5 things to know about teens & hormones

Puberty, with its rush of hormones, has turned many a young life upside down. So how do parents figure out what's normal behavior at this stage of a child's life, and what might warrant some medical intervention?

Here's what you need to know:

1. It's normal for hormones to have a major impact on how a teen behaves

"By definition, most adolescents are 'hormonal,' " said Dr. Michael Schwartz, an associate professor of clinical psychiatry and director of residency training at Stony Brook University School of Medicine.

The challenges come when hormones kick in a physical readiness for adulthood -- such as menstruation, growth spurts, body hair -- when a child is not yet emotionally ready for adulthood, he said. Changes in the body and mind, he said, can lead to everything from "profound self-confidence and even arrogance to feelings of self-consciousness and inadequacy."

2. Look for warning signs

Schwartz advises parents to be on the lookout for these symptoms of hormone-related trouble in teens:

Significant social withdrawal

Change in appetite

Disruption in sleep patterns

Suicidal thinking

Severe anxiety

Alcohol or substance abuse

Extreme sexual "acting out"

Dr. Catherine Budman, a psychiatrist who works with children and adults at North Shore University Hospital in Manhasset, puts it this way: "If you're seeing very significant changes in mood or aggression or other behavior problems, such as withdrawal from usual activities and interests, I wouldn't assume this is normal puberty." But if your kid is simply becoming more independent and challenging you as a parent, she said, that's normal.

3. Be careful about blaming hormones

Medical experts agree that it's difficult to determine exactly what hormones are responsible for when it comes to teen behavior. "Parents should avoid labeling a teen's behavior as hormonally driven because they cannot possibly know that it is -- with the exception of major endocrinological disease -- and because it may short-circuit a more genuine exploration of feelings and behaviors that coincide with the hormone surges but may not be a direct product of these surges," Schwartz said.

For parents who think their teen's behavior isn't normal and may be due to hormones, he suggested seeking help on the psychological front with individual or family counseling. Medication usually isn't necessary, he said, but in certain cases, teens may be prescribed psychiatric drugs.

However, some adolescents do have hormone-related medical conditions that require treatment. Budman said that blood tests can help determine whether there's a problem with thyroid, growth or sex hormone levels.

4. Menstruation can lead to problems

"If you have a young female who is not menstruating or having excessive bleeding with periods or very significant changes in mood, putting her on a birth control pill might even things out," Budman said. That's because birth control pills -- which some young women take even if they're not sexually active -- adjust hormone levels in the body.

Budman said that she recently treated a patient who would cry frequently for unknown reasons. It turned out that she had recently changed her birth control pills, and her mood swings resolved when Budman made another adjustment.

5. Beware of anabolic steroid use

Behavior changes can stem from other causes. Abuse of anabolic steroids, which build muscle, can lead to extreme mood swings, aggressive behavior and intense irritability, Budman said. Though legitimate medical uses do exist for anabolic steroids, their use by teen athletes to build muscle is not among them. (They're also illegal without a doctor's prescription.)

It's possible to treat kids who use steroids, Budman said, but they have to be motivated to stop the abuse. "There really isn't a treatment that you can institute without their cooperation," she added.