More Than Moodiness: Depression and Anxiety in Ages 9–12

Between 9 and 12, kids get better at hiding what they feel — and adults get faster at explaining it away. “Lazy.” “Dramatic.” “Pre-teen attitude.” Here is how depression and anxiety actually show up in the tween years, which versions get missed, and when a pattern deserves a professional look.

Part 2 of a three-part series. Also see: ages 5–8 and ages 13–18.

The tween years are a bridge: a 9-year-old lives mostly in the world of parents and play, a 12-year-old in the world of peers, group chats, grades, and a changing body. Inner life deepens — and so does the ability to conceal it. Depression grows more common as puberty approaches: by ages 12–17, about 8% of U.S. kids carry a current depression diagnosis and 16% a current anxiety diagnosis — well above younger children. [1] The signs shift too: less tantrum, more shutdown. And a hard truth arrives — suicide is the second leading cause of death at ages 10–14 in the U.S. [2] Most moody tweens are fine; the job is spotting the ones who aren’t.

If you’re worried right now

Zoom

Get emergency help now — call 911 or go to the nearest emergency room — if your child:

• Has attempted suicide or self-injured in a way needing medical care
• Talks about wanting to die and has a plan, or has taken steps (searching methods, gathering pills)
• Has swallowed medication or anything toxic
• Cannot be kept safe at home right now

Free, 24/7 crisis support:

• Call or text 988
• Chat at 988lifeline.org
• Text HOME to 741741 (Crisis Text Line)

Get same-day professional advice — pediatrician today, or 988 for guidance — if your child:

• Says anything about wanting to die or being “better off gone,” even as a joke
• Has fresh cuts, burns, or other signs of self-harm
• Is being seriously bullied or threatened
• Has stopped eating, barely sleeps, or seems to see or hear things others don’t
• Shows a sudden collapse — won’t leave their room, attend school, or function

Make an appointment and start tracking if:

• The patterns below persist two weeks or more, keep returning, or are costing your child school, friendships, activities, or sleep

Asking your child directly and calmly about suicidal thoughts does not put the idea in their head — the research is consistent that asking tends to relieve, not harm. [3] One practical step any family can take today: lock up medications and firearms. Secure storage saves lives at this age. [4][5]

What depression can look like at ages 9–12

By this age depression starts to resemble its adolescent form — but tweens rarely announce it.

• Irritability more than sadness. Snappy, negative, easily wounded. Depressed mood often wears an angry face in this age group, and clinicians formally count it. [6][7]
• “Nothing’s fun anymore.” Quitting the team mid-season, abandoning hobbies, drifting through weekends bored and flat. Lost interest shows up as boredom.
• The “lazy” mirage. Homework not started, grades sliding. Low energy, poor concentration, and hopelessness look exactly like poor effort from the outside.
• Self-criticism and shame. “I’m stupid.” “Everyone hates me.” Worthlessness and outsized guilt deserve attention, especially when new or constant.
• Hopeless math. Tweens can now think about the future — so a depressed tween can decide the future is bleak. “What’s the point” matters.
• Sleep and appetite shifts. Trouble falling asleep, unrefreshing sleep, sleeping far more; eating much less or more.

What anxiety can look like at ages 9–12

Anxiety is the most common mental health problem of this age group, and several forms take shape now: [1][9]

• Worry that won’t switch off. Grades, lateness, family money, a parent’s health — a small adult carrying the household’s stress.
• Perfectionism and fear of evaluation. Redoing work, tearing up “ruined” pages, meltdowns over an A-minus, refusal to raise a hand. Social anxiety typically begins around this age. [9]
• Reassurance loops. “Are you sure it’s fine?” on repeat; checking and re-checking. When rituals turn rigid or time-consuming, clinicians also consider OCD — a distinct condition.
• Avoidance with a story. Quitting choir “because it’s boring,” skipping the party “because parties are dumb” — avoidance disguised as preference.
• School avoidance. Sunday-night dread, Monday stomachaches, mounting absences. School refusal peaks again at 10–11 — the middle-school transition — and can involve anxiety, depression, bullying, learning struggles, or all four. [10]
• Panic-like episodes. Sudden racing heart, breathlessness, dizziness, doom. True panic disorder is rare before the teen years (well under 1%) — new episodes deserve a medical check first, and an anxiety evaluation either way. [11]
• The body again. Recurring unexplained stomach pain is strongly linked to anxiety; in one study about 8 in 10 such children met anxiety criteria. [8] Real pain, real anxiety — dismiss neither.

