Co-Occurring Disorders In Teenagers

Many teens who are struggling with theirmental health turn todrugs andalcohol to self-medicate.

According to the Substance Abuse and Mental Health Services Administration’s 2023 National Survey on Drug Use and Health, 60% of people who misuse substances also have a mental disorder. Drug abuse and mental health conditions, such asdepression andanxiety, commonly occur together in teens. In fact,dual diagnosis in teenagers is seen in more than half of allteens who abuse drugs.

The human brain is still developing well into a person’s 20s, and many mental illnesses develop during this period. This is also when the brain is most vulnerable to damage from drug abuse.

According to SAMHSA’s 2023 Survey, approximately 45% of teenagers first diagnosed with a mental health disorder also had asubstance use disorder (SUD), and over 65% who were diagnosed with a SUD also had a mental health disorder.

It can be challenging to determine which problem arose first. An adolescent may develop an addiction to substances after turning to them to cope with mental illness. Conversely, substance abuse can lead to the development of mental health challenges.

What Are The Signs Of Co-Occurring Disorders In Teens?

Substance misuse often leads to mental, physical, and behavioral changes. There are numerous signs to look out for, but there are also particular signs with teen co-occurring disorders that involve both substance abuse and one or more other mental health disorders.Behavioral changes that are often seen as a result of substance use and abuse include the following:

• Decline in academic performance and attendance
• Mood swings
• Lack of interest in previously enjoyed activities
• Changes in friend groups
• Isolation
• Borrowing or stealing money or valuable items
• Irritability
• Decline in motivation
• Restlessness or hyperactivity
• Missing important events
• Engaging in other risky behaviors

Many of these signs vary depending on the substance being used. For example,insomnia, irritability, and weight loss can besigns of stimulant misuse. Further, constricted pupils can indicate the use of opioid drugs, as they can lower energy and motivation.

Many signs of a substance abuse problem overlap with signs that a mental health disorder is present. For example, a teenager might begin isolating as a result of depression, as a consequence of substance misuse, or as a combination of both. Behavioral signs seen in both substance use disorders and mental health conditions include:

• Changes in sleep habits
• Paranoid behavior
• Significant mood swings
• Avoidance
• Isolation

Other notable and concerning changes in behavior are also worth noting, as family members are often the first to notice these disturbances.

Common Co-Occurring Disorders In Teens

Common co-occurring disorders in adolescents are teenage depression and teenage anxiety. Substance abuse and addiction are also seen alongside bipolar disorder, attention deficit hyperactivity disorder (ADHD), and many others.

Teenage Depression And Addiction

For both teens and adults, the co-occurring disorders of drug addiction and depression are a common and dangerous combination. Depression can arise from a blend of biological, genetic, psychological, and environmental factors. Addiction has similar roots, so it is not surprising that the two frequently co-occur. Together, they compound the problems a teenager is going through.

Adolescence is a time of major change for teenagers. As their environments, bodies, and brains change, coping with life’s stressors can become increasingly difficult. Parental guidance is crucial during this period. Without it, adolescent sadness is more likely to develop into clinical depression and substance abuse. Many teens turn to alcohol or drugs instead of getting proper help for their depression.

Teens suffering from depression often appear sad or anxious, but that is not always the case. Depressed teens might also lash out angrily at loved ones over seemingly insignificant things. Parents might feel unsure about whether their child is experiencing typical teenage feelings or suffering from serious depression.

If a teen’s behavior drastically changes, especially if it leads to self-harm, drug misuse, and other risky behaviors, they might be struggling with depression. Common symptoms ofteen depression include:

• Disconnection
• Anxiety
• Irritability
• Feelings of helplessness
• Fatigue
• Sleeping disturbance
• Appetite and weight changes
• Difficulty concentrating
• Physical pains, such as headaches and stomach aches

Additionally, depression can be a powerfulrelapse trigger for teens in recovery. It is crucial totreat co-occurring disorders together so that untreated depression doesn’t cause a relapse into addiction or vice versa.

Teenage Anxiety And Addiction

Feeling anxious is a normal part of growing up. However, when it starts interfering with a teen’s daily life, an anxiety disorder might be present.

One in eight adolescents is affected by an anxiety disorder, while only 20% of affected adolescents receive treatment. Commonteenage anxiety symptoms include:

• Difficulty concentrating
• Fatigue
• Irritability
• Difficulty relaxing
• Excessive sweating
• Nausea
• Exaggerated startle response
• Trembling

On the surface, anxiety disorders can look like normal teenage growing pains. Teens suffering from anxiety disorders, however, can feel incapable of functioning due to excess worry. They may avoid school, work, and activities they once enjoyed, like socializing with friends.

Many teens will turn tocentral nervous system (CNS) depressants like alcohol to calm a hyperactive brain underlying an anxiety disorder, but this relief is only temporary. Teens may eventually become dependent on the substance to feel able to function.

