This association with smoking is not consistently seen with other psychiatric disorders. When there is dysfunction of the dopaminergic and noradrenergic systems, as theoretically occurs during an episode of major depression, there may be an increased reliance on the nicotine receptor-mediated release of amines. Smokers with dysfunction of these aminergic mechanisms, predisposing them to major depression, could have more difficulty when they try to stop smoking due to this overdependence on nicotine-mediated release of amines. It has been proposed that antidepressants may facilitate the release of amines by activating central nicotinic mechanisms. In a number of studies in adults, many persistent smokers suffer from a significantly higher level of anxiety and depression than nonsmokers.
Anxiety also plays a role in teenage use of nicotine.
In teenagers, regular smokers are almost twice as likely as occasional smokers to report high levels of depression and anxiety. An analysis by Patton et al shows an association with the use of smoking by teenage girls as self-medication for depression and anxiety. Psychotic Disorders Psychiatric comorbidity has only been taken seriously in the last decade. Affective disorders are now widely recognized as being associated with smoking. Patients with psychotic disorders often use nicotine to counteract the adverse reactions of the drugs used to treat the primary disorder.