Teens with co-occurring disorders: You are not alone

If you have a substance use disorder along with a mental health disorder, don't worry. Help is available.

Most teenagers who abuse alcohol or other drugs also have a mental health disorder, research shows. The reverse is also true. About half of all teens receiving mental health services have a co-occurring substance use disorder.

Experts also say that, compared with other teenagers, adolescents with emotional and behavioral problems are four times more likely to be dependent on alcohol and other drugs.

It is possible to live a healthy, normal life free from mood-altering chemicals and with your mental health symptoms under control. Most experts recommend getting integrated treatment if you have co-occurring disorders. This means you should get help from someone who has a thorough understanding of both chemical dependency and mental health issues. If you do have more than one provider, it's a good idea that they communicate with each other about your treatment and progress.

The most common co-occurring disorders

For teens and adults alike, the most common co-occurring disorders are anxiety disorders and mood disorders. (Read more detailed descriptions of mood and anxiety disorders and their symptoms)

In addition, about one-third of all teens who go to residential treatment for substance dependency have attention-deficit/hyperactivity disorder (ADHD).

Anxiety disorders

Anxiety is a natural part of life that most of us experience from time to time. Everyday things—such as taking a test, going on a date, learning to drive—can make a person nervous. Occasional anxiety isn't anything to worry about. When this feeling becomes a problem and starts to interfere with your day-to-day life, you may have an anxiety disorder.

Anxiety disorders include:

• generalized anxiety disorder: constant, intense worry and stress about a variety of everyday things 
• panic disorder: intense fear that usually happens for no obvious reason 
• social anxiety disorder: intense fear of social situations 
• obsessive-compulsive disorder: thoughts or impulses that occur again and again, as well as behaviors or rituals that you feel compelled to do 
• post-traumatic stress disorder: anxiety connected to a traumatic or terrifying experience

Anxiety can be overwhelming and it can prevent you from enjoying yourself, friends, school, and social activities. Many teens turn to alcohol or other drugs to help them calm down. However, drugs only create a false sense of relaxation, and they can lead to other problems.

Mood disorders

Many people feel down in the dumps from time to time. They may not know why they feel so sad. Or they may feel happy one minute and angry the next, and wonder why they're on an emotional roller coaster. When these feelings last for a long time, they are called mood disorders.

For some people, depression can be very intense and last for weeks at a time. For others, depression can be less severe but can go on for years. The more severe, short-lasting form is called major depression. The longer-lasting but less severe form is often called dysthymia.

Bipolar disorder involves periods of depression and periods of being really up (often called mania). When teens have bipolar disorder, they may experience extreme swings in mood frequently, but there often seems to be no reason for the shift. It's very unpredictable.

Suicidal thinking

Teens who are depressed may begin using alcohol or other drugs in an attempt to self-medicate - to escape their feelings. But alcohol and other drugs actually make depression worse in the long run because they have depressive effects on the brain. Often, teens who attempt suicide are under the influence of alcohol or drugs. Substance use itself places you more at risk for suicidal thinking and behavior.

Suicidal thinking is a very real emergency. If you're having such thoughts yourself, or know a friend who is, go to an adult you trust - a parent, coach, counselor, or teacher - and ask for help. You can also call a suicide hotline or call 911. If a friend asks you not to tell anyone, do not agree to this. This is a situation where telling can save a life. Depression can be so strong that it prevents a person from thinking straight.

Getting help

Anxiety, depression, and hyperactivity can be overwhelming and can prevent you from enjoying yourself, friends, school, and social activities. Drugs and alcohol may make the symptoms go away for a while, but in the end, using them causes even more trouble. They can also actually make some symptoms worse.

Treatment for these disorders includes talk therapy, relaxation, and sometimes medication. In talk therapy, a therapist or counselor talks about the stress, anxiety, or sadness you might be feeling.

Medications

Sometimes a medication might be prescribed. The right medication can help reduce symptoms, and it can be a great relief if your symptoms are causing a lot of distress. Often when doctors prescribe medications, they begin with a very small dosage and gradually increase the dosage until it's just the right amount for you. It may take several weeks before you feel better with certain medications.

Finding support

Being with other teens who understand what it's like to have chemical dependency and mental health problems can be very helpful.

Try to join a support network for young people, such as Alcoholics Anonymous (AA), Narcotics Anonymous (NA), or a dual recovery group. It's important to find a group in which you feel comfortable, so you may need to "shop around" and attend several different meetings. Find a meeting near you