Ole Miss study links teen depression with higher substance use rates

• Although the public has grown more aware of mental health challenges in recent years, resources for adolescents are lacking, said Andrew Yockey, a University of Mississippi assistant professor of public health.

Nearly 1 in 5 U.S. adolescents experienced depression between 2021 and 2023, and those teens were significantly more likely to use substances such as alcohol, marijuana and opioids, according to a new national study.

Andrew Yockey, a University of Mississippi assistant professor of public health, and graduate student Aminul Apu found that adolescents struggling with depression are more likely to use substances. Their study, published in the Journal of Medicine, Surgery and Public Health, underscores the need to treat mental health and substance use together, rather than as separate issues.

“Research shows that depression will be the top contributor to mortality by 2030, and we know it is affecting adolescents,” Yockey said. “Depression is something that we have pharmacologically studied for years, but in this study, we wanted to look at the shifting patterns and correlations between depression and drug use.

“We found that the rate of major depressive episodes is higher in people who use substances, and that teens experiencing depression are more likely to use substances. That’s a connection.”

In a review of the National Survey on Drug Use and Health data for 2021-23, Yockey and Apu found that alcohol and marijuana are the most common substances used among youth, with tobacco, inhalants and opioids being less common. Some 20% of youth also reported having at least one major depressive episode in the last year.

“There is a growing mental health crisis among adolescents,” said Apu, a second-year public health master’s student from Bangladesh. “And we know that there is also an increase in substance use in this population, so we wanted to have a better understanding of the overlap.

“This can inform things like treatment and prevention.”

Although the public has grown more aware of mental health challenges in recent years, resources for adolescents are lacking, Yockey said. This is especially true for rural youth, which is a high-risk population, according to the study.

Other high-risk populations included teen girls, who are three times more likely to report depression, and non-Hispanic white youth, who had the highest use rates of marijuana, inhalants and tobacco.

Instead of treating substance use as simply an issue of misconduct, a better approach might be to look for underlying reasons why adolescents use those substances, the researchers said.

“That would help for getting intervention services early and specifically targeting these populations that are at highest risk,” Apu said. “For some people, (substance use) could be a form of entertainment, but for others it could be self-medicating or responding to hormonal activities.”

Some substances, including alcohol, can heighten symptoms of depression, making intervention even more vital, the researchers said.

Yockey will continue his work on the intersection of depression and substance use through a new partnership with the University of Mississippi Medical Center. In that National Institutes of Health-funded study, Yockey and researchers from the School of Medicine will focus on suicidal thoughts in relationship to methamphetamine use.

“The third-leading cause of death for young adults in Mississippi is suicide,” the Ole Miss researcher said. “And especially in Mississippi, between 2015 and 2019, there was a nearly 150% increase in methamphetamine use.

“We believe there is a bi-directional relationship there: if you use methamphetamine, your likelihood for suicidality increases, and if you’re suicidal, you’re more likely to use stimulants like methamphetamine. But there isn’t much research showing that connection. That’s the gap we want to fill.”

This material is based in part on work supported by the National Institutes of Health grant no. 5U54GM115428-10.