3 Adolescent Mental Health Red Flags Providers Should Watch for During Summer

June 27, 2025

How school breaks can mask or amplify eating disorders, anxiety, and OCD symptoms and how to intervene

Summer break is often thought of as a time of freedom and fun for teens, but for many adolescents, the shift away from school-year structure can quietly amplify mental health struggles. Without the built-in routines, peer interactions, and external observations of teachers and school counselors, symptoms of anxiety, obsessive-compulsive disorder (OCD), and eating disorders (ED's) can become more entrenched while going unnoticed.


As healthcare providers, summer is a critical time to proactively watch for emerging or worsening behaviors, especially among teens already at risk. Whether you’re a therapist, pediatrician, school staff member, or part of an interdisciplinary care team, it’s important to recognize these three red flags in adolescent patients—and know how to respond effectively.


3 Signs of Mental Health Struggles in Teens and Adolescents


1. Increased Social Withdrawal and Avoidance of Activities

Without the structure of school and extracurriculars, teens with anxiety or OCD may begin to withdraw socially. This withdrawal can look like:

  • Canceling plans repeatedly or refusing to leave the house

  • Avoiding previously enjoyed hobbies or summer activities

  • Expressing vague fears or discomfort around social situations

Why it matters: Social isolation can be both a symptom and a contributor to worsening anxiety, depression, and OCD. Without early intervention, avoidance can solidify into long-term patterns that disrupt development and recovery.


How to intervene:
Encourage parents to maintain predictable daily schedules and gently support social interaction. Recommend therapy focused on exposure and response prevention (ERP) for OCD or CBT for social anxiety. If you suspect anxiety is interfering with functioning, initiate a clinical screening and consider referring to a mental health specialist.


2. Shifts in Eating Patterns or Exercise Behavior

Summer often disrupts regular meal routines, making it easier for disordered eating behaviors to go unnoticed. Watch for:

  • Teens skipping meals, grazing all day, or obsessively “eating clean”

  • Excessive or rigid exercise routines that intensify with added free time

  • Visible weight fluctuations or expressed body dissatisfaction

Why it matters: Summer can be a high-risk time for the onset or escalation of eating disorders, especially for teens experiencing identity changes, body image concerns, or heightened perfectionism. Diet culture and appearance ideals are amplified in the summer, especially on social media sites where teens are spending their free time. With fewer adults monitoring mealtime and activity, unhealthy patterns can escalate quickly.


How to intervene:
Ask direct, nonjudgmental questions about eating habits, body image, and physical activity. Normalize discussions about nutrition, self-esteem, and time spent on social media. If you identify red flags, provide resources for ED-specific care and refer to a registered dietitian or therapist trained in eating disorder treatment.


3. Heightened Rituals or Perfectionism

The lack of structure in summer can intensify OCD symptoms or perfectionistic thinking. This might look like:

  • Obsessive planning or excessive list-making

  • Time-consuming rituals that interfere with daily life

  • Extreme distress when plans change or routines are interrupted

Why it matters: Teens with undiagnosed OCD or perfectionistic tendencies may struggle without the predictable framework of school. What may seem like “quirks” or strong preferences can actually indicate underlying anxiety disorders that deserve clinical attention.


How to intervene:
Explore the function behind the behavior- what purpose does the ritual or routine serve for the teen? Consider early referral to a provider specializing in ERP or anxiety-focused treatment. Educating parents about early signs of OCD is also crucial, as they may simply misinterpret these behaviors as discipline or motivation.


Don’t Wait Until Fall: Early Identification Matters

Summer offers a unique window for providers to identify and support adolescents who may otherwise go unnoticed. By paying attention to subtle signs and initiating conversations, we can help teens access care before symptoms worsen.


Want to learn more about how to support teen mental health this summer?
Join us for our
Summer Series- a free, virtual training series designed to equip providers with practical tools, clinical insights, and a deeper understanding of the full spectrum of eating disorders. Led by Thrive’s founder and nationally recognized eating disorder specialist Kat Geiger, DCSW, LCSW, CEDS-C, PMH-C, this series will break down myths, build clinical confidence, and provide tangible steps you can bring back to your practice immediately.


Let’s Thrive Together

Sign up here to receive access to our clinical tools, webinars, and free CEU trainings with eating disorder and OCD experts.


Together, we can help teens move through summer with more support, stability, and self-understanding.

Thrive Wellness is here to support providers and families across the continuum of adolescent mental health care. To make a referral for specialized mental health support, click here.


Download our free wellness guide.

Discover the power of small, sustainable changes with "How to Thrive: 10 Simple Habits for Healthy Living." This guide offers practical, easy-to-follow habits that promote physical, mental, and emotional well-being.

