#JamesDonaldson On #MentalHealth – #MentalHealthDisorders And #Teen #SubstanceUse

Why it's especially tempting — and risky — for #kids with emotional or #behavioral challenges

Writer: Caroline Miller

Clinical Expert: Sarper Taskiran, MD

What You'll Learn

- Why is #substanceuse more dangerous for #teens with #mentalhealthdisorders?

- Why do #teens with #mentalhealthdisorders use substances?

- Why does #substanceuse make a #mentalhealthdisorder worse?

- Quick Read

- Full Article

- Why are #kids with #mentalhealthdisorders prone to #substanceuse?

- Why is #alcohol use riskier for #teenagers?

- Why #teenagers get addicted sooner

- Why #substanceuse makes #depression and #anxiety worse

- #Psychosis and #substanceuse

When #teenagers are upset or angry, they often turn to #alcohol or #drug use to help them manage their feelings. While #adults do this too, a #teenager’s brain is still developing. So if teens use #drugs or #alcohol to feel better, they’ll run into problems more quickly than #adults.

Drinking or smoking #marijuana can help make #hopelessness, #anxiety, irritability and negative thoughts disappear quickly. But over time, they’ll make them worse. #Teens also become addicted more quickly than #adults. This is especially true if they have #mentalhealthdisorders.

If they’re not treated, almost half of #kids with #mentalhealthdisorders will end up having a #substanceusedisorder. This can make it harder to treat their #mentalhealth. It can also impact their future.

#Alcohol affects #teenagers differently. Instead of slowing them down, #alcohol can make #teens feel more energetic, do riskier things and get more aggressive. Drinking is even more dangerous for #kids with #ADHD because they’re already impulsive. #Substanceuse can also make depressed #teenagers more prone to impulsive #suicidalbehavior.

#Substanceuse is also a problem for #teens or young #adults with #schizophrenia. If a person with #schizophrenia uses drugs or #alcohol, they’re more likely to have psychotic episodes.

Experts note that to encourage #teens to reduce or stop #substanceuse, it’s important give them other coping strategies to manage their problems without turning to substances.

When #teenagers are struggling with emotional problems, they often turn to #alcohol or #drug use to help them manage painful or difficult feelings. In this they are not different from #adults. But because #adolescent brains are still developing, the results of #teenage “self-medication” can be more immediately problematic.

In the short term, #substanceuse can help alleviate unwanted #mentalhealthsymptoms like #hopelessness, #anxiety, irritability and negative thoughts. But in the longer term it exacerbates them, and often ends in abuse or dependence. #Substanceuse escalates from experimentation to a serious disorder much faster in #adolescents than it does in #adults, and that progression is more likely to happen in #kids with #mentalhealthdisorders than in other #kids.

“The rule of thumb is that almost half of #kids with #mentalhealthdisorders, if they’re not treated, will end up having a #substanceusedisorder,” explains Sarper Taskiran, MD, a #child and #adolescent #psychiatrist at the #ChildMindInstitute.  A 2016 study of 10,000 #adolescents found that two-thirds of those who developed #alcohol or #substanceusedisorders had experienced at least one #mentalhealthdisorder.

#Substanceuse also interferes with treatment for #mentalhealthdisorders and worsens the long-term prognosis for a #teenager struggling with one. How can we help these young people avoid the #substanceuse trap when the deck seems to be stacked against them?

#James Donaldson notes:
Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.
Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.
Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.  #http://bit.ly/JamesMentalHealthArticle

Order your copy of James Donaldson's latest book,
#CelebratingYourGiftofLife:
From The Verge of Suicide to a Life of Purpose and Joy

www.celebratingyourgiftoflife.com

Why are #kids with #mentalhealthdisorders prone to #substanceuse?

#Kids who are anxious or depressed may feel more emotionally “even” if they drink or smoke #marijuana. For socially anxious kids, it can quiet the #anxiety enough to allow them to function in peer groups. And since their friends do it, it’s not stigmatized the way taking medication is.

“Pre-gaming is a lot about #anxiety,” notes Jeanette Friedman, MSW, who works with families of #adolescents with #substanceuse problems. “The #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 and criticized.”

A #teen with #anxiety might start by smoking #marijuana to calm down before social events, and soon find himself smoking every morning just to get to #school. “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,’ says Ms. Friedman. “‘If I smoke a little weed, I don’t feel so anxious.’”

#Kids who are depressed may use #alcohol or #marijuana to cheer themselves up, Dr. Taskiran notes, and blunt the irritability that is a symptom of #adolescent #depression. “They know there’s something wrong with them,” he says. “They’re not taking pleasure in things, 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.” #Substanceuse can quiet negative thoughts that plague depressed #kids.

It’s also common for #children with #mentalhealth or #learningdisorders to develop #self-esteem problems, a sense that there’s something wrong with them or that they’re flawed. When these #children reach #adolescence, with its focus on fitting in, notes Ms. Friedman, “they really want to be normal and they don’t feel normal. And that means they’re more vulnerable to somebody passing around a #drug, because they’re just trying to feel better.”

Why is #alcohol use riskier for #teenagers?

#Alcohol affects #teens differently from #adults. While #adults tend to get more subdued and slowed down by #alcohol, in #adolescents it’s the opposite. They tend to become more energetic, engage in more risky #behavior and get more aggressive.

Dr. Taskiran uses the example of driving.  “When #adults drink and drive you worry about slowing of the reflexes and lapses in attention, like missing a stop sign,” he explains. “But with #adolescents, we’re worried that they’re going to get more activated. It’s not that they won’t see the red light, but they might try to run it.”

This is especially dangerous for #kids with #ADHD, who are already impulsive. And #substanceuse makes depressed #teenagers more prone to impulsive #suicidalbehavior.  “The #adolescent will still be depressed,” says Dr. Taskiran, “but the things that usually hold him back won’t be there while he’s intoxicated, like love for family or the belief that he’s going to get better.”

Why #teenagers get addicted sooner

#Adolescent #alcohol or #drug use accelerates very quickly when an untreated #mentalhealthdisorder is present. ”Within months we can see problematic use,” says Dr. Taskiran.

Why are they different than #adults? In the #adolescent brain, pathways between regions are still developing. This is why #teens learn new things quickly. This “plasticity” means the brain easily habituates to #drugs and #alcohol. “If you start drinking at 30, you don’t get addicted nearly as fast as if you start drinking at 15,” adds Ms. Friedman.

#Alcohol and #drugs also affect the same brain regions that are at play in #behaviordisorders like #ADHD and #ODD, says Dr. Taskiran. #Teenagers who have those disorders get more satisfaction from the substance — and are more likely to become addicted. “Biologically they get more from the drug,” he adds, “so that’s why they get more hooked on it.”

It’s important to know that #substanceuse can have disrupt a young person’s life even if he is not technically dependent on the drug. This is especially true for #youth with #mentalhealthdisorders. “You might not see withdrawal, you might not see the craving, which are the hallmark symptoms for dependence,” says Dr. Taskiran. “But the impact in his social life and academic life, or in terms of his #mentalwellbeing, might still be large.”

Why #substanceuse makes #depression and #anxiety worse

“Self-medicating” with recreational #drugs and #alcohol works temporarily to alleviate symptoms of #anxiety or #depression because they affect the same brain regions that the disorders do. But the result is that #teens feel even worse when not using.  That’s one reason #substanceuse is a risk factor for #suicide in #kids with #depression, Dr. Taskiran notes.

 Another negative effect of #substanceuse is that it undermines treatment. First, it diminishes a #teenager’s engagement in therapy, and hence its effectiveness. Second, if she is taking prescription medication, it may lower the effectiveness of that medication. “The #drugs and the medications target the same areas of the brain,” explains Dr. Taskiran. When meds have to compete with #drugs or #alcohol, they are less effective. “Also, it’s not uncommon with #kids who are using substances to be noncompliant with their meds.”

#Psychosis and #substanceuse

Michael Birnbaum, MD, is a #psychiatrist who heads an early treatment program for young people who have had a first psychotic episode, usually signaling the onset of #schizophrenia. Dr. Birnbaum estimates that at least 50 percent of his #patients have at least some history of #drug and #alcohol use. Getting a handle on #substanceuse is important for the recovery process, he says. “Folks who are still using are more likely to struggle with ongoing psychotic symptoms, and also are more likely to have a relapse.”

Most of the people who come to the early treatment program have just come from a hospitalization, he notes,  and they are  eager to make sure that doesn’t happen again. “So part of the discussion is how do we prevent a relapse?” he continues. At Dr. Birnbaum’s program, clinicians work to understand what #substanceuse was doing for the #patient. “It may seem obvious to us,” he says. “’Okay, you need to stop using now.’ But there may be other reasons for continued use that, to the patient, outweigh the risks.”

Dr. Taskiran echoes that approach. “The last thing I’d say from the get-go 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?’”

All #behavior serves a purpose, even if it’s self-injurious or risky #behavior. “If you’re trying to take something away from a #teenager, you need to replace it with something,” says Dr. Taskiran. “So instead of just saying, ‘Don’t do that, it’s bad for you,’ we’re trying to replace the need for substance with a coping strategy, with tools for coping without the substances.”

https://standingabovethecrowd.com/2023/02/jamesdonaldson-on-mentalhealth-mentalhealthdisorders-and-teen-substanceuse/