The Connection Between Substance Abuse and Mental Health Disorders

Substance abuse problems often do not appear in isolation. People who are dealing with an alcohol or drug problem are often dealing with anxiety, depression, or compulsive behaviors at the same time. Dual diagnosis is the clinical term for co-occurring mental health disorders, with nine million Americans experiencing this. In fact, depressions and anxiety during pandemichave grown, leading to more cases of addictions. 

Living with two serious mental health conditions at the same time can be highly disruptive. Co-occurring disorders make it hard to do well in school, stay employed, develop strong relationships, parent effectively or maintain a viable income. These difficulties make the person feel more isolated, driving substance use or mood disorders even further.

Not getting help for co-occurring mental illnesses is a huge problem. It’s estimated that better than 55 percent of people with dual diagnoses never receive any form of treatment, leaving them living a marginalized existence. In fact, around 23% of those with a dual diagnosis are homeless.

Why do substance abuse and mood disorders often go hand in hand? One explanation is that people who feel chronically depressed or struggle with unmanageable anxiety self-medicate with alcohol or drugs to blunt these troubling emotions. The person uses the nearest available and fastest-acting tool to escape overpowering feelings.

Addiction experts still cannot say which comes first: mood disorders or substance use disorder. But other factors influence whether or not a person will respond to one or the other with maladaptive methods.

People may be genetically predisposed to either of these disorders. Suffering from a serious trauma can also affect whether or not a person develops either or both of the conditions. Brain function and interruptions in healthy brain development may also play a role. The problems which most often accompany alcohol or drug addiction include mood disorders like unipolar and bipolar depression, anxiety disorders, PTSD, ADHD, eating disorders, and conduct disorders.

In years past, when people with addiction sought treatment, their psychiatric disorder was set aside and treated as a separate issue. The same was true for those seeking help with depression or eating disorders – often, their substance use was put off for later. According to the National Survey on Drug Use and Health, just seven percent of adults who receive treatment for substance abuse also receive treatment for a co-occurring mental health disorder.

Today, a growing number of mental health professionals believe the better approach is to treat co-occurring conditions at the same time. Treatment plans which address both the addictive and psychiatric needs of patients are viewed as the more successful programs. Relapse rates have often been high for people with co-occurring conditions. Perhaps, this was because what they really needed was the integrated treatment that addressed both of their illnesses.

Integrated treatment should also be balanced treatment. That means there isn’t a silver bullet for recovery, but instead, a full range of therapies can work together to achieve healing. Treatment should include individual therapy with a counselor, group therapy with other dual diagnosis sufferers, medicinal therapy where appropriate, education for those in the support network, and ongoing aftercare.