The high levels of depression among teenage mothers have received considerable research attention in smaller targeted samples, but a large-scale examination of the complex relationship between adolescent childbearing and psychological distress that explores bidirectional causality is needed. Using the National Longitudinal Study of Adolescent Health (Add Health) and the Early Childhood Longitudinal Study--Birth Cohort, we found that teenage mothers had higher levels of distress than their childless adolescent peers and adult mothers, but the experience of teenage childbearing did not appear to be the cause. Rather teenage mothers' distress levels were already higher than their peers before they became pregnant, and they remained higher after childbearing and into early and middle adulthood. We also found that distress did not increase the likelihood of adolescent childbearing except among poor teenagers. In this group, experiencing high levels of distress markedly increased the probability of becoming a teenage mother Among nonpoor teenage girls, the relationship between distress and subsequent teenage childbearing was spurious.