The versions parents miss

• The high performer. Straight A’s, polite — and privately unable to sleep, crying over homework. Across hundreds of studies, parent and child reports of inner symptoms agree only weakly — kids know things about themselves that adults can’t see. [12]
• The “attitude problem.” Irritable depression reads as disrespect; anxious avoidance reads as defiance. Consequences pile up while the driver goes unexamined.
• The ADHD lookalike. Anxiety, depression, poor sleep, and learning disorders all mimic attention problems — and can co-exist with true ADHD. About 4 in 10 children with ADHD also have anxiety. [13]
• Bullying, in person and in the group chat. Bullied kids carry roughly double the odds of suicidal thinking — cyberbullying even more. Tweens hide it out of shame, or fear of losing the phone. [14]
• Kids whose distress gets misread. Distress in Black children is too often treated as a behavior problem, and Black youth are less likely to receive treatment; suicide rates in Black children 5–12 run roughly twice those of white peers. Culture shapes expression too — in some families distress speaks through the body or through silence. [15][16][17]
• Quiet online shifts. Gaming that swallows everything, 2 a.m. scrolling, abandoned group chats, scrubbed accounts. Screen research shows mixed, mostly modest links with mood — but a change in your child’s digital pattern is still information. [18][19]

Two composite examples

Fictional composites — not real children, and not diagnoses.

Ava, 11, has the best grades in her class. She also redoes homework until 10 p.m., asks nightly whether her test went “actually fine,” and has stomachaches most Sunday nights. Her teacher sees a model student. Adults’ reports and Ava’s inner life don’t match — hers is the truer map. [12]

Marcus, 10, quit the soccer team he loved, calls everything “boring,” and blows up over small requests. Grades dropped two letter marks; he games alone. His dad’s read: laziness. But the cluster — lost enjoyment, irritability, withdrawal, sliding schoolwork — is a textbook picture of tween depression. [6][7]

Rare but serious presentations

• Suicidal thinking, planning, or rehearsal. Real at this age — 481 children ages 10–14 died by suicide in the U.S. in 2023. [2] Any mention of wanting to die, “you’d be better off without me,” giving things away, or goodbye-flavored messages gets a calm same-day response. [20]
• Self-harm. Cutting often begins around 12–14; lifetime rates reach about 17% in adolescents. Self-harm and suicidal intent are not identical — but both always warrant assessment, and self-harm is never “just for attention.” [21]
• Seeing or hearing things, confusion, bizarre beliefs, days of no sleep with frantic energy, or barely moving. Rare, urgent, and diagnosis-changing. [22]
• Rapid weight loss, food rituals, or terror of weight gain — eating disorders can begin before the teen years and turn serious fast.

What to watch: a parent observation table

A phase, a stress response, or something more?

Tweens are moody by design, and puberty’s shifts are real. Use the clinician’s filter:

1. Change from baseline. Your sunny kid turning flat matters more than your intense kid staying intense.
2. Duration and rhythm. A rotten week after a friend fight is life. Most days for weeks is a pattern.
3. Trajectory. Growing, or fading?
4. Settings. Home-only trouble points at home; everywhere-trouble raises concern.
5. Proportion. Upset over a real event, or drowning in routine demands?
6. Distress. Is your child suffering — even quietly?
7. Function. Grades, friendships, activities, sleep: what is this costing?
8. Narrowing. Is their world smaller each month?
9. Safety. Death talk, self-harm, severe hopelessness — no waiting period, ever.

Paired examples: moping for a week after not making the team, then rebounding — versus quitting two activities and staying flat for six weeks. Test nerves that vanish by Tuesday — versus stomachaches every school morning since October. After a divorce, move, or death, expect weeks of wobble; grief comes in waves and softens with time. Distress that deepens, spreads, or hardens into “I’m worthless” is something more. [23]

When depression and anxiety travel together

They usually know each other. Depressed youth carry roughly eight-fold odds of an anxiety disorder, and a quarter to half of depressed kids have both. [24][25] The usual order: anxiety first, depression later — untreated childhood anxiety raises later depression risk. [26] Treating anxiety now is depression prevention later; when both are present, make sure the plan names both.

