Depression Treatment Impaired by Teen Substance Use
A teen depression study by the National Institute of Mental Health shows that depression treatment is most effective when teens are not impaired by drug or alcohol use. While lower levels of teen substance abuse may allow teens to focus on managing their depression, researchers noted it is also possible that depression treatment led to less substance abuse among teens.The Link Between Depression and Teen Substance Abuse
Substance abuse is more common among teens with depression than among those without depression. In addition, depression can interfere with teens' response to substance abuse treatment, and substance abuse is associated with a poorer response to depression treatment.
The study, titled "Treatment of SSRI-Resistant Depression in Adolescents" (TORDIA), showed that teens who received a combination of antidepressant medication and cognitive-behavioral therapy were more likely to improve than those on medication alone.
Researchers examined the relationship between substance use, major depression and response to depression treatment. Substance use was defined as using alcohol or drugs without meeting the criteria for a substance abuse disorder.
Study Findings
Overall, substance use among teens in the study was fairly common, with roughly 28 percent reporting experimentation with drugs or alcohol. Teens who struggled with more severe drug or alcohol abuse were typically older, more depressed, had greater family conflict, developed depression at an earlier age, were more likely to have a history of physical or sexual abuse, and were more likely to have co-occurring oppositional defiant disorder (ODD) or conduct disorder (CD). The degree of substance abuse was evaluated based on certain attitudes and behaviors, such as drug cravings, feeling addicted, accidentally hurting oneself or others while using it, and other similar effects.
Participants with low levels of substance abuse throughout the study tended to respond better to depression treatment than those who showed high or increasing levels of substance use
The TORDIA study was one of the first to analyze the association between substance use and depression treatment among depressed teens. The conclusion that depression severity is associated with a history of physical or sexual abuse, ODD or CD, and substance abuse is consistent with past studies. However, in is unclear whether low levels of substance abuse improves depression symptoms, or whether improvement in depressed mood leads to less substance abuse
