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Mental Health and Substance Use Disorders

What is the link? .



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Mental health and substance use disorders affect people from all walks of life and all age groups. These illnesses are common, recurrent, and often severe, but they are treatable and many people do recover.

Mental disorders involve changes in thinking, mood, and/or behavior. These disorders can affect how we relate to others and how we make choices. The coexistence of both mental health and a substance use disorder is referred to as co-occurring disorders.

What research is reporting

Recent reports are surfacing that are shining a light on this dark subject.

The National Institute on Drug Abuse (NIDA)’s Common Comorbidities with Substance Use Disorders Research Report found that about half of individuals who experience a substance use disorder (SUD) during their lives will also experience a co-occurring mental disorder and vice versa. Co-occurring disorders can include anxiety disorders, depression, attention-deficit hyperactivity disorder (ADHD), bipolar disorder, personality disorders, and schizophrenia, among others.

Co-occurring substance abuse problems and mental health issues are more common than many people realize. According to reports published in the Journal of the American Medical Association:

  • Roughly 50 percent of individuals with severe mental disorders are affected by substance abuse.

  • 37 percent of alcohol abusers and 53 percent of drug abusers also have at least one serious mental illness.

  • Of all people diagnosed as mentally ill, 29 percent abuse alcohol or drugs.

Why SUDs and other mental disorders may occur together

Research also suggests these possibilities that could explain why SUDs and other mental disorders may occur together.

While SUDs and other mental disorders commonly co-occur, that does not mean that one caused the other.

  • Common risk factors can contribute to both SUDs and other mental disorders. Both SUDs and other mental disorders can run in families, suggesting that specific genes may be a risk factor.

  • Environmental factors, such as stress or trauma, can cause genetic changes passed down through generations and may contribute to developing a mental disorder or a substance use disorder.

  • Mental disorders can contribute to substance use and SUDs. Studies found that people with a mental disorder, such as anxiety, depression, or post-traumatic stress disorder (PTSD), may use drugs or alcohol as a form of self-medication. However, although some drugs may temporarily help with some symptoms of mental disorders, they may make the symptoms worse over time. Additionally, brain changes in people with mental disorders may enhance the rewarding effects of substances, making it more likely they will continue to use the substance.

  • Substance use and SUDs can contribute to the development of other mental disorders. Substance use may trigger changes in brain structure and function that make a person more likely to develop a mental disorder.

Alcohol and drug abuse can make symptoms of a mental health problem worse

From Help Guide.org:

Abusing substances such as marijuana or methamphetamine can cause prolonged psychotic reactions, while alcohol can make depression and anxiety symptoms worse. Also:

Alcohol and drugs are often used to self-medicate the symptoms of mental health problems. People often abuse alcohol or drugs to ease the symptoms of an undiagnosed mental disorder, to cope with difficult emotions, or to change their mood temporarily. Unfortunately, self-medicating with drugs or alcohol causes side effects and in the long run, often worsens the symptoms they initially helped to relieve.

Alcohol and drug abuse can increase the underlying risk for mental disorders. Since mental health problems are caused by a complex interplay of genetics, the environment, and other factors, it’s difficult to say if abusing substances ever directly cause them. However, if you are at risk for a mental health issue, abusing alcohol or drugs may push you over the edge. For example, there is evidence that those who abuse opioid painkillers are at greater risk for depression. Heavy cannabis use has been linked to an increased risk for schizophrenia.

Alcohol and drug abuse can make symptoms of a mental health problem worse. Substance abuse may sharply increase symptoms of mental illness or even trigger new symptoms. Abuse of alcohol or drugs can also interact with medications such as antidepressants, anxiety medications, and mood stabilizers, making them less effective at managing symptoms and delaying your recovery.

Diagnosis and Treatment

It can be difficult to identify a dual diagnosis. It takes time to figure out what might be a mental health disorder and what might be a drug or alcohol problem.

The signs and symptoms also vary depending upon both the mental health problem and the type of substance being abused, whether it’s alcohol, recreational drugs, or prescription medications.

For example, the signs of depression and marijuana abuse could look very different from the signs of schizophrenia and alcohol abuse. However, there are some general warning signs that you may have a co-occurring disorder: Do you use alcohol or drugs to cope with unpleasant memories or feelings, to control pain or the intensity of your moods, to face situations that frighten you, or to stay focused on tasks? Have you noticed a relationship between your substance use and your mental health? For example, do you get depressed when you drink? Or drink when you’re feeling anxious or plagued by unpleasant memories? Has someone in your family grappled with either a mental disorder or alcohol or drug abuse? Do you feel depressed, anxious, or otherwise out of balance even when you’re sober? Have you previously been treated for either your addiction or your mental health problem? Did the substance abuse treatment fail because of complications from your mental health issue or vice versa?

Get help

Make sure that the program is appropriately licensed and accredited, the treatment methods are backed by research, and there is an aftercare program to prevent relapse. Additionally, you should make sure that the program has experience with your particular mental health issue. Some programs, for example, may have experience treating depression or anxiety, but not schizophrenia or bipolar disorder.


Photo by Elijah Hiett on Unsplash


Now what?

Be patient. Recovering from co-occurring disorders doesn’t happen overnight. Recovery is an ongoing process and relapse is common. Ongoing support for both you and your loved one is crucial as you work toward recovery, but you can get through this difficult time together and regain control of your life.


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