
If you notice warning signs in your preteen’s behavior, it’s a good idea to consult others to see if they’ve noticed changes. Your child’s teachers, friends and relatives can help clarify the picture with their observations.
To address mental health issues, your child’s doctor may be a good place to start. They may refer you to a mental health professional for evaluation, diagnosis and treatment, which may include psychotherapy and/or medication.
Psychotherapy involves talking through thoughts and feelings with a mental health professional, who will help your preteen discover ways to respond to challenges and feelings. Therapists focus on helping preteens learn new behaviors and coping skills.
Medication may be prescribed, depending on the disorder involved. These can include antidepressants, anti-anxiety medications, antipsychotics, mood stabilizers or stimulants. Treatment will include discussion of risks, benefits and side effects. Mental health professionals will closely monitor your child to adjust medications as necessary and make sure they work as intended.
Talking with Preteens
To talk to your preteen about what’s going on, remember to actively listen. They may not always respond to your invitation right away, so remain open to communication. It might come while you’re busy with other children or getting ready to go somewhere. But any overture from your preteen is important. If they want to talk, be receptive; if you really can’t talk, set up a chat for later, confirm it with your preteen and follow through.
Try starting conversations in a neutral way, asking open-ended questions: How are things going? I’ve noticed that you seem more frustrated than usual (or whatever applies). Can you tell me about that? Have you felt this way before? How can I help you feel better? Do you think you’d like to talk with someone else about this? I’m concerned about you and your safety—will you tell me if you feel like hurting yourself or someone else?
You can remind your preteen that everyone has mental health challenges in their life, and that some times of life are more challenging than others. Tell them it’s ok to ask for help, because mental health is important to well-being and happiness.

If you or your preteen need assistance, Best Day’s counselors are ready to help. They can evaluate your preteen and advise you on the best course of treatment to get your child on the path to a full and happy life.
How We Can Help You?
Best Day Psychiatry and Counseling is here to help you have a better day and find a better way. We treat a wide range of psychiatric conditions for both children and adults. Contact us today, we’re ready to help:
Charlotte: (980) 867-4440• Durham: (919) 659-8686 • Fayetteville: (910) 323-1543
Fuquay-Varina: (919) 567-0684 • Greenville: (252) 375-3322 • Raleigh: (919) 670-3939
Wilmington: (910) 500-7072 • Winston-Salem: (336) 934-5556