What’s the Link Between Depression and Teen Substance Use?

Statistically speaking, teenagers who consume drugs or alcohol have elevated odds of developing symptoms of major depression or some other depressive illness. However, researchers don’t fully understand why the connection between depression and substance use exists among people in this age group. In a study published in September 2014 in the journal Drug and Alcohol Dependence, researchers from the University of Southern California explored this topic. They concluded that the presence of a personality tendency called negative urgency largely helps explain why teens affected by depression are often substance users.

Teens and Substance Use

Roughly 24 percent of American teenagers consume alcohol in the average month, according to the 2013 results of Monitoring the Future, a National Institute on Drug Abuse-sponsored annual survey that tracks substance intake patterns among U.S. 12th graders, 10th graders and eighth graders. In addition, roughly 17 percent of American teens consume an illicit/illegal drug in the average month; marijuana consumption accounts for the clear majority of this drug use. Adolescent drug intake has been on the rise in the U.S. since 2008. However, current levels of use still fall well below peak levels set in the mid-1990s. Alcohol use is steadily declining among American teenagers. Monitoring the Future also tracks teen cigarette use. In 2013, approximately 10 percent of U.S. teens smoked cigarettes in the average month. This level of use marks a continuation of a long-term trend of lowered cigarette intake. Broadly speaking, older adolescents have substantially higher odds of drinking, using drugs or smoking than their younger counterparts.


Most people know about major depression, a severe mental health condition capable of robbing affected individuals of their motivation and ability to enjoy everyday life or maintain a sense of well-being. Subtypes of this condition include seasonal affective disorder (SAD), postpartum depression and psychotic depression. Other officially diagnosable forms of depressive illness include dysthymia or persistent depressive disorder, premenstrual dysphoric disorder and disruptive mood dysregulation disorder. In addition, doctors can separately diagnose depression triggered by the consumption of drugs, alcohol or a medication. Major depression is America’s most common severe mental illness.

Negative Urgency

All people have their characteristic reactions to highly stressful situations. Psychologists and psychiatrists use the term negative urgency to refer to people who react to such situations by acting in impulsive or reckless ways. As a rule, people affected by negative urgency have certain underlying personality traits, including a relatively low level of sociability or agreeableness, a relatively low level of conscientious or considerate behavior and a relatively high level of neurotic or anxiety-based behavior.

From Depression to Substance Use

In the study published in Drug and Alcohol Dependence, the University of Southern California researchers used an assessment of 476 teenagers to explore the connection between adolescent depression and adolescent substance use. Specifically, the researchers examined the impact of the rash and reckless reaction to stressful situations that characterizes negative urgency. All of the study participants self-reported their level of involvement in drug, alcohol and tobacco use, as well as their experiences with symptoms of depression and their typical reactions to stressful situations. The researchers confirmed the link between experiencing depression symptoms during adolescence and increased odds of using a range of substances, including alcohol, marijuana, opioid pain relievers, tobacco/cigarettes and the makeshift group of drugs called inhalants (which are particularly popular among younger teens). In addition, the researchers linked the presence of depression to unusually early initial use of alcohol and cigarettes, as well as relatively frequent alcohol and cigarette intake. The researchers concluded that the behavioral impact of negative urgency largely explains the connection between depression and the odds of using drugs, alcohol or cigarettes. In addition, they concluded that negative urgency helps explain the connection between depression and the increased likelihood of beginning alcohol use at an unusually early age. The study’s authors note that, while negative urgency forms a connection point between adolescent depression and adolescent substance use in general, it does not appear to have an impact on how often a teen substance user consumes drugs, alcohol or tobacco. The authors believe that public health efforts that highlight the role of negative urgency may substantially deter substance use among teens affected by depression. They also specifically underscore the potential effectiveness of addressing negative urgency in teenagers who currently consume inhalants or alcohol. By: Gideon Hoyle