• withdrawal from family and peers
• loss of interest in previously pleasurable activities
• difficulty concentrating on schoolwork
• neglect of personal appearance
• obvious changes in personality
• sadness and hopelessness
• changes in eating patterns, such as sudden weight loss or gain
• changes in sleep patterns
• general lethargy or lack of energy
• symptoms of clinical depression
• violent actions, rebellion, or running away
• drug and alcohol use
• symptoms that are often related to emotional state (e.g., headaches, fatigue, stomach aches)
• loss of ability to tolerate praise or rewards