Other things that can look similar

• Sleep debt. Short or broken sleep alone produces irritability, poor concentration, and low mood — and sleep problems and depression feed each other. [27]
• Medical causes: thyroid problems, anemia, celiac and other GI disease, migraine, post-viral fatigue. Testing follows the history and exam — no routine lab panel or scan diagnoses these conditions.
• Medication and substance effects: montelukast (boxed warning for mood and behavior changes), steroids — and caffeine. Energy drinks are never appropriate for children, and caffeine can drive jitteriness, poor sleep, and anxiety. [28][29]
• Learning disorders and ADHD. A child who can’t read at grade level will eventually look anxious, defiant, or “unmotivated.” Testing clarifies.
• DMDD — chronic severe irritability with frequent explosive outbursts — is its own diagnosis. [30] OCD, trauma-related conditions, and eating disorders overlap with anxiety and depression but need their own recognition.
• Environment: bullying, discrimination, academic mismatch, family conflict, food or housing stress. Sometimes the reaction is proportionate to a real problem — fix the environment, not just the child.

What you can say and do

• Open sideways. Car rides beat face-to-face summits. Start with an observation: “You’ve seemed worn down for a few weeks. I noticed you stopped going to practice.”
• Listen past the first “I’m fine.” Try: “You don’t have to talk now. I’m around tonight, and I’m not mad.” Then be around.
• Ask the safety question directly when concerned. “Sometimes when people feel this low they have thoughts about death or hurting themselves. Have you?” You will not make it worse. [3]
• Take bullying seriously. Ask plainly about school and online. Save evidence, involve the school — and don’t confiscate the phone first; losing their lifeline is why many kids stay silent. [14]
• Track, don’t surveil. Two weeks of brief notes — sleep, meals, complaints, absences, triggers — plus the teacher’s view. Guard the basics meanwhile: consistent sleep, meals together, daily movement, no energy drinks. [28]

How an evaluation usually works at this age

Start with your pediatrician: history, physical exam, symptom questionnaires — and your child’s own report now carries real weight. Clinicians often speak with tweens privately, because kids this age disclose things parents don’t see. [12] School input rounds out the picture; disagreement among reporters is expected and informative.

National guidance recommends anxiety screening from age 8 and depression plus suicide-risk screening from age 12 at routine checkups. [31][32][33] Common tools include the SCARED (child and parent versions, ages 8–18), the Short Mood and Feelings Questionnaire, the PHQ-A from age 11, and the ASQ suicide-risk questions when indicated. [34][35][36] A positive screen means “look closer,” never “diagnosis” — and a negative screen with a worried parent still deserves the closer look.

What helps: treatment at ages 9–12

• For anxiety, CBT with gradual exposure is the workhorse. In the largest pediatric anxiety trial (ages 7–17), 60% improved markedly with CBT, 55% with sertraline, 81% with both — versus 24% with placebo. [37] Across dozens of trials, half of children recover with CBT versus fewer than one in five without. [38] Exposure is planned, stepwise, collaborative — never sudden or forced.
• For depression, therapy first for mild-to-moderate cases: CBT adapted for this age, behavioral activation (rebuilding activity, mastery, connection), and family involvement that supports without taking over. [6]
• School partnership. A gradual attendance plan, a real anti-bullying response, and learning evaluation when schoolwork is the battlefield.
• Medication, when severity warrants it, works inside a full plan — never instead of one. Fluoxetine is approved for depression from age 8 and has the strongest pediatric evidence; escitalopram from 12 for depression and 7 for generalized anxiety; duloxetine from 7 for generalized anxiety. [39][40][41] For preadolescent depression specifically, average medication benefits in trials are modest — careful diagnosis and therapy-first sequencing matter. [42][43] All antidepressants carry the boxed warning — about 4 in 100 young people in pooled trials had suicidal thoughts or behaviors versus 2 in 100 on placebo, with no suicide deaths in those trials — which is why close early follow-up is standard. [44][45] Never start or stop without the prescriber.
• Daily-life supports: regular sleep, physical activity (modest symptom reduction in trials), meals, connection — supports, not substitutes. [46]

Where to get help

Your pediatrician is the front door: evaluation, initial treatment, referrals. The school counselor can support and start an evaluation if learning is affected. Community mental health centers and your insurer’s directory list child therapists. For crisis guidance any hour, call or text 988.

