Mental Health

Image by NIDA

People often refer to substance use as “self-medication.” What they are trying to say is that some teens might drink and do drugs to help themselves feel better when they are suffering from a mental health disorder. Self-medicating is not an official medical term, but it does help explain why some teens experiment with drugs and alcohol.

Research does show that some teens have substance use and other mental health disorders at the same time. For example, a teen who is dealing with depression or anxiety might use drugs to try to cope. Or, a teen who can’t stop using drugs might get depressed about it. In fact, science tells us that regular misuse of drugs and alcohol can actually change the way the brain works, which may contribute to a mental health disorder. 

Or, there might not be an easy explanation---inherited traits or a person’s life experience can make them vulnerable to brain changes involved in either depression or substance use. Whatever the reason, this is called “co-occurring disorders” or “comorbidity.” 

Although substance use disorders commonly occur with other mental illnesses, this does not mean that one caused the other, even if one appeared first. It is important to know that interactions between the illnesses can worsen both situations.

Photo by NIDA

Co-occurring disorders are very common in both teens and adults, and there is nothing to be ashamed of in asking for help. A teens mental health can improve when they are willing to share their concerns with a trusted adult. For example, if you tell your pediatrician about your depression, and how drugs make you temporarily feel better, your doctor can then recommend a healthier approach to managing both problems or refer you to a counselor or other expert for help. To start the conversation with parents, guardians, or counselors, teens can show them this fact sheet to help explain how they are feeling.

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Yes. Substance use disorders can change the brain, taking a person’s normal needs and desires and replacing them with the urge to seek and use drugs. These changes in the brain weaken the ability to control impulses that can lead to addiction, where a teen cannot stop using a drug despite negative consequences.

Many people who have a substance use disorder also develop another mental illness, just as many people who are diagnosed with mental illness are often diagnosed with a substance use disorder. Studies show that about half of people who experience a mental illness will also experience a substance use disorder at some point in their lives and vice versa.^{1, 2}  

It can be difficult to determine which disorder started first. Scientists do know that if you have a mental illness like anxiety or PTSD, you are at higher risk for developing a substance use disorder. And if you have a substance use disorder, you are more at risk for developing mental health disorders. Research show that regular drug use can negatively affect areas of the brain involved in stress. In addition, drug use, like smoking marijuana regularly or drinking too much, can also make you worried that your parents or teachers will find out, and you could have some anxiety that you cannot stop using these substances.  

Scientists also know that some of these disorders run in families, so genetics might play a role in both substance use and other mental illnesses. Genes (inherited traits) also play a role in how you respond to a drug. For example, some teens try marijuana and have a psychotic reaction---feeling and seeing things that aren’t really there. This could be related to certain genes.

Secondly, environmental influences can lead to co-occurring disorders. Children who are bullied, abused, or who have experienced trauma are more at risk for substance use disorders and other mental illnesses.

Only trained medical professionals have the expertise to determine the safest and most effective ways to manage the discomfort you feel. Although some drugs may briefly help with mental illness symptoms, sometimes they can also make the symptoms worse and even lead to addiction. Additionally, when a person develops a mental illness, brain changes may enhance the rewarding effects of substances, making it harder to stop using the drugs.³

If you drink or use drugs and/or have other mental health disorders like anxiety or depression, it is critical that you be evaluated by a health professional. There are effective behavioral treatments and medications for mental illnesses and addiction. For a young person with symptoms of a mental disorder, the earlier treatment is started, the more effective it can be. Early treatment can help prevent more severe, lasting problems as you grow up, and can give you the skills to cope and manage these disorders throughout your life.

How do you know if you might have a mental health disorder? Here is a list of signs to watch:

• Do you smoke, drink alcohol, or use drugs?
• Have you lost interest in things you used to enjoy?
• Do you have low energy?
• Do you sleep too much or too little, or are too sleepy throughout the day?
• Are you spending more and more time alone, and avoid social activities with friends or family?
•  Do you fear gaining weight, or diet or exercise too much?
•  Do you hurt yourself (e.g., cutting or burning your skin)?
• Do you engage in risky or destructive behavior, such as fighting, skipping classes, or illegal activities like trespassing or vandalism, alone or with friends?
• Are you still feeling unable to cope with grief a long time after a loss or death of a loved one?
• Do you have thoughts of suicide?
• Do you have periods of unusual energy and activity, and need much less sleep than usual?
• Do you sometimes think someone is trying to control your mind or do you hear things that other people cannot hear? 

If you use drugs or drink to overcome these feelings, it is important to seek help immediately. If you have developed some of these problems because of your use of drugs or alcohol, be sure to tell your health professional the whole truth about your behaviors, so he or she can best help you. Science tells us that the earlier you seek help, the better chance you have of leading a healthier life.

If you, or a friend, are in crisis and need to speak with someone now: 

• Call the National Suicide Prevention Lifeline at 1-800-273-TALK. The trained professionals who answer calls to the Lifeline can talk about more than suicide and can help put you in touch with someone close by.

If you want to help a friend, you can:

• Share resources from this site, including this page.
• Point your friend to NIDA's Step by Step Guide for Teens and Young Adults. 
• Encourage your friend to speak with a trusted adult.

If a friend is using drugs, you might have to step away from the friendship for a while. It is important to protect your own mental health and not put yourself in situations where drugs are being used.

For more information on how to help a friend or loved one, visit our Have a Drug Problem, Need Help? page.

• Drug Facts: Comorbidity: Substance Use Disorders and Other Mental Illnesses 
• Child and Adolescent Mental Health  [National Institute on Mental Health] 
• Common Mental Health Disorders in Adolescence [Office of the Assistant Secretary for Health, Department of Health and Human Services]