What Are Co-Occurring Disorders in Teens and How Are They Treated?

For a number of years, mental health experts asked themselves: does depression bring on addiction? Or does addiction bring on depression? However, what mental health researchers have found is that both can happen. Teens who struggle with mental illness can turn to drugs and alcohol to feel better, which can lead to an addiction. At the same time, addiction can contribute to and even create the experience of mental illness, such as anxiety or depression. Either way, when this happens, it’s referred to as having co-occurring disorders.

Experts know that answering which comes first isn’t as important as making sure that a teen gets treatment for both illnesses simultaneously.

Mental Illnesses that Frequently Accompany Addiction

According to the 2010 National Survey on Drug Use and Health, approximately 45% of people with an addiction also had another form of mental illness.

When someone struggles with an addiction as well as another psychological illness, it is sometimes referred to as having co-occurring disorders. Others might refer to it as having a dual diagnosis. According to the American Society of Addiction Medicine (ASAM), the following are common mental health conditions that teens with addiction also struggle with:

  • Depression
  • Bipolar Disorder
  • Anxiety
  • Obsessive Compulsive Disorder
  • Panic Disorder
  • Post Traumatic Stress Disorder
  • Eating Disorders
  • Attention Deficit/Hyperactivity Disorder
  • Conduct Disorders (in children and teens)

At the same time, for those who seek treatment for a mental illness, the following are types of addictions that tend to accompany those illnesses:

  • Alcohol
  • Heroin
  • Prescription Drugs
  • Cocaine
  • Methamphetamine
  • Amphetamine
  • Marijuana
  • Tranquilizers
  • Hallucinogenic Drugs

It might seem obvious that addictions and mental illnesses can go hand in hand. Teens who experience symptoms of depression, for example, might want to quell those uncomfortable feelings with drugs or alcohol. If a teen is feeling dead on the inside, experiencing rejection from peers, and feeling guilt or shame, then they might be drawn to drinking or using drugs to feel better.

Simultaneous Mental Health Treatment

If you’re a parent or caregiver of a teen who is experiencing an addiction and you suspect a mental illness as well, the most important step to take is to involve a mental health provider who can address both the addiction and the mental illness. In fact, if your teen is receiving treatment for one illness (the addiction) and not the other (depression for example), then full recovery is not likely to happen.

Here are some important tips to remember:

  • Co-occurring disorders require treatment of both illnesses at the same time.
  • Simultaneous treatment needs to begin from the initial intake all the way through discharge and after-care treatment.
  • If your teen is already receiving treatment for one and not the other, it’s important to discuss this with the mental health provider involved to address both illnesses.
  • If you’re unsure whether or not you have a co-occurring disorder, it’s best to involve a mental health provider to determine whether a co-occurring disorder exists.
  • Once you are assessed by a mental health provider, you might be given a diagnosis, which can then lead to the right treatment plan.
  • A treatment plan should include having your teen participate co-occurring disorder treatment, which means that they will receive treatment that addresses both illnesses at the same time.
  • Consider getting your teen into treatment as soon as you can.

Research shows that 50% of teens who have an addiction to alcohol or drugs also struggle with a mental illness. Sadly, only a fraction of adolescents who a dual diagnosis get the treatment they need.

Why Co-Occurring Disorders are Often Overlooked

Both teens and adults frequently don’t get the right mental health treatment. For instance, according to the National Survey on Drug Use and Health (NSDUH), there are about 9 million Americans who have a dual diagnosis. Out of the thousands of men and women who attend addiction treatment, roughly only 7% are treated for both their substance abuse and their mental illness.

There are many reasons why teens don’t get the full treatment they need to address their addiction and mental illness. Here are a few contributing factors:

  • stigma
  • lack of education on co-occurring disorders
  • lack of education on addiction
  • lack of education on mental illness
  • teens are misdiagnosed
  • teen mental health treatment doesn’t include an assessment for addiction
  • teen addiction treatment doesn’t include an assessment for mental illness
  • parents and/or teens might avoid treatment because of the stigma they feel
  • teens are not screened for mental illness at school or by their physician

There are a number of reasons why teens who face addiction and mental illness don’t get the treatment they need.

Teen Co-Occurring Disorder Treatment

If a teen does begin to participate in treatment, there are many forms of treatment they might participate in. These include:

  • initial assessment
  • medical detox
  • individual therapy
  • family therapy
  • behavioral modification therapy
  • group therapy
  • support groups
  • education on chemical dependency/addiction
  • medication
  • recreational therapy
  • mindfulness and meditation

Along with these components of treatment, there should also be strong communication among the psychiatrist, psychologist, family members, social workers, teachers, and other professionals in the teen’s life. Ideally, there should be an integration of services so that the best treatment is provided to your teen.

Lastly, treatment for co-occurring disorders should also explore any underlying issues that may have contributed to either the mental illness or the addiction in the first place. Often, this can be unresolved childhood trauma, the presence of addiction in the family home, the loss of a loved one, or chronic experiences of trauma and helplessness.

If a teen is participating in a comprehensive treatment plan that addresses their history, current psychological needs, recovery from addiction, and recovery from mental illness, they are bound to be able to return to living a happy and healthy life. Furthermore, if a teen is given coping tools to manage stress and has a plan for participating in ongoing self-care activities, then not only will they recover from their dual diagnosis, they will likely sustain their health and happiness long into adulthood.

Further Reading