Does Your Mental Health Matter in Addiction Recovery?


For people who are not struggling with any addictions, it can often be difficult to understand what motivates a person to abuse drugs or alcohol when the dangers are so apparent. Marital issues, loss of job, financial ruin, health problems and legal difficulties are just a few of the problems that chronic substance abusers regularly ignore in pursuit of the next fix. This makes little sense to individuals who are not dealing with addiction, because many of those people are also not dealing with mental illness. Part of the reason why people with substance use disorders (SUDs) do the irrational things they do in order to get high or drunk is because a large majority are also facing difficulties with depression, anxiety, bipolar disorder and other mental illnesses. Mental health and addiction are inextricably linked, which is why it matters immensely when it comes to your addiction recovery.

Drawing The Connection to Addiction Recovery

When a person is suffering from an SUD and a mental illness simultaneously, he or she is said to have a dual-diagnosis. Several organizations, including the National Bureau of Economic Research, the Substance Abuse and Mental Health Services Administration and the National Institute on Drug Abuse have established a clear link between mental illness and the use of addictive substances.

Link between mental illness and the use of addictive substances:

  • Approximately 8.9 million Americans have both a mental health and a substance abuse issue
  • Of those struggling with a dual diagnosis, 55.8 percent receive no treatment for either condition, and only 7.4 percent receive treatment for both
  • In 2012, 26.7 percent of people with mental health issues abused drugs. Among the rest of the population, only 13.2 percent abused drugs
  • 50 percent of people who have severe mental conditions also have a substance abuse problem
  • 37 percent of alcoholics have a mental illness
  • 53 percent of people addicted to drugs also have a mental illness
  • 47 percent of individuals with schizophrenia also had a substance abuse disorder (more than four times as likely as the general population)
  • 61 percent of individuals with bipolar disorder also had a substance abuse disorder (more than five times as likely as the general population).

Drawing a direct causality – whether addiction leads to mental illness or mental illness leads to addiction – is impossible because of the myriad other factors involved, but there is an irrefutable connection. For one, many of the risk factors associated with either condition are very similar. Family history, environment, exposure to stress and life experiences can contribute to the development of mental illness or addiction. [1]

Also, both addiction and mental illness affect similar regions of the brain [2]. For example, dopamine (a neurotransmitter that carries messages from one neuron to another and is associated with the brain’s reward system) is typically affected by addictive substances and may be involved in the development of depression, schizophrenia and other psychiatric disorders [3]. Stress is also something that impacts dopamine levels and the development of mental disorders and the inclination to use drugs or alcohol.

Additionally, each condition feeds off of and exacerbates the other. A person struggling with mental health illness may turn to drugs or alcohol for temporary relief. Likewise, because of the effects drugs and alcohol have on the brain, substance abuse will worsen symptoms of mental illness and can actually lead to the development of psychological disorders.[4]

  1. 1. http://www.samhsa.gov/disorders
  2. 2. http://www2.isu.edu/irh/projects/better_todays/B2T2VirtualPacket/MentalHealthMentalDisorders/NAMI%20-%20Dual%20Diagnosis.pdf
  3. 3.  https://www.drugabuse.gov/publications/research-reports/comorbidity-addiction-other-mental-illnesses/why-do-drug-use-disorders-often-co-occur-other-men
  4. 4. http://www.nami.org/Learn-More/Mental-Health-Conditions/Related-Conditions/Dual-Diagnosis

America’s High Prevalence of Psychiatric Disorders

We have already established a clear connection between addiction and mental illness. When you couple that with the high amounts of mental illness in America, there’s no wonder why there are so many people with addictions in our nation. As of 2014, there were an estimated 21.5 million people over the age of 12 with an SUD.

The US is 5% of the world’s population and uses 75% of all prescription drugs.

Individuals with or without mental illness
Individuals with or without mental illness
Individuals with mental illness receiving treatment
Individuals with mental illness receiving treatment
Risk of substance abuse with mental illness
Risk of substance abuse with mental illness

During the same year, more than 10 percent of the population above the age of 12 admitted to using an illicit drug within the past month. [1]

These figures are likely impacted by the large number of Americans walking around with some form of mental disorder in varying degrees.

