Co-Occurring Anxiety and Depression in Teens

It’s very common for anxiety and depression to become co-occurring disorders. Although frequently anxiety occurs without depression and depression occurs without anxiety, the two can mutually affect each other. For instance, negative thinking and heavy mood can lead to feelings of uncertainty, which can cause anxiety. And when a teen feels uncomfortable with who he or she is that too can lead to strong feelings of anxiety, tension, and inner stress.


On the other hand, it’s common to find depression below the surface of anxiety, where the presence of underlying emotions have been directed inward. When teens (and adults) become afraid of their own feelings, especially if those feelings are challenging, those feelings get pressed inward. Feelings such as anger and shame, especially if they’re intense, can be pushed away. In fact, the word depression has Latin roots that mean “pressed down”. When heavy feelings are pushed inward instead of expressed, it can leave an adolescent feeling “down”, despondent, or low.


Typically, as children grow older, the rates of depression and anxiety are the same regardless of gender. It is usually around 3 to 5 percent for both boys and girls alike. However, when children enter into adolescence, girls are more at risk for experiencing a mood disorder. In fact, female teens are twice as likely to exhibit signs and symptoms of mood disorders. The psychological illness of depression includes symptoms of persistent sadness, loss of interest in daily activities, occupational and educational impairment, along with eventual emotional and physical problems. And anxiety can cause symptoms like a racing heart, dizziness, nausea, shortness of breath, shaking, and sweating palms.


In order to manage these symptoms, teens might engage in substance abuse and/or begin to experience suicidal thinking. It’s common for teens to use drugs as a means to cope. Teens who are using drugs or alcohol as a coping mechanism to manage their symptoms and strong emotions are known to be self-medicating. They are frequently looking for relief from challenging emotions or for a way to better function in school, at home, or at work. In fact, approximately, 60-75% of teens who abuse drugs or alcohol also have a mental illness. Among adolescents who have not used substances before, the incidences of first time drug use is higher among those who have experienced a major depressive episode than those who have not.


Suicide attempts might also be a way to get out of the psychological pain teens experience. Suicide is the third leading cause of death among teens and young adults ages 15-24. Teens who are most at risk for losing their life to suicide include those who hide their depression or anxiety from parents and caregivers. Teen mood disorders – depression, anxiety, bipolar disorder, for example – are common diagnoses of teens who attempt to take their lives.


Teen co-occurring disorder treatment is a form of teen psychological treatment that addresses various disorders separately. It recognizes that depression needs to be treated separately from the anxiety. Along the same lines, if a teen is experiencing an addiction as a result of the psychological illness(es), that also needs to be addressed separately. Treatment must thoroughly address the addiction, the mental illness, as well as any underlying issues that might also be contributing to substance use in the first place. Sadly, many teens who are diagnosed with an addiction might be sent to a rehabilitation treatment center that does not also address the psychological factors of the mental illnesses. This usually leads to teen chronic relapse because the primary cause for the addiction was not addressed.


Typically, teen co-occurring disorder treatment would include individual and family psychotherapy, medication, support groups, and strong communication among the psychiatrist, psychologist, family members, social workers, teachers, and other professionals in the teen’s life. Ideally, there would be an integration of services between the psychiatric and the drug counseling fields in order to best treat a teen with a co-occurring disorder.




Steingard, R. (January 22, 2013). Mood Disorders and Teenage Girls: Why They Are More Vulnerable Than Boys, and What Signs and Symptoms You Should Look For. Child Mind Institute. Retrieved on July 8, 2014 from: