Treating Addiction and Depression in Teens

Depression and addiction feed into one another. When teens suffer from depression or mental health concerns, in combination with substance use disorder, this is called ‘dual diagnosis’ or ‘co-occurring disorder.’ Both problems must be treated concurrently in order to best integrate things and provide the best plan for recovery.

Talk Therapies

Teens who are depressed can reach for drugs or alcohol as a way to lift spirits or numb painful thoughts and feelings. Depression and substance abuse feed into one another which can make things worse. Anytime a teen is experiencing depression or anxiety, substance abuse is risky. Treatment for other mental health conditions can help treat addiction. Medication can help treat depression including Serotonin Specific Reuptake Inhibitors (SSRIs). This includes:

  • Bupropion
  • Fluoxetine
  • Sertraline

Some common therapies that may help can include:

  • Dialectical Behavioral Therapy
  • Mindfulness-Based Relapse Prevention (MBRP)
  • Mindfulness Based Cognitive Therapy for Adolescents with PTSD and Addiction

Some combination of cognitive therapy and possibly mindfulness practice may help teach skills useful for recovery in regards to substance use and mental health conditions (including depression).

Cognitive Restructuring

This widely used approach in cognitive behavioral therapy is used to help people, including teens, deal with feelings of upset related to depression. It involves teaching people to identify thoughts or beliefs underlying depression and anxiety. This includes certain patterns of thinking that may have a direct impact on how a person feels.  It may include describing an upsetting situation, identifying feelings and finding underlying thoughts associated with the situation.

Addiction Treatment

Cognitive Therapy can be helpful in recovery from addictions. The therapist and teen can identify thoughts, feelings and circumstances which surround substance use and, early in treatment, play a critical role in helping the teen identify circumstances likely to lead to drug use and provide insights into the situation. Awareness of triggers can help identify circumstances likely to lead to drug use and provide insight into reasons why the teen may be using the drugs in the first place. Later in treatment, this may help in identifying situations or states where the individual has trouble coping and determine the best response for the situation.

Mindfulness Therapy

Substance abuse is an example of people’s tendencies to move towards pleasure away from pain. Drugs often cause a teen to experience internal psycho-emotional pain. Teens must learn tools for coping and adapting with pain. Mindfulness Therapy can help. This skill takes practice and the type of therapy mindfulness starts is moment-by-moment nonjudgmental awareness of feelings, thoughts and surroundings. Mindfulness therapy includes:

  • Being present to thoughts that arise
  • Differentiating thoughts from feelings
  • Observing thoughts
  • Reducing the tendency to exaggerate negative emotional states, diminishing feelings of guilt, shame, fear and criticism of others

Mindfulness helps instead of trying to ignore negative thoughts or to stop people from thinking. Mindfulness comes from regular practice of short and longer meditations and practices.

Key Lessons

Some of the key things teens with dual diagnosis can learn through mindfulness include:

  • Thoughts, emotions and sensations start, peak then slowly recede
  • Paying attention to how the mind works helps notice moving into past, memories, regrets and other negative feelings that may cause fear
  • Mindfulness is not about avoidance, it is allowing the mind to get out of the past and into the future
  • The present is the only moment that is happening or matters and it is with long term recovery that improving awareness offers insight into depression and addiction for recovery

Mindfulness practice teaches that the only moment that we have to learn about ourselves, to grow, and to change in in the present moment. For that reason Mindfulness Therapy can help with long term recovery and decreasing relapse by improving awareness and offering an opportunity to respond in the moment to triggers and automatic reactions and to act differently.


Sustain Recovery supports adolescent care in a residential setting 30-90 days in length. Call us to find out how to get support for a teen struggling with addiction and may need help for co-occurring issues.