People who are in the midst of rebuilding their lives while in addiction recovery face their fair share of challenges. For those who abuse substances and manage a mental health disorder, those challenges can be more pronounced.
What’s more, there is an inextricable link between substance use disorders and mental health issues. Available government data highlight the prevalence of this issue. In a survey published by the Substance Abuse and Mental Health Services Administration (SAMHSA), an estimated 8.1 million adults had a substance use disorder (SUD) and any mental illness (AMI) in 2015.
The National Institute on Drug Abuse (NIDA) elaborates on the link between certain mental health disorders and substance abuse:
“Data show high rates of comorbid substance use disorders and anxiety disorders—which include generalized anxiety disorder, panic disorder, and post-traumatic stress disorder. Substance use disorders also co-occur at high prevalence with mental disorders, such as depression and bipolar disorder, attention-deficit hyperactivity disorder (ADHD), psychotic illness, borderline personality disorder, and antisocial personality disorder.”
People with anxiety and depression are especially liable to abuse substances to address their conditions. The Anxiety and Depression Association of America (ADAA) estimated that about 20 percent of Americans with an anxiety or mood disorder had an alcohol or substance use disorder and 20 percent of those with an alcohol or substance use disorder also had an anxiety or mood disorder.
Specialized treatment in the form of dual diagnosis is for those with a substance use issue and a co-occurring mental health disorder.
Researchers continue to study the complex relationship between addiction and mental health to understand what happens and why. The National Institute on Drug Abuse (NIDA) lists reasons why substance abuse and mental illness are inextricably linked.
Mental health disorders can lead people to abuse drugs as an act of self-medication. When people engage in self-medication, they can exacerbate the mental health issue and the substance use problem. What’s more, people in this group are also vulnerable to relapse states NIDA.
Some common mental health disorders include:
People with co-occurring conditions will abuse drugs or alcohol to cope with negative situations or to address symptoms of depression or anxiety. Sometimes their substance of choice may lead to sudden changes in mood and bouts of anger, which could result in strained interpersonal relationships and other negative outcomes.
Using substances to self-medicate makes it harder to determine how the two conditions are related. In some cases, substance abuse masks serious underlying mental health disorders, which means many cases have not been properly diagnosed. People with both conditions also may be in denial about either one or both, which means they are unlikely to seek professional treatment.
Thus, substance abuse and mental illness often go hand-in-hand, which also signifies that dual-diagnosis clients must receive care that simultaneously addresses both conditions for them to achieve stability.
The National Alliance on Mental Illness (NAMI) explains that dual diagnosis is a broad term that covers a variety of conditions and situations. “It can range from someone developing mild depression because of binge drinking, to someone’s symptoms of bipolar disorder becoming more severe when that person abuses heroin during periods of mania.”
It does not matter in what order they occur: a mental health disorder can lead to substance addiction, and substance addiction can induce a mental health disorder. However, people with specific mental health conditions are more prone to abuse certain substances.
According to the ADAA, the following mental health conditions correlate with certain substances of abuse:
Social anxiety disorders: People with this disorder may abuse alcohol to lessen their anxiety around social interactions. However, alcohol can only make the anxiety worse. For people with this disorder who resort to drinking, an alcohol use disorder can develop.
Post-traumatic stress disorder (PTSD): It is common for PTSD and substance use to occur together. Thus, people with this mental health condition may resort to using alcohol and depressant drugs like marijuana, opioids, or benzodiazepines to ease their symptoms.
However, substances will only worsen PTSD symptoms. ADAA notes that PTSD and substance use are commonly treated together, particularly in dual diagnosis settings, because symptoms from the mental health issue (intrusive thoughts and sleep disturbances) can cause a patient to relapse back into substance abuse.
Panic disorder: Alcohol and certain drugs can trigger panic attacks. Yet, having a panic disorder can cause people to relapse and resume substance abuse. Alcohol abuse commonly starts before or at the same time as panic disorder symptoms state the ADAA.
Substance abuse treatment centers that specialize in dual diagnosis start with addressing a client’s mental condition. Professionals apply an integrated approach of clinical and therapeutic practices to treat the condition(s).
They also address the unique treatment requirements of a client with particular co-occurring disorders, which differ from people who have single disorders. Dual-diagnosis treatment is a more nuanced approach to a complicated set of conditions. It addresses a mental health impairment in a way that a tradition treatment program cannot.
Clients in reputable dual-diagnosis programs are taught specific therapies that help them transform their thoughts and behaviors toward substance abuse. They attend counseling and therapy sessions and are administered approved medications to treat co-occurring disorders, if necessary.
Other dual-diagnosis treatment benefits include:
Before it can be determined whether a dual diagnosis is present, a mental health professional must carefully evaluate the individual’s condition according to the latest version of the Diagnostic and Statistical Manual of Mental Disorders. If a diagnosis is present, then people who meet the criteria may be eligible to receive treatment at a center that offers this kind of specialized care.
If you have an addiction and mental health disorder, you can use your time in recovery to focus on both at a center that offers dual diagnosis treatment. At California Highlands, we know how tough alcohol withdrawal can be. We view detox as a critical part of recovery from substance abuse and addiction.
Anxiety and Depression Association of America. (n.d.). Substance Use Disorders. from from https://adaa.org/understanding-anxiety/related-illnesses/substance-abuse
Center for Behavioral Health Statistics and Quality. (2016). Key substance use and mental health indicators in the United States: Results from the 2015 National Survey on Drug Use and Health (HHS Publication No. SMA 16-4984, NSDUH Series H-51) [PDF File]. Rockville, MD: Substance Abuse and Mental Health Services Administration (SAMHSA). Date retrieved: July 11, 2019. from from https://www.samhsa.gov/data/sites/default/files/NSDUH-FFR1-2015/NSDUH-FFR1-2015/NSDUH-FFR1-2015.pdf
Grohol, J. M. (2019, May 18). Mental Disorders & Conditions – DSM5. from from https://psychcentral.com/disorders/
National Alliance on Mental Illness. (n.d.). NAMI. from from https://www.nami.org/learn-more/mental-health-conditions/related-conditions/dual-diagnosis
National Institute on Drug Abuse. (n.d.). Introduction. from from https://www.drugabuse.gov/publications/research-reports/common-comorbidities-substance-use-disorders/introduction
National Institute on Drug Abuse. (n.d.). Part 1: The Connection Between Substance Use Disorders and Mental Illness. from from https://www.drugabuse.gov/publications/research-reports/common-comorbidities-substance-use-disorders/part-1-connection-between-substance-use-disorders-mental-illness