Being a teen is already a stressful and confusing time. Experiencing sexual abuse makes life even more confusing. Teens often act as if the abuse did not happen. The pain is too much at times so they work hard to avoid the pain. You may notice in your teen feelings of sadness, nervousness, guilt, and fear; changes in behavior such as withdrawing from friends and family, a drop in school performance, or trouble sleeping; avoiding reminders of the abuse such as people, places, or things; or engaging in unhealthy behaviors such as running away, substance abuse, self-mutilation, or suicidal ideation.