In the exciting upheaval of childhood, where change seems to be the only constant, it can be difficult for parents to recognize the division between normal childish behavior and the warning signs of emotional trouble. The following list can guide a parent’s concern. Such signs should signal a parent to be extra vigilant, to raise uncomfortable issues, and to listen closely to your child’s answer. Don’t be afraid to raise topics that seem ridiculous. Listen to your children and talk to them. Keep the lines of communication open. If you ask your child, “How are you doing?” sometimes they will tell you. Always take them seriously if they come to you and say, “I need to talk to someone.” If your concerns continue, find professional help­–talk to your family doctor, a school counselor, or a therapist. If you are truly concerned that your child is in danger don’t hesitate to call 911. Don’t worry that your child will be embarrassed or angry with you. You are always their parent first.

1.     Sudden changes in behavior

The main thing to look for is a sudden change, in any direction. A child who was very social may suddenly choose to stay in his room. A former recluse may be always going out. Is your daughter coming in late? Have your A-student’s grades dropped? A picky eater who begins to eat voraciously and gain weight or a child who abruptly has no appetite can be a red flag. Reckless behavior–driving too fast, using drugs, drinking–should be particularly concerning. Some kids give up the usual teenage vanity, stop showering or styling their hair. The change doesn’t always have to be negative. A child can enter a mania stage and try to take on the world, as though they can do everything all at once.

2.     Unusually emotional behavior

There may be an increase in aggressiveness. Some children nearing suicide will begin to give away their belongings, say goodbye or say uncharacteristic things: A guy might say to another guy, “I really love you and thank you for being there,” something that he ordinarily wouldn’t say. Some suicidal children may become obsessed with the subject of death, drawing pictures or writing or reading about the subject.

3.     Venting on social media

A lot of times kids will cry out. They’re trying to let somebody know that things aren’t right, but they don’t know how. In their confusion, they say things on Facebook, Instagram or Twitter. One post may not seem to mean much, but put lots of posts together and a troubling picture emerges. Before he committed suicide, a promising young man in my community posted comments like “I wish I wasn’t here any more” and “It will all be over soon.” His last post read, “I can’t wait until tomorrow and it will all be gone.” A parent who doesn’t have training might look at one of those messages and not know to be alarmed. It’s important to just be aware and alert and pay attention to what is said.

4.    Bullying

Social media can be part of the problem. Children have always been bullied, but now bullying can follow them everywhere. In the past, they might hear it at school but if they had a happy home life, they could go there and escape. Now that’s not a possibility. They have phones, texting, Facebook, Instagram, Twitter, it’s endless. Some schools are making kids aware of how damaging bullying is and how they can help but parents need to be aware also.

5.    A troubled past or circumstances

A child who has a history of mental illness, or who has a parent or family member who is mentally ill, has an increased chance of depression. Physical, emotional or sexual abuse can also contribute. So can big things happening in their lives–losing a parent or a friend or knowing someone who committed suicide. Often, homosexual teens who have been struggling with their identity commit suicide due to bullying or the confusion and fear of coming out, as well as their fear of what repercussions may come. The hormone surge that comes with puberty can also add to emotional problems

6.    Physical complaints 

Often a child suffering emotional pain will feel and express that pain as physical ailments–stomachaches, headaches or difficulty concentrating at school.