Mental health affects people of all ages; however, it takes time to learn, practice, and maintain healthy coping skills. It can take weeks, months, even years for some people to develop an understanding of their mental health conditions and triggers and build an internal defense system.

When unsure of how to deal with uncomfortable thoughts and feelings, teenagers often turn to misusing and abusing substances. While adults do this as well, it is more dangerous for teens as their brains are still developing. The plasticity of the teenage brain easily adjusts to things, including substances, so it’s pivotal for teens to establish healthy relationships with substances early on to prevent substance use disorders. “Almost half of kids with mental health disorders, if they’re not treated, will end up having a substance use disorder,” explains Sarper Taskiran, MD, a child and adolescent psychiatrist at the Child Mind Institute.

While dangerous for all teenagers, substance use and misuse are especially risky for teens with mental health disorders. Substance use has been known to amplify the suicidal thoughts of teens plagued by depression. Substance use can also amplify the impulsive behaviors of teens with Attention-Deficit Hyperactivity Disorder (ADHD) and Oppositional Defiant Disorder (ODD). Additionally, a person with schizophrenia is more likely to have psychotic episodes when using substances. Michael Birnbaum, MD, a psychiatrist who heads an early treatment program for young people who signal onset signs of schizophrenia, explained, “Folks who are still using [substances] are more likely to struggle with ongoing psychotic symptoms, and also are more likely to have a relapse.”

Preventing substance use and abuse early is key, but prevention can be more challenging for teens with mental health disorders. Dr. Taskiran illustrated that teens with these disorders are much more likely than their peers to get addicted to substances, saying, “Biologically they get more from the drug.”

So, what can parents, teachers, and other compassionate adults do to prevent the teens they love from slipping into unhealthy patterns? Here are two suggestions:

1. Investigate why teens use substances in the first place.

Teens, as well as adults, misuse and abuse substances for a wide variety of reasons. Some research suggests people with anxiety use substances to “even out.” Jeannette Friedman, Master of Social Work (MSW) recalls, “I’ve had very stressed-out kids say, ‘I get high before I go to school because I’m so anxious when I think about the start of the school day. If I smoke a little weed, I don’t feel so anxious.’” In fact, pre-gaming, something often associated with fun, is actually a symptom of anxiety. “Kids are saying, ‘Let’s go have some fun before we go to the real party.’ But in fact, most of them feel like they need it to calm down enough so they can walk into a group where they’re going to feel exposed,” notes Ms. Friedman.

Dr. Taskiran adopts an alternative theory that is not mutually exclusive to Friedman’s hypothesis. He argues many depressed teens use substances to cheer themselves up and blunt the irritability that is a common symptom of depression. “They know there’s something wrong with them,” he says. “They’re not taking pleasure in things [and] they’re not feeling happy. So, if their peers are offering a drug that makes you happy, that’s often the first thing they turn to.”

Lastly, research on teenage substance misuse and abuse routinely proves that self-esteem and the desire to “fit in” are frequent reasons for substance abuse. Fighting peer pressure is a challenge for people of all ages, but teens are more vulnerable to it because “fitting in” is such an influential part of adolescence.

2. Replace, don’t restrict.

Most parents can attest that telling a teen not to do something is one of the most effective ways to get them to do the opposite. Dr. Taskiran explained, “The last thing I’d say to one of my patients is, ‘Marijuana is bad for you,’ because the kid has heard that from teachers, parents, TV, everywhere. So instead, what I say is, ‘What is it doing for you? What are you getting out of it?’” This forces teens to reflect on their intentions, which can be enough of a paradigm shift for them to change their behavior.

However, if it’s not enough, replace substances with activities that offer the brain a similar release. Offer to go on a walk with your teen to help them relax. Recommend individual or group therapy to process unhappy and confusing thoughts and feelings. Understand that substance abuse is often an indication of other underlying issues that can be coped with in many ways that don’t require ingesting anything.

Maintaining positive mental health can be burdensome and overwhelming. But it is the responsibility of adults to assist teenagers in building the right coping skills to maintain holistic health and happiness. We all share this duty. Thank you for your continued dedication to this effort. Click below for more resources that may help.