Teen Co-Occurring Disorder Treatment

Sometimes, teens with mental health disorders also begin abusing addictive substances. This is known as a co-occurring disorder and it is common for those with mood disorders, anxiety, and eating disorders to also experiment with drugs. Treating both conditions together is critical to your teen’s success in the future.

What Does Teen Co-Occurring Disorder Look Like?

  • Having a mental health disorder can be exhausting and distressing. Teens will turn to drugs as a way to cope with their negative feelings, delusions, and self-destructive thought patterns. They don’t necessarily consider the fact they may become addicted, instead looking to self-medicate.
  • Drug use may alleviate mental health symptoms during use, but may strengthen them when a teen is sober. This vicious cycle can increase thoughts of suicide and instances of anxiety.
  • Teens with co-occurring disorders are more likely to lie about where they are hanging out and what they are doing. They behave erratically and may even be trying to hide their mental health disorder if it hasn’t yet been diagnosed.

Signs of Teen Co-Occurring Disorder

Severe mood swings

Severe mood swings

Owning drug paraphernalia

Owning drug paraphernalia

Loss of interest in hobbies

Loss of interest in hobbies

Dishonesty and lying

Dishonesty and lying

New or questionable friendships

New or questionable friendships

Falling behind in school or at work

Falling behind in school or at work

Isolation and/or withdrawal

Isolation and/or withdrawal

Causes of Teen Co-Occurring Disorder

Mental Health Problems - are both a symptom and a risk factor. Teens will often consider experimenting with drugs after they start to show signs of a mental health disorder. Drugs strengthen the mental health issue and things begin to snowball out of control. Drugs can trigger depression and anxiety, but it is often the other way around.

Access to Drugs - it isn’t usually hard for teens to get their hands on alcohol or lighter drugs, like marijuana. They may begin to steal prescriptions from family members, or they may make contacts at parties or other social events, making it easier for them to get harder drugs like meth, cocaine, or heroin.

Stress - trauma, school stress, and home life issues are all factors to consider when trying to figure out why a teen has started to use drugs. They think they’re going to feel better but in reality they’re on track to make themselves feel worse.

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What are the Causes of Teen Depression?

Everyone is different and can have unique reasons for developing a depressive disorder. While not all of the causes are known, some better-understood causes include:

Physical Disease - especially those that impact the brain or the hormones produced by the endocrine system.

Hormone Imbalances - caused by genetic disorders or thyroid disease; or sometimes as a side-effect of pregnancy.

Neurotransmitter Imbalances - make it difficult to regulate the levels of dopamine, serotonin, and norepinephrine in the body.

Chronic Pain and Chronic Fatigue - can be genetic or be caused by frequent illness or injury. This involves ongoing pain that never ends can cause depressive symptoms.

Environmental Factors - include things like loss of a loved one, physical or emotional trauma, a rough childhood, or even bullying.

Excessive Substance Use - impacts the brain and can cause severe mood swings and Depression.

It boils down to nature versus nurture. In a lot of cases, teens experience a bit of both before they begin to truly develop depressive symptoms. They may have one big contributing event or they may be triggered by smaller sad events.

Teen Co-Occurring Disorder Treatment | Paradigm San Francisco


of people who work full-time have at least one co-occurring disorder.


of people seek treatment for one disorder or the other, but only 5% seek treatment for both.


people struggle with co-occurring disorders.

How Can I Help My Teen with a Co-Occurring Disorder?

Build Trust - Communication is key. Your teen needs to feel as though they can trust you without judgement. Otherwise they will never let you know what’s really happening and how long they’ve been suffering. Let your teen know you’re on their side and have their best interests at heart. A lot of teens are afraid to ask for help with mental health issues.

Educate Yourself About Drugs - no two drugs are alike. The signs and symptoms associated with each are very different. Knowing what your teen has tried and educating yourself about each drug can help you to identify red flags in the future.

Be Supportive Throughout Recovery - recovery programs are great for kickstarting the recovery process, but recovery continues for a very long time. The hard work starts when the teen returns home. Support your teen as they look for new healthy activities, support groups, a regular therapist, and new social groups that will encourage their sober life.

What Types of Teen Co-Occurring Disorder Treatment Are Available?

Teens with co-occurring disorders need their treatments to co-occur as well. Your teen needs to understand how their mental health disorder and drug abuse issues interact and impact each other, so there is really no way to treat one without treating the other. Your teen’s treatment plan needs to take a holistic approach, designed specifically to address their struggles. Teen co-occurring disorder treatment plans need to seriously consider both the short and long-term aspects of the recovery process.