  • 43.8 million adults, approximately 18.5 percent of the adult population, experience mental illness in any given year
  • 21.8 percent of youth aged 13-18 will experience a severe mental disorder at some point in their lives
  • 1.1 percent of adults in the U.S. live with schizophrenia
  • 2.6 percent of adults in the U.S. live with bipolar disorder [2]

With all of these people dealing with some sort of mental health problem, it should come as no surprise that as of 2008, the United States led the world in illegal drug use.[3] The statistics are also supported by the fact that our country accounts for 5 percent of the world’s population yet 75 percent of all prescription drug use.[4] An astounding 70 percent of Americans are on at least one prescription drug and more than half are on at least two.[5]

  1. 1. http://www.samhsa.gov/data/sites/default/files/NSDUH-FRR1-2014/NSDUH-FRR1-2…
  2. 2. http://www.nami.org/Learn-More/Mental-Health-By-the-Numbers
  3. 3. http://www.cbsnews.com/news/us-leads-the-world-in-illegal-drug-use/
  4. 4. http://www.cnbc.com/2016/04/27/americans-consume-almost-all-of-the-global-opioid-supply.html
  5. 5. http://atlanta.cbslocal.com/2013/06/19/study-70-percent-of-americans-on-prescription-drugs-one-fifth-take-5-or-more/

The Problem of Undiagnosed Mental Illness and Self Medication

Even when mental illness is diagnosed at an early stage, there is still the chance for self-medication with narcotics due to a number of different factors:

  • Certain medications for mental illness cause unpleasant side-effects, leading many patients to use other drugs to relieve them.
  • Many patients cannot afford mental health treatment for the necessary amount of time. Being that the symptoms will not subside without proper treatment and medication, this could lead to substance abuse as a replacement.
  • Misconceptions about mental health have led many to believe they can just “get over” the symptoms. The inevitable failure to do so could easily cause a person to resort to substance abuse to find any type of relief.

One of the inherent difficulties in trying to break the cycle of addiction and mental illness is that a large portion of people are living with undiagnosed and thus untreated psychological conditions. One Duke University study based on a survey of more than 10,000 American teens revealed that more than half of teenagers with psychiatric disorders go untreated.[1]

When you consider that 50 percent of all lifetime mental disorders begin by age 14,[2] it adds up to a lot of adolescents walking around with unexplained, undiagnosed and untreated symptoms of mental illness. To find relief, many will begin using drugs or alcohol. This then can develop into a destructive cycle, as a large amount of teenagers who abuse drugs or alcohol will ultimately develop substance abuse problems.[3]

Self-medication is often about people with mental health issues trying to feel normal and exercise some modicum of control over their conditions. No one wants to feel helpless in the face of incessant symptoms of mental illness. [4]

  1. 1. https://today.duke.edu/2013/11/costello
  2. 2. http://www.medscape.com/viewarticle/711264_3
  3. 3. https://consumer.healthday.com/mental-health-information-25/addiction-news-6/addiction-starts-early-in-american-society-report-finds-654435.html
  4. 4. http://drugabuse.com/library/mental-health-and-drug-abuse/

Depression, Anxiety and Addiction – A Dangerous Combination

Anxiety and depression are the two most common mental illnesses that Americans deal with. According to the Anxiety and Depression Association of America (ADAA), anxiety disorders affect 40 million adults nationwide, which is approximately 18 percent of the adult population.

Depression also affects 15 million adults in the U.S., for about 6.7 percent of that population. What makes it even worse is that a person with one condition is likely to suffer from the other.

 

The ADAA estimates that 20 percent of Americans with an anxiety or mood disorder, such as depression, also have an addiction to alcohol or drugs.An estimated 50 percent of those diagnosed with depression are also diagnosed with an anxiety disorder.[1]

Approximately one-third of those suffering from anxiety disorders ever receive treatment, while slightly over 50 percent of people with major depression get the care they need.[2]. The unfortunate reality is that many people dealing with anxiety, depression or a combination of the two will resort to drugs and/or alcohol for relief and develop a subsequent substance abuse problem. Even further, rather than relieving symptoms of depression or anxiety, drugs and alcohol actually make them worse.

