When Help is Not at Hand

Teens turning to marijuana for emotional problems

Joan L. Bottorff, PhD, RN, FCAHS, Barbara M. Moffat, MSN, RN, Joy L. Johnson, PhD, RN, FCAHS

Reprinted from "Cannabis" issue of Visions Journal, 2009, 5 (4), p. 24

In British Columbia, close to 15% of children and youth suffer from a range of mental health issues: 6.5% experience anxiety and 2% suffer depression.1 One in seven children and youth experience mental health problems serious enough to cause significant distress and impair their functioning at home, at school, with their peers and in the community.2

So, we wanted to know what happens when youth, ages 13 to 18, have no one to turn to for help with their emotional challenges. According to the Canadian Community Health Survey, youth are the least likely of all age groups to seek assistance for mental health problems.3

The TRACE project

The TRACE (Teens Report on Adolescent Cannabis Experiences) research project at the University of British Columbia is aimed at understanding the context and culture of frequent marijuana use. In 2006, we began data collection in communities in three regions of British Columbia (Vancouver Island, the Kootenays and Vancouver). During in-depth one-on-one interviews, a total of 77 teens have shared their experiences and perspectives on marijuana use.

Although there have been a number of interesting findings from the TRACE study reported thus far,4-6 we were particularly struck by the number of teens who turned to marijuana to address uncomfortable feelings like depression and anxiety.7 We also found that youth often didn’t know of resources or support that could help them address their emotional problems. As a result, several described how they would isolate themselves and smoke marijuana in the confines of their bedrooms. At times, when teens shared their concerns with the adults they lived with, their concerns were not taken seriously. As a result, some turned to marijuana to find relief from their uncomfortable feelings. Teens often noted how they preferred marijuana over alcohol, believing it to be a healthier and safer option. However, many teens recognized that this was not the solution they were looking for.

Amanda’s* story

For over a year, Amanda noticed that she was feeling increasingly sad and depressed. At 16 years of age, she moved with her mom from a large urban setting to a small community. Amanda had difficulty settling into her new school, felt lonely and missed her best friend. She reported that just a week earlier, a girl in her class had teased her about her designer pants.

Amanda felt she had no one to talk to about how she was feeling. She felt distant from her mother, disliked her mother’s boyfriend and wasn’t comfortable talking to the school counsellors. Amanda confided in an older friend who lived with depression. This friend introduced Amanda to marijuana because “it helped.”

Amanda said: “I use marijuana to battle my depression, so I don’t have to feel anything. If I start to feel like I’m going into a low or am feeling really bad and need a quick pick-me-up, I’ll get my bong from the closet and smoke a few bowls. When you’re in a depression, you seriously believe it, so you need to get out of it. It’s like a pot that you’re boiling. You know, you put the lid on it and the water is boiling and it eventually starts boiling over.”

For Amanda, smoking marijuana was a way to relieve the intensity of her depression. Although she found it was “usually” helpful, it didn’t always work to help her feel better about herself. She also started to worry that she had become addicted to marijuana. During the interview, Amanda described how on her own initiative, she decided to see a psychologist at a health clinic to begin to explore her depression.

Dylan’s* story

Two years prior to participating in the TRACE interview, Dylan discovered that smoking marijuana helped him calm down when he felt anxious. He was always nervous meeting new people. Last September, his family moved across town, and he started attending a new school where he had few friends. Up until four months before he was interviewed, Dylan spent most of his time with his girlfriend. She had recently broken up with him, however, because of his regular marijuana use.

At home, he often felt annoyed and aggravated. His relationship with his mother was strained, he didn’t get along with his stepfather, and he had regular arguments with his older brother. He was concerned about his grades and worried that he’d have to repeat his school year or change schools again because of his academic performance.

Dylan reported that he didn’t smoke marijuana to get high, but to manage his nervousness, to “feel normal” and to calm down before sleeping. Dylan said: “I’m nervous talking to people. So it’s better when I smoke marijuana, because I’m not as nervous. I don’t usually smoke just to get high. Instead, I feel normal when I’m smoking marijuana.”

Dylan was concerned about having to rely on marijuana in this way. He was aware that his marijuana use was a temporary solution that “helped at the moment.” But he also recognized that he wasn’t really addressing his problems. Two of his friends were attending weekly meetings at his school. The friends described the meetings as opportunities to talk about some of the “stuff” going on in students’ lives, and there was free pizza. At the time of our interview with Dylan, he had decided to attend to see if this might help.

