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Helping Teens with Co-occurring Disorders

Adolescents with mental illness and substance use disorder need support and healing.

It’s well-known that teens can be moody, emotional, and withdrawn. While those are sometimes normal teen behaviors, they may also be the symptoms of a mental illness. Like substance use disorder, mental illnesses can be difficult to diagnose in teens because the signs and symptoms can mimic normative teen behaviors.

“It can be hard to identify the signs of mental illness because teens demonstrate some of these symptoms regularly during adolescence,” said Jaymes Murphy, business development assistant at Clearfork Academy, a residential, Christ-centered treatment center in Fort Worth, Texas.

Many of the teenagers who come for treatment at Clearfork Academy are dealing with co-occurring mental illness and substance use disorder. Murphy said the most common mental illnesses among the teens he works with are:

Generalized anxiety: an excessive worry about everyday matters.Social phobias: severe feelings of self-consciousness and insecurity in social settings.Depression: persistent feelings of sadness, anxiety, and/or emptiness.

Sometimes parents think that the symptoms of these illnesses are just their teen’s way of coping with the stresses of adolescence. Parents might think that the behaviors are a phase or something that the teens will outgrow, but if true mental illness is present it’s important that teenagers have access to a proper diagnosis, which can in turn help facilitate effective treatment.

“These symptoms can be very difficult to spot because children’s personalities are not yet fully formed,” Murphy said. “They can become overly shy in many situations or through the awkwardness of their teenage years they can become moody or anxious easily.”

However, parents who are concerned should reach out for professional help. Often times a teen’s primary care provider or pediatrician can give an initial assessment, and refer the family to more specialized mental health care if necessary.

In order to help a teen get an accurate diagnosis, parents should be upfront with the doctor and express all of their concerns and observations.

“To make the process as easy as possible and to determine a diagnosis quicker you should provide your healthcare professional with as much detailed information as you can,” Murphy said.

This includes:

Past mental health evaluations and other medical records.Descriptions of symptoms, when they began, and whether they have changed over time.Any medications or other medical treatments that your child is receiving.Anything else that is requested or that you think might be valuable information.

Parents need to remember that they should not be embarrassed about their teen’s mental health.

“Don’t let shame interfere with getting help,” Murphy said. “Think about the idea that you would seek professional medical assistance if your child had a physical impairment. Although unseen, the brain still requires the same kind of care. Do not write off what your child seems to be feeling or discount the way that they act in hopes that it will ‘wear off.’”

Getting proper treatment at a facility like Clearfork Academy that specializes in the treatment of teenagers is important. At Clearfork, the team uses a biopsychosocial assessment, an interdisciplinary model that examines the connection between biology, psychology and socio-environmental factors in a teen’s behavior. From there, the clinical team determines what (if any) medication a teen needs to manage their mental illness, and what behaviors can be changed through therapy and emotional regulation.

“Once that evaluation occurs the real work begins. We can begin to strip away the dependency on illicit drugs and alcohol as a way of coping with what lies beneath the surface,” Murphy said. “We start the journey of standing with our teens and evaluating their life from a different perspective, asking the hard questions like where does my anxiety, depression, hurt and anger stem from? What are some healthy ways to cope with this junk in my life?”

This is difficult for teens, but is also instrumental for ongoing stability.

“This is perhaps one of the biggest most fragile times in a treatment setting because our teens are conducting self-analysis,” Murphy said. “They are putting in blood, sweat, and tears to determine their hurts, habits, and hang-ups. That is a big ask for anyone let alone a teen.”

However, staff members who are professionally trained and who have their own experiences with mental illness and substance use are able to connect with teens and guide them through that difficult work.

“We recognize those hurts because we have been there,” Murphy said. “We can walk beside them because we have walked through it ourselves. By meeting them where they are in those hurting moments and saying, ‘no matter what you do to me, or how much you say you hate me, I’m not leaving your side’ we bring them hope which blossoms into a breakthrough and an understanding of their present circumstances.”

That allows the adolescents to cope with their mental illness and substance abuse in a way that that they can understand.

“They gain perspective on themselves and we introduce coping mechanisms that not only help them manage their illness throughout their lifetime but allow them to thrive,” Muphy said.

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