What not to assume

• That “lazy” explains a kid who stopped trying. Effort collapse has causes.
• That good grades mean good mental health. [12]
• That she would tell you. Many tweens protect their parents from their pain.
• That “I want to die” said in anger doesn’t count. It always earns a calm follow-up.
• That self-harm is a fad or a bid for attention. It is a signal of pain that needs assessment. [21]

Takeaways

1. Tween depression often looks like irritability, boredom, and “laziness” — not visible sadness. [6][7]
2. Anxiety hides inside perfectionism, reassurance loops, stomachaches, and avoidance dressed up as preference.
3. By 12–17, about 8% of kids carry a current depression diagnosis and 16% anxiety. [1]
4. Change from baseline + persistence + a shrinking life = evaluation.
5. Suicide is the second leading cause of death at 10–14. Death talk always gets a same-day response; locked meds and firearms protect impulsive moments. [2][4][5]
6. Kids report inner pain adults can’t see — make room for their voice. [12]
7. Treatment works: most anxious kids improve with CBT, combined approaches help most — and treating anxiety now lowers depression risk later. [26][37]

FAQ

Is this puberty or depression? Puberty brings moodiness, sleep shifts, and door-slamming. It does not remove joy, friends, and function for weeks at a stretch — that combination is beyond hormones.

My child said “I wish I was dead” during a homework meltdown. Do I take it seriously? Neither ignore it nor panic. When things are calm, ask directly and gently whether they’ve had thoughts like that at other times. One heated phrase usually isn’t an emergency — but it’s always a conversation, and if anything more emerges, call your pediatrician that day. [3][20]

This article is for education only and is not medical advice, a diagnosis, or a substitute for evaluation by a qualified clinician. Evidence reviewed through August 6, 2026. If your child may be in danger, call or text 988, or call 911. — Fady Boules, PMHNP-BC

Related reading

• The Feelings Little Kids Can’t Name: Depression and Anxiety in Ages 5–8
• Behind the Closed Door: Depression and Anxiety in Teens Ages 13–18
• IEP vs. 504 Plan: Understanding School Support Options for Students with Disabilities
• Starting an SSRI: What Families Should Watch For in the First Few Weeks

