Sufferers of various mental illnesses often compound their problems with substance abuse, making it difficult for psychiatrists and therapists to access the right diagnosis and treatment for both. According to professor and psychiatrist James Garbutt, mental illness increases the risk for alcoholism or drug abuse because patients self-medicate to alleviate their symptoms. Unfortunately, alcohol and drugs lead to significant anxiety and depression that make it indistinguishable from mental illness. Finding the middle ground to treat addictions and psychiatric disorders is often the key to bringing patients back onto the road to recovery.
The Most Likely Sufferers of Mental Illness and Substance Abuse
Out of a broad spectrum of mental conditions afflicting thousands of people, certain disorders tend to be frequently associated with alcohol and drug dependency. Sufferers of depression, bipolar disorder, anxiety, and schizophrenia tend to form addictions quicker than other patients. Addictions can range from strictly behavioral to substance abuse. Many reasons exist as to why sufferers develop addictions. In many cases, sufferers become addicted to a certain behavior or substance in an effort to lessen their internal distress. Treating a dual diagnosis of a mental disorder and substance abuse requires further examination and intensive care than addressing each of these conditions alone.
Those who suffer from depression experience more than feeling sad. Intense feelings of inadequacy, loneliness, and disinterest in things that they would normally enjoy accompany the many other symptoms of depression. Depression may seem conquerable with willpower; however, it has left many people debilitated and suicidal. Sufferers of depression may start to abuse alcohol or drugs in an effort to boost their self-esteem and confidence. Unfortunately, this tends to backfire as the addiction begins to take over. Sufferers can beat depression with the right medication and therapy.
People with bipolar disorder experience shifts in mood, energy, and activity levels. They struggle with carrying out day-to-day tasks. Bipolar disorder can ruin lives without proper treatment. The manic-depressive phases differ from the normal ups and downs that everyone goes through from time to time. If left untreated, bipolar disorder can result in damaged relationships, poor performance at work or school, and even suicide. Sufferers of bipolar disorder may attempt to regulate their alternating cycles of depression and mania with various addictions. The euphoria accompanied with lowered inhibitions may cause anxiety sufferers to abuse alcohol or drugs. The co-morbidity of bipolar disorder and substance abuse is difficult to treat, mainly because it becomes hard to differentiate the symptoms of the mental disorder from those produced off the effects of an abused substance.
Anxiety describes an unpleasant state of inner distress, which may manifest in nervous behavior. Anxiety sufferers may ruminate, pace back and forth, bite their nails, or sweat profusely over irrational fears, such as the feeling of imminent death. Sufferers may experience symptoms of restlessness, fatigue, muscular tension, and difficulty concentrating. People may experience anxiety without a disorder; anxiety only becomes problematic when symptoms persist. Anxiety sufferers may develop co-morbidity to alcohol and drugs as a means to lowering inhibitions and feeling more like ‘themselves.’ Addictions develop when this feeling of ‘normality’ wears off, leaving the sufferer ‘anxious’ to return back to a calm state.
Schizophrenia, a debilitating brain disorder, leaves sufferers in shambles. Sufferers experience symptoms that do not coincide with reality, such as auditory, visual, and kinesthetic hallucinations. Many sufferers develop delusions of persecution, usually originating in the belief that others are plotting against them. Schizophrenics may not make sense when they talk or they may sit for hours and not say anything at all. Schizophrenia produces symptoms unseen in other disorders, which makes it difficult to treat as a stand-alone problem. The unpredictability of this disorder and the behavior exhibited from the sufferers alike leads to the development of addictive disorders. The combination of the two can be disastrous if not handled with proper care.
- Bipolar Disorder and Alcoholism
- Substance Use Disorder in Hospitalized Severely Mentally Psychiatric Patients: Prevalence, Correlates, and Subgroups (PDF)
- Bipolar Disorder and Addiction
- DrugFacts: Comorbidity: Addiction and Other Mental Disorders
The Underlying Causes of Substance Abuse Among the Mentally Ill
Many factors exist that could explain the frequent occurrence of addiction and mental illness, including genetics, chemical deficiencies, and environmental stimuli. Genetic factors seem to account for the frequency of having both a mental disorder and chemical dependency. Studies also seem to suggest that a reduction in neuro-chemical functioning occurs in patients who have lowered amounts of serotonin. Further evidence indicates that addiction and mental disorders form in patients who have a dysfunction in the group of chemicals in the brain called monoamine oxidases. Environmental stimuli or the lack thereof may also cause patients to turn to alcohol and drugs to keep them preoccupied and distracted from their perceived realities.
- Dual Diagnosis: Substance Dependence and Mental Illness (PDF)
- When Mental Health and Substance Abuse Problems Collide (PDF)
- Substance Abuse and Mental Illness Fast Facts (PDF)
- Mental Illness: The Challenge of Dual Diagnosis
The Shared Relationship Between Substance Abuse and Mental Illness
No clear connection exists that explains the connection between mental health and addiction. People with mental illness tend to develop substance abuse problems, and those with substance abuse problems tend to develop mental disorders. According to addiction psychiatrist Stephen Gilman, fifty percent of sufferers with an addictive disorder develop a psychiatric illness. That number tends to be higher among sufferers of certain mental conditions, such as post-traumatic stress disorder (PTSD), antisocial personality disorder, sleep disorders, depression, and anxiety disorders. Researchers have yet to uncover exactly why this occurs in particular disorders, except for the fact that certain behaviors tend to trigger the illness. For instance, alcoholics who abruptly stop drinking may experience withdrawal symptoms that closely resemble those seen in schizophrenic sufferers. Alcoholism and drug abuse can cause changes in the brain that may induce personal and mental disorders. All of these factors serve as indicators for those who suffer from both addiction and mental illness.
- Substance Abuse More Likely Among Patients with Mental Illness
- Co-Occuring Mental Health and Substance Abuse Disorders (PDF)
- Substance Abuse and Mental Health: Substance Abuse and Co-Occurring Disorders
- Comorbid Drug Abuse and Mental Illness: A Research Update from the National Institute on Drug Abuse (PDF)
Treating Substance Abuse and Mental Illness: The Hidden Caveat
According to Gilman, psychiatrists and therapists have difficulty distinguishing between the addictive and psychiatric symptoms in sufferers. Sufferers must undergo a two-week period of sobriety to determine where the problem lies before an assessment can begin. In clinical terms, treatment begins at the time the patient seeks help because the addiction plays a vital role in symptomatic display. However, misdiagnosis and under-treatment is not uncommon in cases of addiction and psychiatric illness, especially when an alcohol addiction masks itself as bipolar disorder. Although not entirely impossible, unraveling the causes of each disorder simultaneously requires special attention to get to the heart of the matter.
- Treatment Compliance in Patients With Co-Occurring Mental Illness and Substance Abuse
- Substance Misuse in the Severely Mentally Ill (PDF)