Substance-Induced Mood Disorders: What To Look For With Your Teen

Substance-induced mood disorders, as they imply, are mood disorders caused when someone either starts or stops taking a particular substance. These disorders impact the way that you think, feel, or act, and the mood change can last for days or as long as several weeks. Prescription medications and illegal drugs can result in depression, an extreme increase in energy, and an inability to control one’s actions (similar to mania or a manic mood).

One’s thoughts, emotions, and actions are impacted by chemicals that are made in the brain. Without the correct balance of their brain chemicals, or when drugs and prescription medications are taken in excess, it changes the balance of these chemicals. And unfortunately, some illegal drugs and prescription medications can cause mood problems while you are taking them. In most cases, substances that are considered when referred to substance-induced mood disorders include:

• Alcohol and illegal drugs such as cocaine and lysergic acid diethylamide (LSD, otherwise known as acid)
• Nonprescription medicines including decongestants
• Prescription medicines to treat heart problems and high blood pressure
• Prescription pain medicines, antianxiety medication, antidepressants, etc.

Symptoms of Substance-Induced Mood Disorders in Teens and Adolescents

Teens, regardless of their age and the type of mood disorder that they experience will likely show varying and different symptoms of depression. Typical symptoms of a substance-induced mood disorder may include:

• Perpetual feelings of sadness
• Feelings of hopelessness or helplessness
• Low self-esteem
• Feelings of inadequacy
• Excessive guilt
• Expressing feelings of wanting to die or exhibiting behaviors of self-harm
• Suicidal thoughts or attempts
• Loss of interest in activities that the teen once enjoyed
• Difficulty with maintaining and developing relationships
• Insomnia or hypersomnia
• Changes in appetite or weight (an increase or decrease)
• A decline in energy levels
• Difficulty concentrating
• Inability to make decisions
• Frequent physical complaints of headache, stomachache, or fatigue
• Threats of running away from home (or actually running away from home)
• An extreme hypersensitivity to failure or rejection
• Irritability, hostility, or aggression (or combination of all)

With mood disorders, the above feelings or ailments often appear more intense than what teens would be expected to feel from time to time as a normal part of youth. It is of additional concern if these feelings continue for a course of time longer than just a few days, or if they interfere with the teen’s interest in being with friends or taking part in regular and expected activities at home, school, or from a part-time job. While teens who express thoughts of suicide should be evaluated right away and without hesitation or presence of any other symptoms, it is vital to note that other possible symptoms of substance-induced mood disorders in teens may include:

• Difficulty achieving in school
• Constant anger
• Rebellious behaviors
• Trouble with family
• Difficulty with friends and peers

Examples of Certain Substance-Induced Mood Disorders 

Substance-induced disorders are different from autonomous co-occurring mental disorders as all or most of the psychiatric symptoms are the correlating result of the use or abuse of a particular substance. But this doesn’t mean that substance-induced disorders exclude or hinder co-occurring mental disorders. It simply means that if the specific symptoms manifest at a definitive point in time, it is more likely the outcome of substance use or abuse, intoxication, or withdrawal rather than that of an otherwise underlying mental illness. 

This said teens can indeed experience both substance-induced mental disorders and mental disorders that are not the root cause of substance abuse. Since approximately one in five teens in the U.S. suffer from a mental illness or disorder that is serious enough to impact their daily activities. This can make it all that more difficult to determine the root causes of these disorders.

Some examples of common substance-induced mood disorders include:

• Alcoholism or alcohol abuse – In most people, teens included, moderate to heavy consumption of alcohol is correlated with euphoria, moodiness, an inability to manage impulses, and increased social confidence (i.e., getting high). Such manifestations might even appear hypomanic, and with teens in particular, these symptoms are generally followed the next-day with fatigue, nausea, and a hangover. For teens that are faced with multiple stresses from parental pressure, academic requirements, etc., the initial alcohol use can give the teen a sense of escape. However, as the addiction to alcohol continues, the moodiness and inability to manage impulses can lead to the increased predilection of violence towards oneself as well as others. Prolonged alcohol use causes an increase in the incidence of dysphoria, anxiety, and a potential for violence. As teens may try to manage their alcohol use on their own, they will often experience feelings of alcohol withdrawal such as agitation, anxiety, tremors, an exaggeration of reflexes, rapid heartbeat, increased blood pressure, profuse sweating, inability to sleep, nausea, or vomiting.
• Amphetamine and cocaine abuse – Teens who experiment with amphetamines or cocaine tend to experience a feeling of euphoria, as well as a sense of internal well-being. This then creates the perception in the teen that they are more powerful or strong, and that they can accomplish anything. And unfortunately, as low to moderate doses of amphetamines can increase certain test-taking skills temporarily in those with attention deficit disorders, many teens turn to these drugs not only for the euphoric feeling but also because they believe it will help them academically or in another related manner. With street cocaine and methamphetamines, however, the typical dosing is usually beyond the window that allows teens to function. Thus, as the dosage increases, the chances of dangerous impulsive behaviors increase as well, including, violence, promiscuity, etc. Teens who become chronic heavy users of these substances will often go on to experience paranoid delusional states, usually for just a temporary period of time, but in some extreme cases, this can last far longer. 
• Opioids – Teens who experiment with opioids often experience an intense feeling of euphoria or well-being. When teens stop using the drug, their withdrawal results in agitation, extreme body aches, gastrointestinal disruptions and discomfort, dysphoria, and a craving to continue the use of opioids. Even with abstinence from opioids, anxiety, depression, and insomnia can linger for weeks.