References

1. Sappenfield O, Alberto C, Minnaert J, et al. Adolescent mental and behavioral health, 2023 National Survey of Children’s Health data brief. HRSA Maternal & Child Health Bureau; October 2024. https://mchb.hrsa.gov/sites/default/files/mchb/data-research/nsch-data-brief-adolescent-mental-behavioral-health-2023.pdf
2. National Institute of Mental Health. Suicide statistics (CDC WISQARS 2023 data: suicide second leading cause of death ages 10–14; 481 deaths). https://www.nimh.nih.gov/health/statistics/suicide (accessed August 6, 2026)
3. Dazzi T, Gribble R, Wessely S, Fear NT. Does asking about suicide and related behaviours induce suicidal ideation? What is the evidence? Psychol Med. 2014;44(16):3361-3363.
4. Anglemyer A, Horvath T, Rutherford G. The accessibility of firearms and risk for suicide and homicide victimization among household members: a systematic review and meta-analysis. Ann Intern Med. 2014;160(2):101-110.
5. Lee LK, Fleegler EW, Goyal MK, et al; American Academy of Pediatrics. Firearm-related injuries and deaths in children and youth: injury prevention and harm reduction. Pediatrics. 2022;150(6):e2022060070.
6. Walter HJ, Abright AR, Bukstein OG, et al. Clinical practice guideline for the assessment and treatment of children and adolescents with major and persistent depressive disorders. J Am Acad Child Adolesc Psychiatry. 2023;62(5):479-502. PMID 36273673
7. Vidal-Ribas P, Brotman MA, Valdivieso I, Leibenluft E, Stringaris A. The status of irritability in psychiatry: a conceptual and quantitative review. J Am Acad Child Adolesc Psychiatry. 2016;55(7):556-570.
8. Campo JV, Bridge J, Ehmann M, et al. Recurrent abdominal pain, anxiety, and depression in primary care. Pediatrics. 2004;113(4):817-824.
9. Kessler RC, Berglund P, Demler O, et al. Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry. 2005;62(6):593-602.
10. Fremont WP. School refusal in children and adolescents. Am Fam Physician. 2003;68(8):1555-1560.
11. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 5th ed. Arlington, VA: APA; 2013 (panic disorder prevalence below age 14 estimated under 0.4%).
12. De Los Reyes A, Augenstein TM, Wang M, et al. The validity of the multi-informant approach to assessing child and adolescent mental health. Psychol Bull. 2015;141(4):858-900. PMID 25915035
13. Centers for Disease Control and Prevention. Data and statistics about ADHD (2022 National Survey of Children’s Health: about 4 in 10 children with ADHD had anxiety). https://www.cdc.gov/adhd/data/index.html (accessed August 6, 2026)
14. van Geel M, Vedder P, Tanilon J. Relationship between peer victimization, cyberbullying, and suicide in children and adolescents: a meta-analysis. JAMA Pediatr. 2014;168(5):435-442.
15. Bridge JA, Horowitz LM, Fontanella CA, et al. Age-related racial disparity in suicide rates among US youths from 2001 through 2015. JAMA Pediatr. 2018;172(7):697-699.
16. Lindsey MA, Sheftall AH, Xiao Y, Joe S. Trends of suicidal behaviors among high school students in the United States: 1991–2017. Pediatrics. 2019;144(5):e20191187.
17. Congressional Black Caucus Emergency Taskforce on Black Youth Suicide and Mental Health. Ring the alarm: the crisis of Black youth suicide in America. December 2019. https://theactionalliance.org/sites/default/files/ring_the_alarm-_the_crisis_of_black_youth_suicide_in_america_copy.pdf
18. Odgers CL, Jensen MR. Annual research review: adolescent mental health in the digital age: facts, fears, and future directions. J Child Psychol Psychiatry. 2020;61(3):336-348.
19. Office of the U.S. Surgeon General. Social media and youth mental health: the U.S. Surgeon General’s advisory. 2023. https://www.hhs.gov/sites/default/files/sg-youth-mental-health-social-media-advisory.pdf
20. American Academy of Child and Adolescent Psychiatry. Suicide in children and teens. Facts for Families No. 10, updated May 2024. https://www.aacap.org/AACAP/Families_and_Youth/Facts_for_Families/FFF-Guide/Teen-Suicide-010.aspx
21. Swannell SV, Martin GE, Page A, Hasking P, St John NJ. Prevalence of nonsuicidal self-injury in nonclinical samples: systematic review, meta-analysis and meta-regression. Suicide Life Threat Behav. 2014;44(3):273-303.
22. Benarous X, Consoli A, Raffin M, et al. Catatonia in children and adolescents: new perspectives. Schizophr Res. 2018;200:56-67.
23. American Academy of Child and Adolescent Psychiatry. Children and grief. Facts for Families No. 8. https://www.aacap.org/AACAP/Families_and_Youth/Facts_for_Families/FFF-Guide/Children-And-Grief-008.aspx (accessed August 6, 2026)
24. Angold A, Costello EJ, Erkanli A. Comorbidity. J Child Psychol Psychiatry. 1999;40(1):57-87.
25. Garber J, Weersing VR. Comorbidity of anxiety and depression in youth: implications for treatment and prevention. Clin Psychol (New York). 2010;17(4):293-306.
26. Pine DS, Cohen P, Gurley D, Brook J, Ma Y. The risk for early-adulthood anxiety and depressive disorders in adolescents with anxiety and depressive disorders. Arch Gen Psychiatry. 1998;55(1):56-64.
27. Lovato N, Gradisar M. A meta-analysis and model of the relationship between sleep and depression in adolescents. Sleep Med Rev. 2014;18(6):521-529.
28. Schneider MB, Benjamin HJ; American Academy of Pediatrics. Sports drinks and energy drinks for children and adolescents: are they appropriate? Pediatrics. 2011;127(6):1182-1189 (reaffirmed 2018).
29. Temple JL. Review: trends, safety, and recommendations for caffeine use in children and adolescents. J Am Acad Child Adolesc Psychiatry. 2019;58(1):36-45.
30. American Academy of Child and Adolescent Psychiatry. Disruptive mood dysregulation disorder. Facts for Families No. 110. https://www.aacap.org/App_Themes/AACAP/Docs/facts_for_families/110_disruptive_mood_dysregulation_disorder.pdf (accessed August 6, 2026)
31. US Preventive Services Task Force. Screening for anxiety in children and adolescents: recommendation statement. JAMA. 2022;328(14):1438-1444.
32. US Preventive Services Task Force. Screening for depression and suicide risk in children and adolescents: recommendation statement. JAMA. 2022;328(15):1534-1542.
33. Weitzman C, Guevara J, Curtin M, et al; American Academy of Pediatrics. Promoting optimal development: screening for mental health, emotional, and behavioral problems — clinical report. Pediatrics. 2025;156(3):e2025073172.
34. Birmaher B, Khetarpal S, Brent D, et al. The Screen for Child Anxiety Related Emotional Disorders (SCARED): scale construction and psychometric characteristics. J Am Acad Child Adolesc Psychiatry. 1997;36(4):545-553.
35. Johnson JG, Harris ES, Spitzer RL, Williams JBW. The Patient Health Questionnaire for Adolescents: validation of an instrument for the assessment of mental disorders among adolescent primary care patients. J Adolesc Health. 2002;30(3):196-204.
36. Horowitz LM, Bridge JA, Teach SJ, et al. Ask Suicide-Screening Questions (ASQ): a brief instrument for the pediatric emergency department. Arch Pediatr Adolesc Med. 2012;166(12):1170-1176.
37. Walkup JT, Albano AM, Piacentini J, et al. Cognitive behavioral therapy, sertraline, or a combination in childhood anxiety. N Engl J Med. 2008;359(26):2753-2766.
38. James AC, Reardon T, Soler A, James G, Creswell C. Cognitive behavioural therapy for anxiety disorders in children and adolescents. Cochrane Database Syst Rev. 2020;(11):CD013162.
39. Prozac (fluoxetine) prescribing information (pediatric MDD age 8+). https://www.accessdata.fda.gov/drugsatfda_docs/label/2017/018936s108lbl.pdf
40. Lexapro (escitalopram) prescribing information, revised May 2023 (MDD age 12+; GAD age 7+). https://www.accessdata.fda.gov/drugsatfda_docs/label/2023/021323s055,021365s039lbl.pdf
41. Cymbalta (duloxetine) prescribing information (pediatric GAD age 7+). https://www.accessdata.fda.gov/drugsatfda_docs/label/2020/021427s052lbl.pdf
42. Cipriani A, Zhou X, Del Giovane C, et al. Comparative efficacy and tolerability of antidepressants for major depressive disorder in children and adolescents: a network meta-analysis. Lancet. 2016;388(10047):881-890.
43. Hetrick SE, McKenzie JE, Bailey AP, et al. New generation antidepressants for depression in children and adolescents: a network meta-analysis. Cochrane Database Syst Rev. 2021;(5):CD013674.
44. U.S. Food & Drug Administration. Suicidality in children and adolescents being treated with antidepressant medications (2004 public health advisory; since removed from fda.gov). Archived copy: https://web.archive.org/web/20260517093045/https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/suicidality-children-and-adolescents-being-treated-antidepressant-medications (accessed August 6, 2026)
45. Bridge JA, Iyengar S, Salary CB, et al. Clinical response and risk for reported suicidal ideation and suicide attempts in pediatric antidepressant treatment: a meta-analysis of randomized controlled trials. JAMA. 2007;297(15):1683-1696.
46. Recchia F, Bernal JDK, Fong DY, et al. Physical activity interventions to alleviate depressive symptoms in children and adolescents: a systematic review and meta-analysis. JAMA Pediatr. 2023;177(2):132-140.

