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The first time Faith-Ann Bishop cut herself, she was in eighth grade. It was 2 in the morning, and as her parents slept, she sat on the edge of the tub at her home outside Bangor, Maine, with a metal clip from a pen in her hand. Then she sliced into the soft skin near her ribs. There was blood—and a sense of deep relief.

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Any of these signs can occur in children who are not depressed, but when seen together, nearly every day, they are red flags for depression.

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Children and teenagers with social anxiety disorder SAD may live with symptoms into adulthood without ever being diagnosed. Social anxiety disorder involves an intense fear or phobia of social and performance situations. Although most teenagers go through periods of normal anxiety related to the changes that go along with adolescence, those with SAD experience fear that is out of proportion to the situations that they face. For some teenagers, social anxiety becomes chronic, affecting school performance, extracurricular activities, and the ability to make friends.

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