Seven Common Co-Occurring Disorders in Teens
Written by Rob Alston
& Medically Reviewed by Paula Holmes, LCSW
Medically Reviewed
Last updated:
Last Updated - 08/16/22
View our editorial policyTeens with dual diagnosis disorders have both substance abuse and another diagnosed mental health condition simultaneously.
Perhaps you’ve heard the term before relating to mental health and wondered, what is a dual diagnosis? A dual diagnosis refers to the presence of a substance use disorder and a mental health diagnosis simultaneously. An estimated 65% of teens with a substance use disorder have a dually diagnosed mental health condition. In the treatment of teen mental health, practitioners assess the potential of a dual diagnosis to ensure that the best treatment options are arranged to meet the patient’s needs.
Understanding the needs of teens and having a proper assessment of the presence of a dual diagnosis can result in better outcomes. If a teen has a substance use disorder and is dually diagnosed with depression, the symptoms of each of these conditions impact the other. A thorough diagnosis and the identification of dual conditions help struggling teens get the help they need. There are seven common diagnoses that can co-occur with substance use disorder in teens.
Antisocial Disorders
Antisocial personality disorder in teens is a diagnosis that manifests as:
Antisocial Personality Disorder Symptoms
Lack of empathy for others
Disregard for right and wrong
Limited ability to connect with people genuinely
Manipulating others
Teenage antisocial personality disorder poses a significant risk for substance use and addiction as a result of having fewer inhibitions about using substances. Causes of antisocial behavior in adolescents can vary. Genetic factors, maternal substance use, and environmental influences can all play a part in the development of an antisocial personality.
Anxiety Disorders
Anxiety disorder in teens is prevalent. Teens who have struggled with anxiety in childhood and don’t receive treatment are more likely to experience substance use disorder. Teens with anxiety may turn to substances as a method of self-medication or reducing distress caused by anxiety. Others may use substances as part of an impulse-related anxiety condition and become physiologically and psychologically addicted as a result. Teenage anxiety disorder symptoms include:
Anxiety Disorder Symptoms
Feeling overwhelmed and stressed
Restlessness, feeling jittery
Tearfulness
Feeling a loss of control
Gastrointestinal upset
Headaches and fatigue
Social avoidance/changes
Excessive worry
Rising anxiety levels among youth is an important factor to pay attention to and treat early on. Doing so may help prevent some instances of substance use disorder during the teenage years and contribute to a more healthy lifestyle.
Attention-Deficit/Hyperactivity Disorder (ADHD)
ADHD in teens and substance use disorder often co-occur. ADHD drug abuse and alcohol abuse sometimes emerge for teens who struggle with the condition. It can be difficult to manage ADHD, particularly in settings that are challenging for people with this condition, such as traditional classrooms and school settings. The impulsivity related to ADHD puts teens at a greater risk of substance use disorders. Social challenges, boredom, and behavioral issues can also reduce feelings of success in the school setting overall. Signs of ADHD in teens often manifest as:
Symptoms of ADHD
Problems concentrating
Distractibility
Impulsivity
Hyperactivity
Disorganization
Bipolar Disorder
Bipolar disorder in teens impacts mood regulation, impulsivity and ability to function. The correlation between substance use disorder and bipolar disorder in youth is significant, in that substance use treatment is often sought before the diagnosis of bipolar disorder. Bipolar disorder co-occurs with a substance use disorder 60% of the time. Testing for bipolar disorder in teens can help determine if their symptoms meet the criteria for the diagnosis. Common symptoms include:
Bipolar Disorder Symptoms
Distinct episodes of mania and depression
Suicidal ideation
High energy with little need for sleep
Mood changes
Impulsive, erratic behavior
Irritability
Excessive, inappropriate guilt
Fatigue and exhaustion
Borderline Personality Disorder
BPD in teens affects feelings of belonging, stability, and self-esteem. People with this disorder are at an increased risk of a substance use disorder as a result of the turmoil and feelings of rejection that the condition causes. BPD in teenagers can make it difficult to trust others and the disorder often causes teens and others with the condition to engage in risky behaviors, including substance abuse. Teenage BPD symptoms include:
Borderline Personality Disorder Symptoms
Intense fear of abandonment
Low self-esteem
A belief that people reject and abandon them routinely
Risky and self-injurious behaviors
Suicidal ideation
Intense anger and irritability
Feelings of emptiness
Depression
Teen depression is at an all-time high, particularly in women. Depression in young adults and teens, unfortunately, increases the likelihood of developing substance use disorder. The use of alcohol or drugs in response to depression only worsens the condition. Depression in adolescents can present a bit differently than in adults. Some of the more common symptoms of depression in this age group include:
Depression Symptoms
Irritability
Shifts in mood
Changes in eating patterns
Preoccupation with death/dying
Low self-esteem
Changes in hygiene practices
Fatigue or restlessness
Changes in sleep patterns
Weight loss or gain
Inability to make decisions
Cognitive fog
Eating Disorders
Eating disorders in adolescence pose significant health problems, and these conditions frequently co-occur with substance use. Teens with eating disorders may go to great lengths to hide their condition from others. The negative self-evaluation and low self-worth that come with eating disorders can cause some teens to resort to substance use as a means of self-medication. The results are anything but therapeutic and usually result in greater feelings of self-loathing and loss of control. Some signs of teenage eating disorders can include:
Eating Disorder Symptoms
Perfectionist tendencies
Unrealistic standards for oneself
Excessive exercise
Frequently going to the bathroom following a meal
Mood changes
Obsessiveness about food intake/calories/carbohydrates
Low self-esteem
See More: Take a Mental Health Quiz
Helping Teens Cope with Dual Diagnosis Disorders
If you’re wondering how to talk to your teenager about drugs, help is available. The risk for teens with dual diagnosis is significant, as both conditions impact the other and will likely worsen over time if left untreated.
There are teen drug rehab programs that can help. Specialized dual diagnosis treatment centers in Florida can offer comprehensive treatment options that work with your teen’s specific needs. These programs offer strengths-based therapies to help your teen recover in a safe environment. Contact The Recovery Village Palm Beach at Baptist Health today to learn more about treatment options for co-occurring-disorders or addiction for your loved one.
View Sources
Drugfree.org. “Substance Use & Mental Health in Teens and Young Adults.” Accessed October 11, 2019.
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