If you or someone you know is in crisis

• Call 911 or go to your nearest emergency room for any life-threatening emergency.
• 988 Suicide & Crisis Lifeline — call or text 988, available 24/7. En español: marque 988 y oprima 2. Veterans: 988 and press 1, or text 838255.
• Crisis Text Line — text HOME to 741741.
• The Trevor Project (crisis support for LGBTQ+ young people) — call 1-866-488-7386, or text START to 678-678.
• National Sexual Assault Hotline (RAINN) — call 1-800-656-HOPE (4673) or text HOPE to 64673; free, confidential, 24/7. Online chat at RAINN.org/hotline.
• National Domestic Violence Hotline — call 1-800-799-SAFE (7233) or text START to 88788; 24/7, help in 200+ languages. Online chat at TheHotline.org. If your phone or computer may be monitored, calling from a safer device is an option.
• Riverside County — Inland SoCal Crisis Helpline 951-686-HELP (4357), 24/7 (Inland SoCal United Way / 211+, in partnership with RUHS-BH); Community Access, Referral, Evaluation and Support (CARES) Line 800-499-3008, 24/7.
• San Bernardino County — Access Unit (Behavioral Health Helpline) 888-743-1478, 24/7; Mobile Crisis/CCRT 800-398-0018 (24/7, all ages) or text 909-420-0560. Arrowhead Regional Medical Center (ARMC) has a dedicated walk-in adolescent psychiatric ER (ages 13–17).
• Children under 13 — call 911 for immediate danger, contact your county's mobile crisis team (they respond to all ages), or go to the nearest pediatric emergency room.
• California Peer-Run Warm Line (non-crisis — someone to talk to) — call or text 1-855-600-WARM (9276); daytime and evening hours, not a 24/7 line.
• NP Fady (non-emergency) — for routine scheduling or questions, call (909) 707-6261. This line is not monitored for emergencies.