Teens in this age range are seeking to establish their unique identity, often separate from parents and family. They are beginning to think for the first time about spiritual and philosophical ideas in truly abstract ways. And they generally experience powerful and deep emotions that they may believe no one else has experienced before or that no one else can understand.

Grief and loss during this time generally will increase a teen’s concerns regarding the normal physical changes taking place in their bodies. Grief also may be expressed by frequent headaches or stomach aches, or through feeling sad and depressed. These are normal reactions, and should be viewed in an understanding and tolerant way by any adult caregiver.

Another common reaction is for middle teens to manifest their grief in mood swings and outbursts of anger. Some teens withdraw to a safe place, such as a bedroom, where the anger may be acted out by pounding on a wall or beating a pillow. Some may act out the anger through inappropriate social behavior, pouting or aggression toward others. Grades may decline in part due to sleep disturbances, but also due to depression and a general feeling of meaninglessness.

It is normal for middle teens, both girls and boys, to want a special “friend,” such as a teddy bear to hug and sleep with during this time. It may be important for a caregiver to protect this information from other family members and friends, especially in the case of a boy. The teenager also may want to cling to or wear a special article of clothing that belonged to the deceased. He or she may adopt certain mannerisms or behaviors associated with the deceased loved one or idealize his or her relationship with the deceased. Being tolerant of what may be seen as “childish” or immature behavior allows middle teens to process the loss in their own, personal and important ways.

Older teens are busy with the business of becoming young adults. Most children—from the pre-teen years into the early teen years—are focused on a desire to be an adult. As an older teen, this focus becomes reality. During these years, teens want to be treated with respect and collegiality.

Being helpful to older teens is complicated by the fact that while they may be young adults, they do not have the full responsibilities or experiences of adulthood. They also are in the process of differentiating and distancing themselves from the parental figures in their lives. Their peer group is their major authority—and how they are seen and judged by their peers is of primary importance to them.

Older teens may react to their grief by rigid conformity to their peer group. They may become sullen or withdrawn and non-communicative. Their anger may be expressed through exaggerated conflict with parental figures and through pushing hard to overturn formerly understood and reasonable limits. They may become insecure about the future, question the meaning of life, and question or abandon the family’s belief system. They may have sleep problems, such as recurrent or disturbing dreams and insomnia. As with middle teens, grades may decline due to sleep disturbances, depression and a general feeling of meaninglessness.

Some older teens may idealize the deceased loved one. They may adopt mannerisms, habits and preferences of the deceased. They may want to wear certain items of clothing, especially a hat, shirt or jacket that belonged to their special loved one. Or they may react by feeling abandoned and angry at unfulfilled expectations in their relationship with the deceased. They sometimes may revert to regressive behaviors. Examples of this include being immature and childish, or masking fears with joking and sarcastic remarks. Being tolerant of unexpectedly immature or overly affected behaviors in older teens will help them learn how to live better with a major loss in their life.