Assessing and Treating Substance-Induced Mood Disorders

Teens who have been abusing various substances will at some point begin to exhibit the symptoms of a mood disorder, even though they might initially be able to hide their addiction and drug or alcohol use. In many cases, the symptoms start to be exhibited when a teen tries to stop their use, or when they are suffering from acute intoxication or withdrawal. When substances are involved, the ability of a physician to provide diagnostic certainty becomes complicated. As such, in most situations, treatment will begin with a period of substance abstinence (via a detoxification process) which provides an opportunity for the symptoms of acute intoxication and withdrawal to subside.

Physicians will generally start by recommending that the teen enter a rehabilitation treatment program, especially if they are exhibiting four or five of the aforementioned symptoms. Rehabilitation can be highly effective, and in many cases, the experience creates a major turning point in the teen’s life. Unfortunately, the vast majority of addicted teens do not receive treatment for their substance-induced mood disorder.

Teens who are admitted to rehab will go through proper diagnosis, and their treatment plan will then be customized based on their addiction and symptoms. When your teen arrives for rehab, there’s a good chance that the offending substance will still be actively coursing through their system. The process of detoxification is where their body flushes the drugs or alcohol out of the system so that it can begin to heal. The human body will do this naturally, and the length of time will vary based on the patient’s situation and the particular substance that they were abusing. 

It is highly suggested that detoxing be conducted under the care of medical and therapeutic professionals to ensure that it is done safely, and out of reach from harmful substances. Many parents mean well and try to approach the detoxification process at home, but as the teen may experience withdrawal symptoms, doctors are far better equipped to aid the teen through any withdrawal pains.

Using Therapy During the Rehabilitation Process 

Teen drug and alcohol rehabilitation is often focused on using therapy. In teenagers with substance use disorders (SUDs), biological factors play an immense role. The nucleus accumbens is still developing during the teenage years, which explains the teen’s tendency for thrill-seeking. The nucleus accumbens plays a key role in the reward circuit of the brain as its operation is based primarily on these two critical neurotransmitters: 

• Dopamine – Promotes desire
• Serotonin – Effects satiety and inhibition

These factors, in combination with genetic and environmental factors, can help medical professionals understand why a teen is struggling with substance abuse, and what led to the abuse. To fully understand and address your teen’s problem comprehensively, the first course of action during the rehabilitation process (after detoxification) is one or more types of therapy. 

After detoxification, your teen’s physician will help to determine if the teen will require inpatient rehabilitation (residential stay), or outpatient rehabilitation. The specific rehab program will then determine the type of therapy. Therapy is available and offered in both individual and group settings. Depending on the severity and complexity of your teen’s situation, along with the substance or substances that they have been abusing, their doctor may prescribe one or more of the following types of therapy, in addition to other methods not listed here.

• Cognitive behavioral therapy (CBT) – This treatment option works to uncover why the teen decided to use an illegal substance or a prescription medication. CBT is based on the premise that thoughts are what cause behaviors and the way we perceive, interpret, and assign context to the environment in which we live and breathe. During a teen’s rehab for substance abuse, sessions of CBT encourage the teen to develop self-regulation and coping skills, use various strategies to avoid high-risk situations, people or places, and to develop skills to enable the development of problem-solving skills and to develop better communication skills.
• Family therapy – In many cases, the physician will recommend family therapy for the teen, parents, and siblings within the home. Family-based therapy underscores the role of the family in a teen’s substance abuse. Family therapy sessions aim to bring together those closest to the teen and then address ongoing issues and concerns such as poor family communication, a lack of cohesiveness, and an inability to problem solve. This method of treatment focused on the fact that the family has the greatest and most profound and long-lasting influence on the teen’s development. 
• Recreational therapy – Especially important for teens, recreational therapy engages teens in active leisure activities such as sports, arts and crafts, group games, etc. Healthy leisure and physical activity can benefit the teen in several ways, and recreational therapy helps to treat the whole person and not just the mind. In the worst of substance addictions, a teenager can easily forget how to enjoy life outside of drugs or alcohol, and in fact, a loss of interest in activities that the teen once enjoyed is a common symptom that helps parents and medical professionals to identify the presence of a substance-induced mood disorder. Recreational therapy then helps the teen to effectively loosen up throughout the process of treatment and helps them to rediscover the positive traits of their personality, essentially, who they are. The process of bonding with other recovering addicts, and relearning how to interact with others in a healthy way can improve physical health and provide a boost to the teen’s self-esteem and their feelings of self-worth. 

Supporting Your Teen Through Their Substance-Induced Mood Disorder

No parent ever wants their teen to suffer, and so parents are often as confused as they are motivated in wanting to help their child clean or sober up, and get back to the wonderful child that they used to be. However, parents need to understand that who their child was may not be who their teen will be after recovery. In many cases, the teen who comes out of the rehabilitation process is a better version of themselves. Thus, parents need to stay supportive be keeping an open mind, and ensuring that they are not latching onto beliefs or experiences of the past.

As a final note, the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline is available at 1-800-662-HELP (4357). This line is confidential, free, and available 2every hour of the day and every day of the year for teens, adults, and other family members experiencing mental and/or substance abuse disorders. This service will provide a referral to local treatment facilities, and community-based organizations and support groups. Callers can also order publications (at no cost) and other resources and insightful information to help them through the addiction treatment and recovery process. If you’re in the Southern California area and are looking for a facility that may be perfect for you and your teen, reach out to Hillcrest for more information!