Depression among teenagers is a serious health concern that is often seen in association with drug and alcohol abuse. In fact, between 24 and 50% of adolescents with a substance use disorder struggle with depression as well.1
Substance abuse may co-occur with mental health issues for several reasons. For instance, abusing alcohol or drugs can lead to poor school performance, financial struggles, or legal problems which, in turn, can contribute to worsening moods. Likewise, feelings of depression caused by non-drug-related issues, in some instances, can lead teens to drugs as an attempt to cope—though substance abuse ultimately does not offer any lasting relief and can potentially further worsen depression.
Many people experience symptoms of depression at some point in their lives that can manifest in different ways, such as depressed mood, decreased interest in activities, sleep and appetite changes, and suicidal thoughts.2 While depression affects people of all age groups, it is alarmingly prevalent during the teen years—12.5% of American adolescents between the ages of 12 and 17 have experienced at least 1 major depressive episode within a given year.3 Symptoms of major depression typically last around 2 weeks and impact everyday functioning, such as the ability to engage in school or work or to stay connected socially.2
In this article, we will look at the:
- Risk factors that contribute to drug abuse and depression.
- Assessments that further examine mental health and substance use concerns.
- Treatment options that are available for those who are struggling with a dual diagnosis of substance abuse and depression.
What Contributes to this Problem?
A wide variety of factors may contribute to both teen substance use and depression, including:4-7
Because depression and substance use have a significant impact on one another, it can be difficult to separate these concerns into independent issues. Therefore, it is important to be properly assessed and treated for both depression and substance abuse issues.
Getting Proper Assessment
To find appropriate treatment, it is important to first be assessed by a therapist or psychiatrist for a mental health disorder or a substance use disorder. It is especially helpful if the clinician has experience working with teens who have dual diagnoses (e.g., a mental health issue in addition to a substance use disorder).1
During a mental health assessment, the professional conducting it will ask a series of questions about your mental health history, such as whether or not you have been previously diagnosed with a mental health disorder or if you have ever been hospitalized for mental health issues. You will also be asked about your current mental health symptoms and evaluated for any safety concerns, such as the presence of suicidal thoughts.7
A thorough assessment also reviews:
- Any pertinent medical issues.
- Family history of mental health disorders.
- Substance use concerns.
- Social history.
- Current social activities.
- Employment history.
- Any traumatic experiences you have had.
Mental health evaluations are conducted in order to make diagnoses such as major depressive disorder, which will then be used to help guide your treatment.
Treatment Options Available for Your Teen
In cases of co-occurring depression and substance abuse, an integrated, simultaneous treatment approach is commonly used. The following evidence-based treatment options are effective for people struggling with a dual diagnosis:1,8-10
A combination of these therapies may be administered at various stages of recovery and in several different treatment settings, including:
Different therapeutic combinations may be used to best treat those with a dual diagnosis. For example, CBT and mindfulness-based techniques may be used in individual or family therapy while you attend an outpatient treatment program. The important thing is to get the help you need for your depression and substance abuse as soon as possible so you can begin a healthy life in recovery.
- Kaminer, Y., Connor, D.F., & Curry, J.F. (2007). Comorbid Adolescent Substance Use and Major Depressive Disorders: A Review. Psychiatry (Edgmont), 4(12), 32–43.
- American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders: Fifth Edition. Arlington, VA: American Psychiatric Association Publishing.
- National Institute of Mental Health. (n.d.). Major Depression Among Adolescents.
- Griffin, K.W., Botvin, G.J., Scheier, L.M., Diaz, T., & Miller, N.L. (2000). Parenting Practices as Predictors of Substance Use, Delinquency, and Aggression Among Urban Minority Youth: Moderating Effects of Family Structure and Gender. Psychology of Addictive Behaviors: Journal of the Society of Psychologists in Addictive Behaviors, 14(2), 174–184.
- Khoury, L., Tang, Y.L., Bradley, B., Cubells, J.F., & Ressler, K.J. (2010). Substance Use, Childhood Traumatic Experience, and Posttraumatic Stress Disorder in an Urban Civilian Population. Depression and Anxiety, 27(12), 1077–1086.
- Neher, L.S. & Short, J.L. (1998). Risk and Protective Factors for Children’s Substance Use and Antisocial Behavior Following Parental Divorce. American Journal of Orthopsychiatry, 68(1), 154–161.
- Cook, M.N., Peterson, J., & Sheldon, C. (2009). Adolescent Depression: An Update and Guide to Clinical Decision Making. Psychiatry, 6(9), 17–31.
- Chapman, A.L. (2006). Dialectical Behavior Therapy: Current Indications and Unique Elements. Psychiatry, 3(9), 62–68.
- Quello, S.B., Brady, K.T., & Sonne, S.C. (2005). Mood Disorders and Substance Use Disorder: A Complex Comorbidity. Science & Practice Perspectives, 3(1), 13–21.
- Witkiewitz, K. & Bowen, S. (2012). Depression, Craving and Substance Use Following a Randomized Trial of Mindfulness-Based Prevention. Journal of Consulting and Clinical Psychology, 78(3), 362–374.