According to the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5), teens with anxiety disorders are more likely to develop bipolar disorder than their peers. Therefore, treating co-occurring anxiety disorders and drug abuse early on can prevent more severe disorders and addictions from developing later.

Teenage Bipolar Disorder And Addiction

Bipolar disorder is characterized by severe swings between extremely happy and productive moods and depressed moods accompanied by inactivity.

Most teens have emotional ups and downs. Bipolar mood swings, on the other hand, are more intense than average adolescent angst. During a bipolar episode, a teenager may seem like a completely different person. Teens having a bipolar episode can stay in a given mood for weeks at a time, with their daily routines becoming highly disrupted as a result. The following lists show the two extremes of bipolar disorder:

Some therapists and doctors insist that every teenager with a bipolar disorder diagnosis be screened for alcohol or drug problems. Teens who have bipolar disorder experience such dramatic mood swings that they often turn to drugs or alcohol in an attempt to cope.

Loved ones need to be emotionally supportive of teenagers suffering from bipolar disorder. Helping teens find healthy emotional outlets and alternatives to substance use is also crucial for long-term recovery.

Teenage ADHD And Addiction

Those suffering fromADHD struggle with impulsiveness, hyperactivity, and inattention.

Teens with ADHD are far more likely to abuse drugs and alcohol than their peers. SAMHSA’s 2023 survey shows that 35% of teens with ADHD have used at least one substance, while only 20% of teens without ADHD reported the same.

Low levels of the neurotransmitter dopamine can contribute to ADHD and substance abuse simultaneously. Additionally, teens with ADHD are often punished in school and at home for behavior they can’t control. This leads to mental stress that can worsen mental health symptoms and contribute to the misuse of substances. Common symptoms of ADHD include:

• Difficulty paying attention
• Restlessness
• Aggression
• Trouble sitting still
• Frequently interrupting others
• Ongoing procrastination

Teens with untreated ADHD are three times more likely to suffer from drug or alcohol addiction when they become adults. Treating ADHD and co-occurring substance abuse while teens are young is crucial to prevent the conditions from worsening.

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What Are The Risk Factors For Co-occurring Disorders?

Depression, ADHD, anxiety disorders, bipolar disorder, and other mental health conditions increase the risk of drug and alcohol use in teens. Having these mental health concerns go untreated is a key risk factor in the development of a substance abuse disorder. Genetic propensities for these disorders also increase risk.

Conversely, misuse of substances is also a serious risk factor for the development and progression of mental health disorders. Usingmarijuana, for example, is a risk factor for the development of psychosis, especially among those with a family history of it. Another risk factor is abuse of prescription medications, which can lead to irritability and mania. Others include:

• Stress
• Childhood trauma
• Lack of emotional support
• Susceptibility due to the brain’s developmental state
• Low self-esteem
• Peer and environmental influences
• Impulsivity and risk-taking behavior

Identifying these risk factors and treating mental health conditions lowers a teenager’s chance of developing a problem with substance use. Reducing or eliminating substance use improves treatment outcomes for teens with mental health disorders.

How Does The Family Play A Role In Teen Co-occurring Disorder Treatment?

Family membersplay a crucial role in the treatment of teenagers’ co-occurring disorders. Families are often the first ones to notice concerning changes in teens’ behavior, thus increasing the chance of recognizing signs of mental health disorders. Learning about symptoms helps in early identification, allowing for timely treatment. Understanding risk factors and symptoms will help you to be supportive and encourage a loved one to get professional help.

There are many ways that family members can help a teenager struggling with co-occurring disorders. They include the following:

• Learn about signs of mental health and substance-related disorders, as well as options for treatment.
• Encourage the teenager in your life to attendpsychotherapy and be proactive in their treatment.Family therapy can also be very beneficial.
• Encourage healthy behaviors and activities such as focusing on academics, participating in sports, volunteering, and joining groups at school.
• Promote structure.
• Joinsupport groups for people experiencing similar circumstances.

Family members play a crucial role in helping teenagers seek help when it is most needed. Their support and empathy encourage teens to hold onto hope that things can improve, and they help them take the necessary steps toward living a healthier life.

Treating Teenage Co-occurring Disorders

When it comes to teenagers with a dual diagnosis, both disorders must be treated at once. There are many options for receiving proper treatment from specialized providers, including the following:

• Outpatient teen rehab, includingintensive outpatient treatment
• Partial hospitalization
• Inpatient teen treatment
• Medical treatment with a focus ondetox for teens, when relevant

Group therapy and support groups can also be helpful. Still, it is important to note that some traditional approaches, such as the12-step model of recovery, may not be the best approach for teens with co-occurring disorders. Aspects of treatment models designed for adults can often be too stressful or confrontational for teenagers struggling with mental health and substance abuse concerns.

Find Treatment For Your Teen

The first step in supporting your teenager is first identifying the problem. Then, you can provide emotional support and explore treatment options.

Contact a treatment provider today to learn more about addiction treatment options for your teen and help them get on the path to recovery. You can also filter by age range in ourrehab directory to find centers near you that specialize in teen treatment.