A third of girls aged 14 and 15 in the Midlands drink alcohol every week, according to a new survey.
The vast majority of teenage girls said they suffered from depression and self-doubt, and blamed the pressures of school and having to look good for their unhappiness.
More than a fifth of teens in the region have tried drugs and many said they believed the availability of drugs and alcohol fuelled their depression.
The Teen Emotional Health Survey 2005, commissioned by teen magazine Bliss, questioned 2,000 girls aged between 14 and 15.
The Midlands had the highest number of participants who said they were unhappy - 32 per cent of those questioned said the word described them, while half said they felt "insecure".
Nineteen per cent of girls in the region said they had been on a drinking binge when they felt down, compared to 15 per cent nationally, and 34 per cent said they drank every week. The national average was 30 per cent.
Twenty-one per cent said they had tried drugs - compared to the national average of 19 per cent - with 17 per cent of them saying they had tried ecstasy.
Only 62 per cent of girls in the Midlands live with their mother and father and 71 per cent claimed they had been bullied, with 41 per cent saying they were bullied over their intelligence.
Nationally, 35 per cent said they were currently unhappy or miserable, while six per cent went as far as saying life was not worth living.
The girls interviewed blamed the pressure to look good (94 per cent), too much homework and coursework (84 per cent), the pressure to succeed academically (62 per cent) and the rise in broken homes (52 per cent) for their sadness.
The director of Open Door, a counselling service for young people in Birmingham and Solihull, said teenagers' problems were compounded by the fact that often nobody was around to listen.
Carmel Mullan-Hartley said the service, which has been operating for 37 years and has an NHS contract, was receiving greater numbers of referrals of young people who felt low or depressed.
"For many, many young people who use our service one of the fundamental things is really low self-esteem.
"This can be for a variety of reasons. One of them does seem to be the need to look good, and to be slim and attractive and beautiful, and that puts pressure on them.
"One of the dangers is that young people are not really listened to.
"People referred to us are asked 'how do you feel?' and they don't know how to answer it because no one has ever listened to them before.
"Schools try to give emotional support but they are not always best positioned for that. Schools are very much caught up in achieving results and meeting targets."
Ms Mullan-Hartley said the early teens were a pivotal time in a young person's life.
If trauma happened, such as breakdown of the family unit, they did not always have the internal resources to deal with it.
"If a child is not nurtured and valued he or she may be struggling to build up resilience and it is then much harder to cope with life events.
"If young people are feeling low, they turn to whatever is available to block it out, drink or drugs, and it's understandable because they are readily available," she added.