Mental health and substance abuse problems affect people of all ages. But teenagers are especially vulnerable to developing both.

When a teen has a substance use disorder and a mental health diagnosis, it’s called a co-occurring disorder.

If you have a teen in your home, you should know what a co-occurring disorder looks like.

It’s harder to control co-occurring disorders than either addiction or mental health issues alone. The earlier you recognize that your teen needs help, the sooner they can start recovering.

What is a Co-Occurring Disorder?

A co-occurring disorder is when someone has diagnoses for a mental health disorder and a substance use disorder.

For example, teens with addiction who also show signs of depression or anxiety would be diagnosed as having co-occurring disorders.

Sadly, co-occurring disorders are common.

6 out of 10 people with substance abuse disorders also suffer from mental health conditions, according to the National Institute on Drug Abuse.

These include:

  • Anxiety disorders
  • Bipolar disorder
  • Depression
  • Personality disorders
  • Post-traumatic stress disorder
  • Schizophrenia

Are Teens With Addiction At Risk for Co-Occurring Disorders?

Yes, teens are at risk for co-occurring disorders if they have addiction problems.

A February 2019 study found that substance use and mental conditions go hand-in-hand.

They found links between addiction and:

  • Anxiety disorders
  • Depression
  • Post-traumatic stress disorder

Many of these psychiatric conditions go undiagnosed and untreated.

This is because active substance use can make it hard for doctors to diagnose conditions the right way. In turn, that affects treatment plans.

Co-occurring disorders can intensify substance use. Substance use can also worsen mental health conditions. It’s much harder to control these issues together instead of alone!

It’s important for medical professionals to accurately identify co-occurring disorders in teens who use substances for treatment to be successful.

What Are the Signs of Mental Illness in Teens?

It’s hard to say what mental illness looks like in teens. It can be different from case to case.

Depression symptoms look very different from the signs of schizophrenia, for example.

Many different signs might mean mental illness in teens. Some of them are easy to dismiss as “teens being teens,” like trouble sleeping or irritability. But it’s important to take your teen’s mental health seriously.

The signs of mental health problems in teens include:

  • Avoiding friends
  • Losing interest in activities
  • Absences from class
  • Poor school performance
  • Self-harm, such as cutting, picking, or hair-pulling
  • Suicidal thoughts or behavior
  • A lack of motivation
  • Sleep problems
  • Irritable moods
  • Manic or risky behavior, such as having unsafe sex
  • An inability to sit still and focus on tasks
  • Chronic anxiety or worry
  • Smoking, drug use, or drinking
  • Oversleeping and loss of energy
  • Being hyperactive one moment and having no energy the next

If your child is having drastic behavior changes, it might be time to seek help.

There are several common mental health disorders among teens, according to the Department of Health and Human Services. These include anxiety disorders, depression, attention-deficit hyperactivity disorder (ADHD), and eating disorders.

While they’re the most common mental health disorders, they’re far from the only ones. Teens can also develop issues like:

  • Bipolar disorder
  • Personality disorders
  • Oppositional-defiant disorder

What Are the Signs of Addiction in Teens?

The signs of addiction in teens show themselves in different ways. But parents could easily mistake them for mood swings.

A study published by the National Institutes of Health says that one common sign is a “change in behavior and mannerism,” but that could mean many things.

Early warning signs of addiction include:

  • Frequent change of friends
  • Poor excuses and confrontational behavior
  • Skipping family time, routines, and activities.
  • Violating curfew
  • Unusual and violent behavior following small arguments or simple requests
  • Poor decision-making
  • Poor school performance and skipping classes

You may start to see behavioral signs like a lack of motivation or lack of self-control. Later, the signs progress to:

  • Stealing money
  • Neglecting personal hygiene
  • Lying
  • Disrespect for authority
  • Skin changes, such as needle tracks
  • Drowsiness and fatigue

Drugs and drug paraphernalia might be visible in your child’s room. That can include items like syringes, bongs, or even empty paint containers.

It’s very important for parents, school teachers, and health providers to identify the warning signs and proactively talk to kids who might be using drugs.

How Can You Help Your Teen With a Co-Occurring Disorder?

Teens with a co-occurring disorder benefit from close relationships with their families. Stability is another factor that impacts these teens.

Consider implementing some family changes, like:

  • Being home in time for dinner
  • Having boundaries and expectations
  • Spending quality time with your teen
  • Talking to your teen about their interests and their days

Call a Helpline for Teen Substance Use or Mental Health

Calling a helpline or hotline can give you free access to treatment referrals and support. You can call a helpline whether you’re a parent, a teen, or a concerned friend or loved one.

If your teen needs help, there are several valuable resources available:

  • The Substance Abuse and Mental Health Association (SAMSHA) National Helpline is free! It’s confidential and operates 24/7 all year round. It’s a treatment referral and information service for individuals and families seeking help for mental or substance use disorders. This helpline is available in English or Spanish. (1-800-662-4357)
  • The National Suicide Prevention Lifeline (1-800-273-TALK), in addition to offering suicide prevention, can connect individuals and families seeking help for substance use to a medical professional.
  • The Partnership at offers information and resources on teen drug use and addiction for parents. It’s a great resource for anyone who wants to learn how to intervene and prevent teen drug and substance use. There’s also a toll-free helpline (1-855-378-4373).

Get Help For Teen Substance Use Today

It’s important to get your teen help for their disorders as soon as you can. The earlier you get help, the better their outcomes.

The next step is to get treatment.

The right treatment center knows how to handle teens and co-occurring disorders. Look for programs that specialize in teens and mental health. It’s very important that your teen’s treatment addresses all of their disorders, not just substance use.

Some evidence-based treatments for co-occurring disorder include:

  • Counseling: Talking with a counselor can be a powerful emotional outlet. A counselor can teach your teen how to handle their emotions without drugs or self-destruction.
  • Group support: Believe it or not, there are 12 step groups for teens. Other teen-friendly support groups can help remind your child that there’s a light at the end of the tunnel.
  • Therapy: Different kinds of therapy teach you mindfulness techniques and coping strategies. Cognitive-behavioral and dialectical behavior therapy are two common types.
  • Medication: Medications can treat depression, anxiety, and other disorders. They can also treat withdrawal in some cases. If your teen is recovering from heroin or alcohol, then medication-assisted treatment (MAT) may be part of their routine.

Why are you still waiting? Now’s the time to get help for your teen. Call a treatment center today to learn more! If you aren’t sure where to call, search through our directory to find the nearest treatment center in your area.


  1. Mental Health and Substance Use Disorders (2019, April 13)
  2. Co-Occurring Mental Health Disorders (2019, February 2)
  3. Principles of Drug Addiction Treatment (A Research Based Guide, January 2018)
  4. Normal Teenage Behavior or Mental Health Issue? Know When to Seek Help (2018, 2 February)
  5. Common Mental Health Disorders in Adolescence (2019, 1 May)

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