Research has consistently shown that the existence of any affective disorder or an SUD increases the risk for developing the other disorder. The ADAA estimates that 20 percent of Americans with an anxiety or mood disorder, such as depression, also have an addiction to alcohol or drugs.[3] Analysis of data from the National Epidemiological Survey on Alcohol and Related Conditions (NESARC) of over 34,000 U.S. adults revealed that individuals who had used alcohol or other psychoactive substances to reduce feelings of fear, anxiety or avoid other symptoms related to mental health had a significant risk of developing an SUD.[4]

Another study that reviewed literature and research about dual diagnosis dating back to the late 1980s found that “individuals who suffer from both mental illnesses and substance use disorders have an increased likelihood of serious clinical consequences and less favorable long-term outcomes, including, for example, risk of hospitalization, medication noncompliance, violence, overdose and suicide.”[5]

  1. 1. https://www.adaa.org/about-adaa/press-room/facts-statistics
  2. 2. https://www.nimh.nih.gov/news/science-news/2010/just-over-half-of-americans-diagnosed-with-major-depression-receive-care.shtml
  3. 3. https://www.adaa.org/understanding-anxiety/related-illnesses/substance-abuse
  4. 4. http://pubs.niaaa.nih.gov/publications/NESARC_DRM2/NESARC2DRM.pdf
  5. 5. http://www.jpsychopathol.it/

The Relationship between PTSD and Substance Abuse

One of the most commonly occurring anxiety disorders in the world is post-traumatic stress disorder (PTSD).
Relationship between PTSD and SUD:

  • PTSD can lead to SUD
  • Having an SUD can increase the likelihood of experiencing a traumatic event
  • Having an SUD can increase the probability of getting PTSD following a traumatic experience.

It is a disorder that develops in a person who has experienced a shocking, scary or dangerous event.[1] It is most often associated with the military, but rape and sexual assault are also among the leading causes of PTSD.[2]

Research has consistently connected PTSD to SUD. Among people with lifetime PTSD, lifetime SUD is estimated to be between 21 – 43 percent, compared to 8 -25 percent in those without the condition. Even further, as many as 75 percent of veterans with lifetime PTSD also meet the clinical criteria for SUD as well.[3]

Victims of PTSD often resort to using drugs and alcohol because dealing with the pain of reliving a traumatic experience can be too much. Additionally, many are going through everyday life dealing with symptoms of PTSD and are either undiagnosed or receiving no treatment. The lack of adequate coping skills in PTSD victims is a high predictor for developing an SUD.

  1. 1. https://www.nimh.nih.gov/health/topics/post-traumatic-stress-disorder-ptsd/index.shtml
  2. 2. https://www.drugs.com/health-guide/post-traumatic-stress-disorder.html
  3. 3. http://www.medscape.com/viewarticle/564893_2

Finding Proper Dual Diagnosis Treatment

In addition to a large portion of dual-diagnosis patients not receiving or seeking treatment, another issue is that when they do get treatment for one condition, the other is often left untreated. Being that there’s an established link between both conditions, and it is well known that they feed off of and exacerbate each other, it should come as no surprise that treating one without the other is essentially like running in place – it gets you nowhere.

In addition to a large portion of dual-diagnosis patients not receiving or seeking treatment, another issue is that when they do get treatment for one condition, the other is often left untreated.

Up until the 1990s, these mental health and substance abuse problems were treated separately. When conditions overlapped, patients were often denied treatment for mental illness until they achieved sobriety. Proper dual diagnosis treatment now includes concurrent care for both conditions.

People who are battling addiction and mental health disorders frequently feel overwhelmed with life and caught in a never-ending cycle. They want to be free from the symptoms of their depression, anxiety, bipolar disorder or any other condition, but are unsure of any way to cope besides substance abuse.

Many eventually realize that drinking alcohol and abusing drugs are only short-term fixes and actually make the problems worse. But by then, addiction may have set in. At Unity Behavioral Health, we believe the best way to defeat addiction is by working together. This includes a full suite of mental health screenings and treatments, and an extensive list of innovative therapies. Our team of addiction care experts, mental health professionals, researchers and therapists have an incredible understanding of what works and what doesn’t when it comes to dual diagnosis treatment. We would love for you to be our next success story. But we can’t help you if you don’t take the first step of realizing you need help, and take the second step of reaching out and asking for the assistance you need. We realize that mental health and addiction have a toxic relationship, and our mission is to help our patients break the cycle. Our strategies include exploring the origins of substance abuse and mental illness, uncovering triggers for drug or alcohol use and teaching valuable life skills and coping abilities. Contact us today at 561-812-5500 to learn more.