November 11, 2025
Are you looking for a meaningful way to give back this holiday season? Thrive Wellness is excited to continue our 6th Annual Giving Tree Program in collaboration with Perenn Bakery this winter. This year, Thrive Wellness Reno and Perenn Bakery are proud to partner with Ronald McDonald House Charities® of Northern Nevada. The organization supports families with children receiving treatment at area hospitals, providing comfort, hope, and a home-away-from-home during challenging times. Ronald McDonald House Charities offers essential services, removes barriers, strengthens families, and promotes healing when children need healthcare the most. How It Works Simply take one (or a few) tags from the Giving Tree, each listing an item you can purchase and donate for residents of the Ronald McDonald House. Then, drop off your item(s) at one of our designated donation locations by Friday, December 19. Items Needed: Restaurant gift cards Walmart or Target gift cards Games, puzzles, and coloring books Toys (Barbie, Hot Wheels, Lego sets, craft sets, magnet blocks, baby dolls, action figures, journals, infant toys, etc.) Children's books (picture, chapter, and graphic novels) Toiletry sets (for adults) Lotion/self-care gift sets (for adults) Sweatshirts/hoodies (adults, XS-XXL) Scarves, gloves, fuzzy socks, pajamas (all sizes) Infant diapers, onesies, and baby bottles Bulk individually wrapped snacks (granola bars, chips, etc.) Please ensure all donations are new, in original packaging, and unwrapped. Donation Drop-Off Locations Please deliver donations by Friday, December 19, to one of the following sites: Thrive Wellness 491 Court St., Reno, NV 89501 201 W Liberty St., Suite 201, Reno, NV 89501 Perenn Grocery 7600 Rancharrah Pkwy, Suite 130, Reno, NV 89511 Perenn Rancharrah 7750 Rancharrah Pkwy, Suite 110, Reno, NV 89511 Perenn Midtown 20 St. Lawrence Ave, Reno, NV 89509 Claio Rotisserie 3886 Mayberry Dr., Suite D, Reno, NV 89519 Why We Give Back Through our Giving Tree program, we’re honoring one of our core values at Thrive Wellness: staying rooted in community. This annual tradition allows us to give back to those who need support most during the holiday season. We invite you to join us by taking a tag at any Thrive or Perenn location and helping spread kindness throughout our community. There’s no better way to embrace the holiday spirit than by supporting local families with thoughtful, heartfelt donations. We are deeply grateful for your generosity and continued support. Thank you for helping us make a difference!
September 22, 2025
Eating disorders are one of the most serious mental health concerns facing today’s adolescents. They can affect every aspect of a young person’s life, including their physical health, school performance, relationships, self-esteem, and more. According to the National Institute of Mental Health, about 2.7% of adolescents in the U.S. will experience an eating disorder in their lifetime, and many more engage in disordered eating behaviors that may not meet full diagnostic criteria. The good news is that providers are in an influential position to notice early warning signs, open conversations, and connect families to support before these patterns of behavior become too engrained. Why Early Intervention Matters The earlier an eating disorder is identified and treated, the better the treatment outcomes. Research shows that getting support quickly after the disorder’s onset is linked to faster recovery, lower relapse rates, and healthier long-term development (Treasure & Russell, 2011). Waiting too long to seek help can mean medical complications, deeply ingrained behaviors, and a more difficult path to healing. For many adolescents, a caring provider who notices the signs and advocates for treatment can make all the difference in recovery and can even save lives. Recognizing Early Warning Signs Adolescents may not always disclose their struggles directly, so providers should keep an eye out for a range of indicators: Physical signs: noticeable weight changes, menstrual irregularities, digestive issues, dizziness, or fatigue. Behavioral patterns: skipping meals, restrictive eating, excessive exercise, frequent dieting, eating in secret, or leaving for the bathroom after meals. Emotional and cognitive signs: preoccupation with weight or body shape, food rituals, heightened anxiety around eating, or perfectionistic tendencies. It’s important to remember that eating disorders don’t always “look” a certain way. Teens can be distressed about food and body image even if their weight appears to be within a “normal” range. Screening Tools and Assessments Using free screening tools available online can be an effective way to gauge a patient’s needs and gain further insight on treatment options for a possible eating disorder. Here are 4 free screening resources we recommend you use before making a referral for a higher level of care. EDE-Q (Eating Disorder Examination Questionnaire) : helps assess eating attitudes and behaviors. Nine Item Avoidant/Restrictive Food Intake disorder screen (NIAS) : helps to assess the signs of ARFID in children. Eat 26 Screening Tool : a screening measure to help you determine attitudes towards food and eating. BEDS-7 (Binge Eating Disorder Screener) : for situations where binge eating is suspected. When possible, gathering input from parents, teachers, or coaches can also help, as teens may minimize their experiences out of fear or shame. The Role of Primary Care and Pediatric Providers Routine checkups are often where eating disorders first come to light. Providers treating children, teen, and adolescents can: Incorporate simple questions about eating habits and body image into wellness visits. Track growth charts and weight trends while pairing them with questions about mood, anxiety, and behavior. Foster trust by creating a safe, nonjudgmental space where adolescents feel comfortable sharing sensitive information and know there will be no weight stigma. Coordinating Multidisciplinary Care Supporting a young person with an eating disorder works best when care is collaborative . In order to treat the whole person, there are usually multiple members of a treatment team needed, including: Medical support: monitoring vital signs, lab work, and physical health. Therapeutic care: evidence-based approaches such as family-based therapy (FBT) and cognitive-behavioral therapy (CBT) help address thoughts and behaviors. Nutritional guidance: dietitians provide education, meal support, and reassurance. Family involvement: engaging caregivers empowers them to support recovery in everyday life. Addressing Barriers and Stigma Many families face challenges in seeking help, whether due to stigma, lack of awareness, or limited access to specialists. To help, providers can: Normalize conversations about body image and mental health as part of overall well-being. Use culturally sensitive approaches that honor diverse experiences with food, body, and health. Connect families to community organizations, online resources, or telehealth when in-person specialty care is limited. Eating disorders in adolescents are serious, but with early recognition and timely support, recovery is possible. Providers are often the first to notice changes and can play a vital role in opening doors to crucial support. By blending professional expertise with empathy and collaboration, providers can guide adolescents and their families toward lasting recovery and a healthier future. References National Institute of Mental Health. (2023). Eating Disorders . Treasure, J., & Russell, G. (2011). The case for early intervention in anorexia nervosa: theoretical exploration of maintaining factors. The British journal of psychiatry : the journal of mental science, 199(1) , 5–7.
By Julia Actis, LCSW September 11, 2025
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