Talk Therapy

This type of therapy literally entails sitting with a professional to discuss a teen’s behavioral patterns and thoughts. Cognitive behavioral therapy and other treatment methods are used to help teens better understand their negative thoughts so that they can recognize them, stop them, and consciously replace them with healthier affirmations.

Your teen will learn exercises they can use at home to continue reinforcing positive thoughts. This process works very well, even without medications. Teens who struggle with anxiety, depression, and other mood disorders find it particularly helpful.

Group Therapy

This is another very helpful therapy for those with co-occurring disorders. Teens needs to talk to and hear from those in their own peer groups. The unique insights will help them to understand they are not alone and others in therapy can offer their own unique perspectives. Most teens find themselves motivated by group therapy.

Lifestyle Changes

Your teen won’t be able to recover from their substance abuse issues without making lifestyle changes. They’ll need to learn to treat themselves with care and respect. While in treatment, your teen will need to make new friends, find safer social circles, exercise regularly, and find new hobbies. They’ll learn to schedule themselves carefully so they can balance their responsibilities with their new interests. Positive pursuits will leave your teen with little time to focus on negativity.


Individuals with co-occurring disorders are sometimes encouraged to avoid medications, especially if they are struggling with substance abuse. There are cases where medications can help control the symptoms of anxiety and other severe mood disorders, making it easier for the teen to focus on therapy.

While antidepressants are not typically addictive, they can be habit-forming if a teen doesn’t learn other, healthier ways to cope with stress and anxiety. When prescribed, the therapist will work to ensure they’re simply a part of the process as opposed to the actual solution.

Teen Co-Occurring Disorder Treatment at Paradigm San Francisco

We have a number of Paradigm locations around the San Francisco area. Our mission is to help our teens overcome and move past their struggles. Our scenic location is surrounded by nature, creating a quiet, nurturing environment.

Our treatment centers limit the number of teens in a group at any given time. This is to ensure that every teen in our program receives the individual attention necessary to succeed after therapy. Teens learn to set goals, decide what sobriety means to them, and spend time learning to simplify and control their own lives. They’ll spend time in group therapy, classroom settings, art classes, and other activities while focusing on making the lifestyle changes necessary to succeed.

Integrated Treatment

Teen co-occurring disorder treatment plans are tailored to the teen’s co-occurring disorder. A teen abusing drugs needs a different style of treatment than a teen abusing alcohol; just as teens with depression need different treatment than those with anxiety. Your teen’s therapist will spend time helping your teen discover the underlying causes of their condition so they can create a realistic, holistic treatment plan.

Strict Focus

Small therapy groups are great because there is less risk of teens developing social hierarchies and clashing with each other. The staff at Paradigm San Francisco works hard to give teens the attention they need individually while encouraging them to work together and support each other. They learn healthier communication skills and form strong bonds that will support them in their future efforts towards recovery and sobriety.

“ I’m an artist based in Los Angeles and working full time, as a single parent, I was not always aware of what was happening with my son. At 16 his behavior took a destructive turn and I felt helpless in knowing how to deal with his illness and how to make it better. Growing up I always found healing close to the ocean so as soon as I researched online and found Paradigm I knew it would be a good place to send him. There is no such thing as “fixing” someone who suffers from mental illness and addiction but Paradigm provided the necessary tools and emotional support we needed to make a change. The family therapy sessions helped me realize a lot about myself and showed me how to be a better parent. I am forever grateful to this facility and staff for helping us when I felt at a dead end. “

– G. H.

Frequently Asked Questions About Teen Co-Occurring Disorder

How do I know if I have a co-occurring disorder?

It’s really not easy for individuals to diagnose themselves. A mental health professional needs to take you through a series of questions or tests, following strict guidelines. Don’t be afraid to reach out for help if you just feel like “something is wrong.”

Do you feel anxious or depressed? Do you suddenly have what you feel are intense fears of things that never bothered you before? Do you think about suicide or self-harm? You may need to seek help.

Anyone using drugs or abusing alcohol, especially in secret or after obtaining them illegally, risks developing an addiction.

Is it really bad to use alcohol for relaxation?

Some people can enjoy alcohol with no worry, but others can’t. Teens should never drink alcohol because their brains are underdeveloped and are more susceptible to developing dependencies. California law allows for teens to casually consume alcohol in the home while in the presence of family (e.g., for special occasions), but this still creates a huge risk. A lot of people who develop addictions later in life started with drugs or alcohol as teens.

Alcohol should never be used as a coping mechanism. Media and commercials make alcohol look like a great way to unwind, but regular use isn’t healthy. Any regular, ongoing use of alcohol or a drug should be considered dangerous --- especially if you are trying to alleviate stress.

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