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Common co-occurring disorders affect an estimated 9.2 million adults in the United States and millions of teens. According to government statistics, teens who have experienced a depressive episode were more than twice as likely to begin using illicit drugs or alcohol, and nearly a third of teens who had never tried alcohol before only did so after a major depressive episode.

It doesn’t stop at depression. Mental health disorders and substance use disorders are often intertwined, with one feeding into the other, creating a dangerous and vicious cycle. Teens are especially at risk, given their ongoing mental and physical developments, and the inherent risk of early drug use and its impact on a teen’s emotional and cognitive state.

Understanding how drugs and mental health issues go hand in hand can help families take better care of their loved ones, recognize risk factors and symptoms, and seek help as soon as possible. Stigma and vilification do nothing but make things worse; support, love, and information are key to helping our teens get access to the care they need to thrive and lead fulfilling lives.

What is a Co-Occurring Disorder?

A co-occurring disorder is any diagnosed mental health issue in concurrence with a substance use problem. Excessive drinking alongside depressive thoughts, anxiety attacks and recreational drug use, marijuana and episodes of psychosis – these are just a few examples of common co-occurring disorders, which can prove especially destructive for teens.

It’s estimated that about 60 to 75 percent of teens with substance use disorders also have a concurrent mental health disorder. This can be anything from one of ten different personality disorders to frequent panic attacks, social anxiety problems, depressive or suicidal thoughts, schizophrenic episodes, eating disorders, ADHD, or OCD.

The way drug use interacts with and amplifies these symptoms can make diagnosis and treatment difficult. Specialists can identify and help create individualized treatment plans for teens with a co-occurring disorder by combining different treatment methods to build a holistic plan against both addiction and a teen’s thoughts and behavioral problems.

Let’s look at a few ways different substances and conditions can interact.

1. Alcohol and Depression

Alcohol and depression are closely related, both in terms of risk factors and the effects either have on one another. In terms of co-occurring disorders, most literature references alcoholism and depression or alcoholism and anxiety disorders.

While ubiquitous, alcohol is a dangerous drug. Being intoxicated can lead to feelings of euphoria and loss of inhibition – but the comedown from being drunk and the long-term effects of excessive alcohol consumption are undeniable. On top of being an addictive drug, alcohol is an exceptionally dangerous substance for the body. It can lead to negative long-term effects, such as nerve damage, brain damage, liver damage, heart damage, and cancer.

Alcohol’s availability and status in society mean that many teens grow up learning about its dangers, while also being aware of its effects, both the good and the bad. But teens have trouble recognizing risk and are more susceptible to alcohol’s addictive effects. For teens struggling with depression, the motivation to care about the long-term effects of alcohol is very low. Instead, it becomes an effective way to deal with negative and even suicidal thoughts for a short time.

This type of self-medication is a common feature in co-occurring disorders. In many cases, teens turn to drugs as a means of escaping the symptoms of their mental health issues, or the risk factors that contribute to them.

2. ADHD and Addiction

Attention deficit and hyperactivity disorder is another condition with a high level of co-occurring substance use. However, most of this substance use is not linked to ADHD medication, which can be addictive.

Because of the effects of stimulants like amphetamine and methylphenidate on a person with ADHD, properly dosed ADHD medication when applied at a young age drastically reduces the risk of substance use in patients with ADHD.

It’s cases of unmedicated ADHD that often struggle with excessive drug use, especially when an unintentional form of self-medication becomes recreational. ADHD is more than just a problem with focus – teens and adults with ADHD struggle to concentrate, plan, retain information, or complete tasks.

It can be a debilitating condition that affects every aspect of life and robs a person of independence and agency. Some drugs help alleviate these issues temporarily – but without professional help, self-medication can turn to addiction.

3. OCD and Self-Medication

Like other anxiety disorders, OCD is characterized by overwhelming discomfort surrounding certain obsessive or intrusive thoughts, coupled with compulsive behavior to soothe those thoughts. Addiction often fits into this destructive cycle by providing an alternative, yet still maladaptive coping mechanism for the unwanted thoughts and behaviors associated with OCD.

Trying to quit not only bears the difficulty of overcoming the addiction but having to deal with recurring and powerful OCD symptoms as well. Treating that kind of combination requires addressing both concerns together.

4. Eating Disorders and Substance Abuse

Eating disorders have the highest death rate among any type of mental health issue. They pose an immense physical danger to teens and adults alike and claim thousands of lives per year.

That danger is compounded by drug use, which can often begin as a means of appetite suppression, or to deal with symptoms of anxiety or depression alongside an eating disorder.

5. Personality Disorders and Drug Use

There are ten different personality disorders, each affecting a person’s psyche in a different way. Personality disorders are different from other mental health disorders in that they fully encompass a person’s thought processes and behavior, essentially molding their personality into something dysfunctional.

For many people with personality disorders, drugs can be a way to escape the thoughts and behaviors that they struggle to reconcile with reality. In other cases, the risk of drug use is fueled by their symptoms.

Why Teens Are Susceptible

Studies show that younger people are more likely to struggle with addiction later in life the earlier they start taking drugs. And because mental health issues are a common risk factor for drug use, teens are especially susceptible to the issue of co-occurring disorders and the long-term impact they can have.

The immaturity of the teen brain is also a problem. While both a person’s body and brain complete maturation into adulthood in the late teens, the brain continues to adapt and mature well into a person’s 20s and 30s.

The parts of the brain that are still lagging in progress in one’s teens include those dedicated to managing thoughts and emotions, executive function, decision making, risk assessment, and long-term planning.

It’s important to seek help for teens struggling with addiction or a mental health issue, or both. The long-term physical and mental effects of a co-occurring disorder can be prevented through early treatment and a focus on long-term recovery.