There is a connection between people having both mental illnesses and substance use disorders at the same time during their lifetime. This phenomenon is called comorbidity which means that someone has two or more disorders or medical conditions. In fact, the National Institute on Drug Abuse states that about 50% of people who experience a mental illness in their lifetime will also experience a substance use disorder and vice versa. In fact, over 60% of adolescents in community-based substance use disorder treatment programs also meet diagnostic criteria for another mental illness.

The research has indicated that adolescence is a vulnerable time for addiction & mental health disorders to develop as the brain is still developing executive functions such as decision making & impulse control. The National Institute on Drug Abuse states that “early drug use is a strong risk factor for later development of substance use disorders, and it may also be a risk factor for the later occurrence of other mental illnesses.” Additionally, there are some findings in the research that mental illness is often diagnosed before a substance use disorder develops which suggest that earlier diagnoses of youth mental illness may diminish comorbidity.

Therefore, it seems that the earlier the intervention of services provided for mental illnesses and substance use concerns, it is more beneficial for youth. This is especially true for people that have common risk factors for mental illnesses and addiction including genetic factors and epigenetic vulnerabilities (family history), having issues with similar areas in the brain, and environmental influences such as early exposure to stress or experiencing trauma. In fact, there is evidence that some mental, emotional, and behavioral problems among youth can be prevented or considerably diminished by evidence-based prevention interventions. These interventions should focus on reducing risk factors for mental illnesses and substance use disorders and emphasize increasing protective factors in youth. Some key protective factors for youth include having a supportive family, school, and community environ­ments. Therefore increasing these areas in their lives as much as possible can be a great preventative measure for youth. This could mean having regular dinner times together as a family, helping youth with their school work and getting them involved in sports & extracurricular activities.

In addition, there are many treatments have been shown to be effective for children and adolescents with substance disorders and mental illnesses. The National Institute on Drug Abuse highlights the following modalities: Multi-systemic Therapy, Brief Strategic Family Therapy, Multidimensional Family Therapy, Cognitive Behavioral Therapy, Dialectical Behavioral Therapy, Assertive Community Treatment, Therapeutic Communities, Contingency Management (CM) or Motivational Incentives (MI), Exposure Therapy, Integrated Group Therapy, Seeking Safety, and Mobile Medical Application. Moreover, medications can be effective for treating substance use disorders and mental illnesses so it can be helpful to consult a physician or psychiatrist in addition to therapy for many individuals. Some medications may be able to assist in treating multiple diagnoses.

If you suspect that your child or adolescent is at risk for developing mental illnesses or substance use disorders, the best thing you can do is intervene with services as soon as possible. Although the symptoms of mental illnesses vary depending on the individual, there are some common things to look out for including extreme mood changes, feeling very sad & tired, excessive worrying & fear and social isolation. Other common symptoms to look out for regarding substance use include: cravings to use the substance, wanting to cut down or stop but not managing to, taking the substance in larger amounts or for longer than one is meant to, neglecting other parts of one’s life because of substance use, continuing to use even when it causes problems in relationships and using substances even when it puts them in danger.

You can also contact the SAMHSA’s National Helpline, 1-800-662-HELP (4357), (also known as the Treatment Referral Routing Service) or TTY: 1-800-487-4889 is a confidential, free, 24-hour-a-day, 365-day-a-year, information service, in English and Spanish, for individuals and family members facing mental and/or substance use disorders. This service provides referrals to local treatment facilities, support groups, and community-based organizations.

-Lindsay Doten, MSW, LGSW

Intervention Manager
Youth and Family Therapist