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Addictions and Mental Health

 Mental Health’s Role in Addiction

One of the common challenges faced by professionals involved in substance abuse treatment is the fact that many people who are addicted to drugs also suffer from another mental health problem.  The is called co-morbidity or co-occurring disorders.  Aside from the abuse of a drug, the person also has a mental health disorder of some kind.  Addictions and mental health disorders often occur in the same person.  According to data collected by the National Institutes for Health, 20.2 million adults in the U.S. have been diagnosed with a substance use disorder.  Of those, 7.8 million also suffer from another mental illness.   SAMHSA data corroborates this.  In 2012, 26.7% of people with a mental health issue also abused drugs.  The Journal of the American Medical Association reported that 50% of the people who suffer from a severe mental health disorder also abuse drugs.


Rates of Co-Morbidity

Studies show that persons with certain mental health disorders are more likely to abuse drugs as well.  Approximately 15% of people with antisocial personality disorders abuse drugs.  People who suffer from Bipolar disorder abuse drugs at the rate of 14.5%.  4.3% of people with an anxiety disorder also abuse drugs.  According to the U.S. Department of Veterans Affairs one-fifth of veterans suffering from PTSD also have a substance abuse problem.  This data clearly indicates that there is a clear link between mental health disorders and substance abuse.  Addictions and mental health problems often appear together.  People with a mental health disorder are also more likely to use tobacco.


Data released by the National Bureau of Economic Research outlines the connection between mental health disorders and substance abuse.  The report that people with mental health disorders consume 38% of alcohol consumed in the U.S.; 44% of cocaine used in the U.S. and 40% of cigarettes sold in the country.  If all persons who had ever been diagnosed with a mental health issue are included, they consume 69% of alcohol; 84% of cocaine and 68% of cigarettes.


Many mental health professionals who work with substance abuse suggest that a major connection between mental health disorders and substance abuse is the desire to self-medicate.  They suggest that the person suffering from a mental health disorder of some kind learns that they can escape from the mental and emotional pain they suffer by using drugs.  A person with some kind of anxiety disorder or who is suffering from panic attacks, for instance, may discover that using a sedative of some kind, such as alcohol, helps to lower the degree of their anxiety.  People suffering from depression may use marijuana or some stimulant to feel better.  A person with a low energy level may use Adderall or meth to increase their energy level.  Unfortunately, such self-medication treats only the symptoms, leaving the underlying mental health problem untreated.  Addiction and mental health disorders might be seen as two sides of the same coin.  Mental health problems affect substance abuse and substance abuse affects mental health disorders.


Another connection between addiction and mental health disorders is that the same areas of the brain are affected.  Dopamine, is affected by addictive drugs and is probably involved in such mental health disorders as depression and schizophrenia.  Many antidepressants and antipsychotics actually target the dopamine system in the brain.


Often, people who are diagnosed with a mental health disorder are prescribed medications that also produced unpleasant side effects.  Rather than deal with these side effects, many patients choose to self medicate with a drug instead.  Treatments for schizophrenia, for example, often cause depression so persons being treated might also use a stimulant to avoid the depression.


Long term abuse of some drugs can lead to the development of a mental health disorder.  Most drugs of abuse affect the brain.  After a period of sustained abuse, this effect on the brain can cause damage to the brain that results in a mental health disorder.


Some people have only mild symptoms of a mental health disorder and therefore cannot be diagnosed according to the DSM.  In order to treat their symptoms in the absence of a diagnosis, such persons may choose to use drugs.


The adolescent brain is not yet fully developed.  Drug abuse by adolescents can interfere with the proper development of the brain, resulting in a mental health disorder.  Even among adults, substance abuse can make the symptoms of a mild disorder more severe or even lead to the development of a mental health disorder.


Treatment of Co-Occurring Disorders

One of the first things that a substance abuse treatment professional must determine in a new patient is whether there is a co-occurring mental health disorder.  Such co-occurring disorders may be masked by the drug use but begin to reappear during and after detox.  It is necessary to treat both disorders at the same time.  An untreated mental health disorder is probably going to make a substance abuse disorder worse.  In the same way, an untreated substance abuse disorder will make an untreated mental health disorder even worse.  Addictions and mental health go hand in hand.


It is not easy to determine whether a co-occurring disorder exists.  If you think you might suffer from addiction and a mental health disorder yourself, here are some questions you can ask yourself:

  • Does your drug use help you manage unpleasant feelings or help you concentrate?
  • When you use drugs, do you feel a difference in your mental health issues?
  • Do any of your relatives struggle with a mental health disorder or substance abuse?
  • Do feelings of depression or anxiety continue even when you’re not using drugs?
  • Is there some abuse or trauma in your past that you have not had treatment for?
  • Have you already been treated for a mental health disorder or a substance abuse disorder but treatment was unsuccessful?


The treatment facility that a person with co-occurring problems chooses should be one that can provide an integrated approach to treating both the mental health disorder and the substance abuse problem.  One that understands the connection between addiction and mental health.


Some things to look for in choosing a treatment facility are:

  • Treatment addresses both your mental health disorder and your substance abuse problem.
  • You take an active role in treatment decisions and setting goals.
  • You receive education about the problems you are being treated for.
  • You are taught healthy skills to manage your mental health disorder that do not involve the use of drugs.
  • The facility helps you to think more clearly about your use of drugs.
  • You are given the opportunity to learn about alcohol and other drugs and how they affect your behavior.
  • The facility is active in helping you find employment.
  • The facility actively supports your participation in self-help groups.


Symptoms of Common Mental Health Disorders

You may be wondering whether you are suffering from addiction and a mental health disorder.  Depression, anxiety and the manic phase of bipolar disorder are most commonly connected with substance abuse.  Depression is characterized by:

  • Feeling hopeless or worthlessness
  • Lack of interest in daily activities
  • An inability to experience pleasure
  • Changes in appetite
  • Change in sleep patterns or weight
  • Lack of energy
  • Difficulty concentrating
  • Anger
  • Physical pain


Symptoms of mania in persons suffering from bipolar disorder include:

  • Feelings of euphoria
  • Irritability
  • Unrealistic beliefs about yourself
  • Little need or desire for sleep
  • High energy levels
  • Rapid speech
  • Racing thoughts
  • Being impulsive
  • Being hyperactive
  • Being quick to anger
  • Rage


Treating Addictions and Mental Health Together

Addiction and mental health are connected.  Each problem has an impact on the other.  Treatment for one should also integrate treatment for the other.  In reality, you cannot truly separate addictions and mental health.  It’s the whole person that suffers and therefore the whole person that must be treated.

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