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A co-occurring disorder refers to cases where a person has some form of anxiety disorder, mood disorder, personality disorder, or other mental conditions, coupled with a drinking problem or drug addiction. Also known as a dual diagnosis, teen co-occurring disorders does not refer to examples of polysubstance addiction (being addicted to more than one substance) or a string of mental health issues without signs of drug use or addiction (such as anxiety coupled with depression).

Teen co-occurring disorders represent a special issue because they are quite widespread and yet not effectively treated most of the time. Dealing with a dual diagnosis requires a very individualized approach as the symptoms of a mental disorder and compulsive drug use often complicate both diagnosis and treatment.

To understand why teen co-occurring disorders are so common, it’s important to discuss how drug use can affect a teen’s mental health, and how existing mental health issues affect a teen’s likelihood to rely on drugs.

Why Is Drug Use More Common Among Teens With Mental Disorders?

The numbers speak for themselves – as many as six in ten teens who have participated in substance use disorder treatment programs meet the criteria for at least one other mental health issue. Other data also supports the fact that substance use disorders (addiction) often co-occur with other mental disorders, including (but is not limited to):

    • Anxiety disorders
    • Major depression
    • Bipolar disorder
    • Attention-deficit hyperactivity disorder (ADHD)
    • Psychotic disorders
    • Schizophrenia
    • Personality disorders

It’s often a chicken or the egg situation, wherein it’s not always clear which came first – the drug use, or the mental health problems. They feed into each other. A teen struggling with symptoms of consistent low mood may find they care less when they’re drunk, or that drinking helps them take the edge off their anxiety.

However, alcohol hits back with stronger symptoms of depression and anxiety afterwards. This can feed a cycle that eventually leads to withdrawal issues and signs of addiction or problem drinking. The same goes for many other co-occurring disorders, where drug use at least partially starts as a coping mechanism and creates a vicious cycle. This can complicate treatment.

People who go into treatment for drug use may not benefit from the kind of therapy being offered at most drug rehab facilities in the absence of a trained and experienced psychiatrist. Any attempts to help them get sober and stay sober fail when they eventually begin to struggle with symptoms that their drinking or drug use was masking, in the short-term.

Furthermore, addiction can complicate treatments for many mental health issues. Withdrawal symptoms can make mental health symptoms worse. Certain drugs amplify and exacerbate symptoms of psychosis, anxiety, and low mood. And a treatment program that tries to focus on one but not the other may only serve to waste a teen’s time.

How Mental Disorders Interact With Common Drugs

Common drugs among teens include marijuana, alcohol, and subscription drugs, and drug use is often matched with ADHD, anxiety disorders, and depression. Substance use is especially high among teens with untreated ADHD, while teens who received medication for their ADHD were less likely than their peers to use drugs (even though ADHD medication can be addictive).

This may suggest that teens who lack access to treatment for their mental health issues are more likely to turn to drugs as an ineffective coping mechanism. Teens who experienced abuse or trauma are also far more likely to not only struggle with feelings of depression or trauma-related mental health issues, but also turn to substance abuse in their youth at a greater rate than their peers.

Among teens with depressive symptoms, many drugs may induce short-term feelings of euphoria and general content. However, when the high ends, they may be left feeling even more empty as a result. Some of the signs of a comorbidity between depression and substance use include feelings of helplessness, irritability, appetite changes, unexplained pains and aches, and frequent thoughts or mention of suicide.

In cases of anxiety, drugs like alcohol or marijuana can help soothe and reduce feelings of fear, worry, and paranoia. However, their effects in the long-term are disastrous to both the body and the mind. Marijuana with high levels of THC, which is the psychoactive compound in the drug, is tied to higher levels of anxiety, even though marijuana’s other compounds (like CBD) show potential benefits in treating mental health issues.

In teenagers with symptoms of psychosis, which include hallucinations or aberrant thoughts and false sensory experiences, drugs like marijuana can exacerbate or trigger symptoms. Other drugs may also affect their condition, as with as stimulants as well as depressives like alcohol can interact heavily with psychosis and related symptoms, such as paranoia, delirium, and angry outbursts.

The Challenges of Treating Teen Co-Occurring Disorders

One of the reasons why drug rehab facilities are not always well-equipped to deal with co-occurring disorders are because they require a holistic treatment approach. Holistic treatment simply means approaching a case from a perspective of treating the patient rather than the disorder.

Since co-occurring disorders are a combination of issues complicated by a variety of factors – such as a teen’s home life, school life, early experiences, family history, and more – they require a treatment approach wherein a team of professionals rather than a single professional work together to treat a teen’s physical and mental symptoms, addressing their condition behaviorally, socially, emotionally, and physically.

This can mean combining treatments or modalities to deal with a series of symptoms from different angles. Every case requires an individualized approach, and treatment takes time.

Seeking Help for a Dual Diagnosis

Some treatment facilities specialize in dual diagnosis/co-occurring disorders, providing inpatient and outpatient services to deal with both addiction and mental health issues, with a staff experienced in handling both.

If you or a loved one is struggling with a complicated mental health situation coupled with non-medical or recreational drug use, including heavy smoking or frequent drinking, then it may be important to find a healthcare provider specifically targeting teen co-occurring disorders.