Teenage Substance Abuse? 15 Signs of a Troubled Youth

Troubled teens throw families into utter chaos. Every teenager goes through mood changes and volatility so it can be hard for some parents to decide on what is in the normal range for teenage behavior. As a psychiatrist that specializes in helping families with addicted teens or young adults, I try to educate families on what are the warning signs that they may have a troubled teen on their hands. Here are 15 signs of a troubled teen:

1. Is your teen using drugs or alcohol (teen substance abuse)?


2. Is your teen having significant mood swings?


3. Does your teen isolate in their room right after school?


4. Has your teen's school performance changed for the worse?


5. Is your teen skipping classes and blowing off homework?


6. Has your teen quit eating with the family and quit participating in family activities?


7. Is your teen losing weight?


8. Has your teen's sleep pattern changed?


9. Does your teen seem depressed or anxious?


10. Has your teen withdrawn from their former group of friends?


11. Is your teen hanging around with friends that seem like a bad influence?


12. Is your teen breaking rules and being defiant of authority?


13. Has your teen gotten in any legal trouble (shop lifting)?


14. Does your teen seem agitated?


15. Is your teen lying a lot?

The most likely reasons you may have a troubled youth is that your teen either is abusing drugs or alcohol (teenage alcoholism or teenage drug abuse), suffering from anxiety, or depression, or your teen has developed an eating disorder (or a combination of these). Most of the other warning signs stem from these conditions. Anxiety and depression can lead to a teen using drugs and alcohol in an attempt to feel better or, conversely, teenage alcoholism or teen drug abuse can actually cause anxiety and depression. RJ, is an 18 year that I saw in my practice. His parents brought him to me because he was skipping school and told them he felt very depressed. He had already been kicked out of 4 schools due to skipping classes and not turning in homework assignments. His parents had sent him to several alternative school environments and were at their wit's end. On evaluation he was suffering from clinical depression and an Anxiety Disorder.

However, he also suffered from teen drug addiction and teenage alcoholism. With a patient like RJ, is unclear if his depression or anxiety came before the drug and alcohol use or after the abuse. He had been abusing drugs and alcohol since he was 14 years old. He also had a family history of depression. To give him the best outcome, I withdrew him from drugs and alcohol with medication that prevented symptoms of withdrawal. I then prescribed an antidepressant that also helps anxiety. Antidepressants are not addicting. I also worked with the family and helped to teach both parents to set boundaries with their son and let him suffer the consequences of any drug and alcohol use. They also agreed to go to Families Anonymous meetings. RJ participated in group therapy with other kids his age who suffer from addiction. RJ, one year later, has maintained his sobriety and is going to a school that has a self paced program. He continues to take antidepressants and is not depressed or anxious. He gets along much better with his parents now who have learned to set limits with him. RJ has done well because his treatment has involved getting him off drugs and alcohol so he did not suffer withdrawal. His therapy has involved dealing with addiction and learning new coping skills and communication skills. The antidepressants have helped with depression and anxiety so that he can function at a higher level. His parents have learned to raise their expectations of him by setting limits if he doesn't honor basic responsibilities. A successful outcome with a troubled teen demands a multi-factorial approach.