It's normal for teenagers to be sad sometimes, or to have periods when they are frustrated and distant. With peer pressure, social media, school work and hormones wreaking havoc, teens face challenges every day. However, behavioral changes like sadness that last for more than two weeks could be a sign that your child is suffering from teen depression. According to the National Institute of Mental Health, in 2015 an estimated 3 million adolescents aged 12 to 17 in the United States had at least one major depressive episode in the past year. (1)
Link Between Depression and Substance Abuse
There is a correlation between depression and drug abuse and, it is so common, it has its own term - dual diagnosis. According to the National Survey on Drug Use and Health (NSDUH), 45 percent of people with addiction have a co-occurring mental health disorder. (2) Mental health and addiction counselors believe that mental health disorders and substance abuse are physiologically, biologically, genetically and psychologically based. Other factors that lead to teen depression and drug abuse are environmental stress, i.e. unhealthy family dynamics or difficulty at school, a teen who is self-medicating because they are depressed, or drug abuse that worsens a pre-existing mental health condition.
Addiction and depression both originate in the brain, making people who have mental health issues more prone to addictive behaviors. For teens this is especially difficult, as their developing brains are particularly vulnerable to the damage caused by substance abuse. Depression that has been triggered by the consumption of alcohol, drugs or medication can be separately diagnosed.
Another factor in depression and teen drug use is the concept of negative urgency. Negative urgency is when one has a disposition of mood-based rash action, (i.e. urgency) and thus a tendency to act rashly without considering the consequences, particularly during emotional states. (3) Those with negative urgency tend to lose control over their behaviors when they are sad, angry, frustrated or fearful. People who have negative urgency also have certain underlying personality traits, i.e. a low level of agreeableness or sociability, a low level of considerate behavior and a high level of anxiety-based behavior. In a study of 476 adolescents who completed confidential surveys, it was found that the behavioral impact of negative urgency explains the connection between depression and the use of cigarettes, marijuana, alcohol, and prescription pain killers. This suggests that the emotional vulnerability teens are susceptible to if prone to negative urgency, increases the likelihood of experimenting with drugs. (4)
Symptoms of Teen Depression & Substance Abuse
If you think you're teen is depressed and suspect he/she is using drugs, there are symptoms and warning signs to be aware of. Depressive symptoms to be on the look out for are loss of interest or pleasure in the activities they normally enjoy, depressed or anxious mood, preoccupation with death, dying and suicide, sadness resulting in crying spells for no reason and changes in their normal behavioral patterns such as sleep issues, eating habits, concentration and their self image.
Physical symptoms of depression: complaints of pains, including headaches, low back pain, fatigue, and stomachaches.
Identifying substance abuse in your teen can be challenging as many of the symptoms of depression also occur in teens who are abusing drugs. However, there are behaviors and symptoms specific to drug abuse to be aware of:
Emotional/behavioral warning signs of drug abuse: skipping class, drop in attendance, complaints from teachers, stealing money and always asking for money, engaging in suspicious or secretive behavior, demanding more privacy like locking doors, using eye drops to hide bloodshot eyes, using chewing gum or mints to cover up breath, has the "munchies," laughs at nothing, disappears for long periods of time, periods of sleeplessness or high energy followed by long periods of sleep.
Physical signs of drug abuse: bloodshot eyes, frequent nosebleeds, seizures without a history of epilepsy, unusual smells on their breath, body or clothing, sweating, shaking, tremors, changes in speech, sores around mouth, vomiting, wetting lips or excessive thirst, skin abrasions or injuries, red or flushed cheeks, track marks on arms or legs, and burns on fingers or lips from "joints" burning down.
When a teen is depressed and in treatment, counseling often only addresses the depression, and not the substance abuse. The same issue happens when a teen is undergoing drug rehabilitation, wherein the treatment is primarily about drug abuse and does not address the underlying mental health issue. It's imperative when a teen is dealing with depression and substance abuse that both issues be properly treated by knowledgeable mental health and drug rehabilitation counselors. There are a high percentage of depressives who relapse after rehabilitation if only the physical issues of drug abuse are treated. Treatment options include:
Detoxification - There may be withdrawal symptoms, but professional medical staff monitor the patient and administer tapering amounts of the substance or a medical alternative to lessen the effect of withdrawal.
Inpatient Rehabilitation - A place that helps patients 24/7 with focused medical care and mental health counseling.
Medication - to help with depression, as well as with withdrawal symptoms.
Psychotherapy - a critical component of recovery for the patient with mental health issues. Understanding the root causes of one's depression plays a key role in recovery after treatment.
Self help and support groups - A dual diagnosis can feel overwhelming to the patient and family. Support groups provide a safe place to express oneself, to feel validated, and to gain an nvaluable support network for life after treatment.
Get Your Teen The Help She/He Needs
Don't give up on your teen. He/she needs you at this critical stage in their development. If you suspect your teen is depressed and using drugs, initiate a conversation and compassionately ask questions about their drug use. Do not overreact if they admit to using drugs. Seek counseling and/or treatment as soon as possible. Your teen's life might depend on it.
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- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4253553/ - Study - Depressive symptoms, negative urgency and substance use initiation in adolescents; Raina D. Pang, Layla Farrahi, Shannon Glazier, Steve Sussman, Adam M. Leventhal; Drug and Alcohol Dependence; Published Online: September 25, 2014.