Parents in South Florida often reach out when home starts to feel like constant tension, school starts to unravel, and friendships shift overnight.
At Adolescent Wellness Academy, Dr. Maria Mejia, PhD, LMFT, Clinical Director for AWA Davie, talks with families every day about teen anxiety and teen depression, what they look like in real life, and what signs matter most.
She also explains why many teens struggle to open up in weekly sessions and how peer connection can change the trajectory for co-occurring disorders in teens.
The Most Common Concerns Dr. Mejia Sees Day To Day
When Dr. Mejia thinks about the teens coming into AWA, she describes a shared core even when the labels differ. Teens may arrive for anxiety, OCD, depression, behavior concerns, substance use, or safety issues, but many connect around “really intense emotions that they don’t know how to manage.” Those emotions tend to show up in the same three places.
- School, attendance drops, mornings turn into conflict, grades slip because a teen cannot show up
- Friends, social withdrawal grows, a teen feels disconnected, and rejection feels overwhelming
- Home life, irritability increases, shutdown happens fast, conversations escalate
Dr. Mejia also meets families who already tried outpatient therapy. She hears, “I’ve tried therapy, I keep changing therapists,” and the same pattern repeats: “they’re not really opening up, they don’t want to talk.” She explains that teens can feel “intimidated to sit in a room with another adult and talk about their problems,” and many feel alone, like “it’s just them.”
AWA’s approach does not rely on one hour per week to carry everything. Dr. Mejia points out that families may address “pretty significant mental health and behavioral issues,” but weekly therapy only covers “one hour out of your entire week.” That gap matters when teen anxiety shapes the whole day.
How Teen Anxiety And Teen Depression Look Different Than Adult Symptoms
Parents often expect teen anxiety to sound like worry and teen depression to sound like sadness. Dr. Mejia asks families to look at functioning first, especially in school. She describes the expectation of adolescence as the ability to go to school and “engage meaningfully.” When teen anxiety ramps up, school often becomes the pressure point.
Dr. Mejia names a pattern many parents recognize. Anxiety can trigger physical symptoms that block attendance, including “constant GI” issues. Families may also live through the daily standoff: “Is it a fight every morning to get them up and to school?”
Teen depression can also look different than adult depression. Many teens do not describe it directly. Parents often see irritability, sleep shifts, and withdrawal, especially after school, when masking all day takes a toll.
Teen anxiety often shows up through these behaviors:
- Avoidance and frequent absences
- Perfectionism that turns into shutdown
- Social fear that limits participation
- Irritability that covers fear
Teen depression often shows up through these behaviors:
- Pulling away from friends and activities
- Low follow-through and motivation
- Anger spikes and quick overwhelm
- Staying in bed, isolating at home
Early Warning Signs Parents Often Dismiss As Typical Teen
Adolescence does include mood swings. Dr. Mejia encourages parents to notice patterns that persist and start shrinking a teen’s world. She returns to school as an early marker because school demands expose coping limits.
Dr. Mejia’s warning signs often sound practical, not dramatic:
- Absences stack up
- Anxiety becomes physical, including “constant GI” symptoms
- Mornings become “a fight every morning.”
- A teen starts collecting “detention, suspension, things like that.”
- Substance use puts a teen “at jeopardy of getting expelled.”
She also reminds parents to look beyond grades. A teen can perform academically while struggling behaviorally and emotionally.
Dr. Mejia asks parents to consider whether school stress blocks treatment progress. If school demands overwhelm a teen, the teen may not have enough space to learn coping skills and practice them consistently.
How Social Withdrawal And Friendship Changes Show Up
Many parents describe friend groups changing fast. Some teens stop responding to texts, stop hanging out, and stop joining activities they used to love. Others keep a social life online while avoiding in-person connections.
Dr. Mejia describes how disconnection often sits under multiple symptoms. Teens may feel isolated because their “mental health and behavioral issues cause a lot of disconnect in their social life, in their friendships, in their family.” That disconnect can create a loop.
- Teen anxiety makes school and friends feel unsafe
- Avoidance reduces practice and confidence
- Isolation increases shame and hopelessness
- Teen depression deepens because life gets smaller
Dr. Mejia also describes a subgroup that needs special attention. Teens with severe social anxiety may switch to virtual school, then lose peer connection. She notes that some teens end up with “no social connection” and need a structured way to reconnect with peers their age.
Why Peer Connection Helps Teens Open Up
Dr. Mejia explains that teens often open up faster when they sit with peers.
She says, “There is a lot of power in teenagers sitting in a room with other kids their same age going through very similar issues.” Even when the reasons differ, one teen for anxiety and another for OCD, she sees how they connect because “a lot of the core is the same.”
In groups, teens can share and receive support without feeling judged. Dr. Mejia describes how peers respond, “they’re not judging you, they’re listening to you, they’re giving you advice, support.”
She also highlights the reality that drives many teen therapy successes: adults can repeat a message “until we’re blue in the face,” but teens may hear it from a peer and respond because they feel “more receptive and more open.”
What Gives Dr. Mejia Hope With Co-Occurring Disorders In Teens
Parents often worry that multiple issues will cancel out progress. Dr. Mejia sees the opposite when the treatment plan supports the full picture. She describes teens who come in for different reasons and still connect because they share the same core struggle with emotional intensity and skill gaps.
That perspective matters for co-occurring disorders in teens, including combinations such as:
- Teen anxiety and teen substance use
- Teen depression and eating disorder behaviors
- Anxiety with behavior problems and school consequences
Dr. Mejia also emphasizes that teens often need more than weekly care at the start. She describes an “intensive approach” that includes group, individual, and family work, and she frames that intensity as a way to help teens stabilize and then “return to outpatient services and thrive.”
What Parents Can Track At Home This Week
Parents often ask what to watch for between big moments. Dr. Mejia’s interview points to function, safety, and consistency.
Signs that a teen may need more support:
- School refusal, frequent absences, or daily morning conflict
- Physical anxiety symptoms that block attendance
- Isolation that grows week over week
- Panic after social stress or peer conflict
Signs teen depression may need more support:
- Loss of interest in friends and activities
- Increased irritability and shutdown at home
- Sleep shifts that disrupt school
- Motivation collapse and missing assignments
Signs behavior concerns may point to distress:
- Repeated detentions or suspensions
- Escalation in arguments and defiance
- Risky choices tied to coping, not fun
Safety concerns should move to the top of the list. Dr. Mejia describes safety risk as a key factor when a teen struggles to keep themselves safe, including “cutting themselves” and “vocalizing suicidal ideation.”
What Progress Can Look Like
Dr. Mejia wants teens to regain routine, rebuild confidence, and reconnect socially in a healthier environment. She describes the end goal in practical terms: a teen who feels ready to return to school and who faces daily challenges with more stability than before treatment.
She also emphasizes that progress shows up in small, consistent wins, more reliable mornings, fewer absences, calmer reactions at home, and better follow-through on coping skills. Over time, teens begin to trust themselves again and feel less overwhelmed by everyday pressures.
About the Author
Dr. Maria Angelica Mejia
