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Teens Mental Illness and Substance Use



Teens Mental Illness and Substance Use

Why do some children and teens start using substances at a very young age? Often, they have a co-occurring disorder or more than one, that make them want to take something to feel better, or feel normal. They turn to substances to serve that purpose. Substance use makes the situation worse, even if teens and children think they feel better. Conversely, sometimes children take substances that bring on a mental illness. It’s a complicated  puzzle that’s different for every family so correct assessment and diagnosis for effective treatment is very important.

Teens go through many stages and often it’s not easy to tell whether a moody kid who’s drinking is just a moody kid drinking, or whether much more is going on. Very generally speaking, kids who are happy, have good relationships with their parents friends and teachers, are doing well at school and feeling good about themselves, are less likely to seek out substances to make them feel better. But this is a generalization. Each child and his/her situation is different. So assessment about what’s going on early is crucial to dealing with what often is an escalating problem. This can’t be emphasized enough. Have a mental health professional, a doctor, psychologist, or social worker trained in addiction, assess your situation.

 Co-occurring disorders relate to a syndrome of having both substance use disorders (SUDs) and a mental illness(es)

Typically, what is found is a combination of the use of a few drugs/alcohol and at least 1 – 2 co-occurring mental health problems. Teens may be depressed, anxious, have learning or other problems, including autism, personality problems or others. When we find children and teens using, we need to automatically suspect that they have a co-occurring disorder as we often find this young population at high risk for both disorders.

Also, it is often a “which came first situation – the chicken or the egg” – as the initial illness may be unknown or both disorders may take place at the same time. Likewise, having a co-occurring disorder is more difficult to treat and the teen with this disorder will have more problematic symptoms and will have a harder time in recovery.

In examining statistics from SAMHSA (Substance Abuse and Mental Health Services Administration), we find that:

  • alcohol is the most abused substance (21.1%)
  • tobacco (19.6%)
  • illicit drugs (14.9%)
  • 2012 – there were 1.4 million estimated first-time marijuana users age 12-18

Substance Use Disorders:

With these disorders, we look at a continuum of symptoms with the level of severity of symptoms from mild, moderate, to severe. These symptoms include criteria such as: a problematic use of the drug, increased tolerance (having to use more to get the same effect), difficulty in cutting down or stopping the use, social impairments, cravings, consequences related to the use, and withdrawal. Substances may include:




opioids/narcotics such as hydrocodone and oxycodone (pain medications)

hallucinogens such as LSD, ecstasy and PCP


sedatives, anxiolytics and hypnotics such as benzodiazepines (Ativan, Xanax), downers,


stimulants such as uppers, amphetamines, cocaine, and crack.

Mental Health Disorders

NAMI (National Alliance on Mental Health) relates that over one-half of young people with a SUDS diagnosis also have a mental illness(es).Common mental health issues for teens include:

anxiety disorders

ADHD (attention-deficit hyperactivity disorder)

mood disorders such as depression and bipolar disorders

stress and trauma disorders such as post-traumatic stress disorder

eating disorders

oppositional defiant disorder and conduct disorder (behavioral problems)

autism spectrum disorders

less common disorders such as schizophrenia/psychotic disorders, OCD (obsessive-compulsive disorders), and personality disorders

When we look at these two lists, we see there are a variety of combinations of substance use and mental illness problems that may express themselves together. For example, finding a teenager addicted to inhalants, marijuana, and drinking alcohol may also be combined with using the drugs to try to feel better from the depression and anxiety he/she/they may be experiencing. And we need to look at this use in three ways:

  1. the drug(s) may cause symptoms that look like a mental illness
  2. the mental illness symptoms may mimic drug use
  3. the drugs and the mental illness/es combine to display a picture of a co-occurring disorder with symptoms of both illnesses and symptoms that can worsen the disorders separately or together (i.e., using alcohol, which is a depressant, when depressed causes worsening depression)

Don’t Panic Get Help Early

If you see your child using, don’t write it off to harmless experimentation (like you might have done in your teen years. Drugs are different now). Substance use and mental illness, co-occurring, are like any challenging physical illness. Think of any chronic relapsing disease, like heart disease or diabetes, that need diagnosis and long term treatment. Recovery for teenagers with co-occurring disorders is challenging, and must be taken seriously. If one learns coping skills for one of the illnesses, that coping skill can be transferred to the other disorders as well. An integrated approach which focuses on treating both disorders at the same time is necessary for recovery.

Reach Out Recovery Exclusive by Carol Anderson

If your teen needs help, and you need help too, click on the link below for a free resource to explore addiction and mental health professionals near you.





Carol Anderson, D.Min., ACSW, LMSW, is a licensed clinical social worker with over 25 years of experience in the fields of mental health, addictions, and co-occurring disorders. Her other specialties include grief and trauma, women’s issues, chronic pain management, holistic healing, GLBTQ concerns, and spirituality and transpersonal psychology. Dr. Anderson has been educated and trained in the fields of education, social work, and spirituality, and she holds a Doctor of Ministry degree (non-denominational/interfaith) specializing in spirituality.

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