By Dr. Lori Butterworth, Child & Adolescent Psychotherapist
Recently, I was talking with the parents of a 12-year-old girl in my psychotherapy practice. They described something that has become increasingly familiar: their daughter and her friends compare mental health diagnoses almost the way kids used to compare favorite bands or clothing brands.
Lori Butterworth
One has ADHD. Another took a quiz on TikTok and thinks she has OCD. Someone else has anxiety, depression, autism or trauma. Sometimes it can even get competitive; who has the newest diagnosis, the most symptoms or the most complicated explanation for why life feels hard.
This is a striking cultural shift. Not long ago, young people often hid mental health diagnoses because they feared being judged. Today, many teenagers readily identify themselves by them.
There is something genuinely good about that change. We have reduced stigma. Young people know more about mental health, and kids who are truly struggling may be more willing to ask for help.
But I also worry that we are increasingly teaching young people to interpret the normal discomforts of life as evidence that something is wrong with them.
Adolescence is uncomfortable. You feel left out. Your best friend suddenly prefers someone else. You get rejected. You embarrass yourself. You fail a test you studied for. Your body changes. You become intensely aware of what everyone else might think of you.
- You can feel anxious without having an anxiety disorder.
- You can have trouble concentrating without necessarily having ADHD.
- You can be heartbroken without being clinically depressed.
- You can experience something painful without automatically describing it as trauma.
These distinctions matter, not because we should minimize suffering, but because young people also need to learn an enormously important lesson. Feeling bad does not mean something is wrong with you. Feeling bad sometimes is part of life.
Much of psychological health involves learning to make room for uncomfortable emotions rather than immediately trying to eliminate them or explain them away.
In my work with young people, I often talk about the difference between pain and pathology. Pain is part of being alive. We will all experience disappointment, uncertainty, loneliness, fear, jealousy, grief and failure. Mental health does not mean avoiding these experiences. It means developing the ability to move through them.
The problem with reaching too quickly for a diagnosis is that a label can sometimes become an explanation for why a young person should avoid discomfort.
“I have social anxiety, so I can’t go to the party.”
“I have ADHD, so I can’t do this assignment.”
“This makes me anxious, so I shouldn’t have to do it.”
Yet many of the most effective psychological treatments teach almost the opposite lesson: we can feel anxious and still go. We can feel uncomfortable and still try. We can be disappointed and recover.
That is resilience.
For parents, this means resisting two extremes. Don’t dismiss your child by saying, “There’s nothing wrong with you.” But also, don’t assume every difficult feeling requires a diagnosis.
Instead, get curious.
When your teenager says, “I have anxiety,” you might ask, “What are you worried about?” If she says, “I’m depressed,” ask, “What has been feeling really hard lately?”
Move the conversation from the label back to the experience.
Of course, psychiatric disorders are real, and accurate diagnosis can be enormously helpful. A young person with significant OCD, depression, ADHD or another condition deserves appropriate assessment and evidence-based treatment.
But even then, the goal of therapy should not be to build a life around a diagnosis. It should be to build a life.
Our children need to know that sadness, anxiety, rejection and uncertainty are not signs that they are broken. They are part of the full range of human experience.
One of the most important things we can teach young people is not how to label every uncomfortable feeling with a diagnosis, but how to experience it, make room for it, and discover that they can move through hard feelings and come out stronger on the other side.
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Dr. Lori Butterworth , PsyD, MEd, MA is a licensed clinical psychologist and the founder of the Center for Youth Mental Health and Jacob’s Heart Children’s Cancer Support Services. She can be reached at lori@cymh.org or 831-222-0052.