New approaches needed to help teens with mental health concerns

There are health risks for youth that use marijuana, including dependence to marijuana. Withdrawal symptoms and cravings are signs of dependence among some youth who smoke marijuana regularly.8 Research suggests that dependence on marijuana affects one in six to seven youth who use marijuana, and that those who are dependent are at risk for symptoms of depression and psychosis.9 This evidence, together with published findings from the TRACE project,7 indicates that new approaches to addressing teens’ mental health concerns are needed. By linking teens with supportive community resources and appropriate health care providers, fewer teens may choose to rely on marijuana for relief from their emotional problems.

School staff are well positioned to recognize changes in students’ academic performance and emotional well-being. And schools are the logical place for students to access support in times of need. For example, Vancouver’s SACY (School Age Children and Youth) substance abuse prevention program has piloted an alternative suspension program for students caught drunk or stoned. Suspended students work with a helping adult at a central location to do a substance use self-assessment and develop a plan to re-enter their school, substance free. The plan includes identifying an adult ally at their school who they can approach for support.10

Other community-based programs are also available. One example, the Freedom Quest Regional Youth Services in the Kootenays, offers counselling and advocacy while focusing on reducing risks associated with substance use (website: www.freedomquestonline.ca/index.htm).

Some of the youth interested in finding better ways to manage their uncomfortable feelings were able to connect with programs like this in their school or community. They found turning to others instead of marijuana helpful. Several TRACE participants, at the end of the interview, talked about the benefits of being able to talk about marijuana and what is going on in their lives. They made the point that the TRACE interview was the first time they had been able to talk to someone about their problems.

Paying attention to youth with emotional problems like depression and anxiety, taking their concerns seriously and connecting them with the resources they need is essential for promoting youth mental health. 

* pseudonyms; these are constructed stories using real data

 
About the author

Joan is a Professor in the Faculty of Health and Social Development and the Director of the Institute of Healthy Living and Chronic Disease Prevention at UBC Okanagan.

Barbara is Project Director for the TRACE (Teens Report on Adolescent Cannabis Experiences) project of the Centre for Nursing and Health Behaviour Research at the UBC.

Joy is a Professor at the UBC School of Nursing. She is also Scientific Director at the Institute of Gender and Health, a branch of the Canadian Institutes for Health Research (CIHR), the Canadian government’s agency responsible for health research funding

Footnotes:
  1. British Columbia Minister of Children and Family Development. (2003). Child and youth mental health plan for British Columbia. Victoria: Author. www.mcf.gov.bc.ca/mental_health/mh_publications/cymh_plan.pdf.

  2. British Columbia Ministry of Children and Family Development. (2008, May 20). Report highlights improved mental health services [Press release].www.llbc.leg.bc.ca/public/PubDocs/bcdocs/439481/2008CFD0027-000788.pdf.

  3. Statistics Canada. (2003, September 3). Canadian Community Health Survey: Mental health and well-being. The Daily. www.statcan.ca/Daily/English/030903/d030903a.htm.

  4. Haines, R.J., Johnson, J.L., Carter, C.I. et al. (2009). ‘‘I couldn’t say, I’m not a girl’’—Adolescents talk about gender and marijuana use. Social Science & Medicine, 68(11), 2029-2036.

  5. Johnson, J.L., Moffat, B., Bottorff, J. et al. (2008). Beyond the barriers: Marking the place for marijuana use at a Canadian high school. Journal of Youth Studies, 11(1), 47-64.

  6. Moffat, B.M., Johnson, J.L. & Shoveller, J.A. (2009). A gateway to nature: Teenagers’ narratives on smoking marijuana outdoors. Journal of Environmental Psychology, 29(1), 86-94.

  7. Bottorff, J.L., Johnson, J.L., Moffat, B.M. et al. (2009). Relief-oriented use of marijuana by teens. Substance Abuse Treatment, Prevention, and Policy, 4:7. doi:10.1186/1747-597X-4-7.

  8. Gray, K. (2007). Marijuana use, withdrawal, and craving in adolescents. Psychiatric Times, 24(13). www.psychiatrictimes.com/display/article/10168/54561.

  9. Hall, W. & Degenhardt, L. (2007). Prevalence and correlates of cannabis use in developed and developing countries. Current Opinion in Psychiatry, 20(4), 393-397.

  10. Prevention gets SACY-er in Vancouver. (2008, March). City of Vancouver Mayor’s Four Pillars Coalition Newsletter. http://vancouver.ca/fourpillars/newsletter/march08/SACY.htm.

 

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