Adolescence:  When Isn't It "Just a Phase?"

Mark J. Blotcky, MD
JAMA. 1977;237(20):2232-2233. doi:10.1001/jama.1977.03270470068034.
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DESPITE many popular opinions to the contrary, most of today's adolescents function with gratification and competence in most spheres of their lives most of the time. Symptoms that will require treatment by a specialist develop only in a minority. But here, precisely, is the enigma for the clinician. In this period of rapid, serious, and lasting change in the young patient's life, when can the symptoms rightly be called "adolescent turmoil"? When can the parental denial, "It's just a phase," be justified, and how does the clinician make that judgment? When is referral to a psychiatrist necessary, and how does one go about making it?

A Tale of Two Teenagers  Joan, a 17-year-old high school senior, was, in many ways, a model youth. Her grades were excellent. She loved to read and ponder philosophical issues. There were no family fights, but Joan's parents were concerned with her lack of direction.


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