Mental illness and substance abuse are serious medical conditions on their own, but when they are combined, they can be debilitating to your health and well-being. Unfortunately, this situation is all too common: Roughly half of the people in the United States who have a mental health disorder also abuse a substance, and that figure is the same when talking about people who have a substance use disorder and also have a secondary mental health issue. In 2018 alone, that equaled about 9.2 million American adults.
If you are grappling with both substance abuse and mental health issues, you have what is called co-occurring disorders, or comorbidity. These co-occurring disorders present particular problems and require specialized treatment for mental illness and substance abuse.
The Interplay Between Mental Illness and Substance Abuse
Drug or alcohol abuse is considered a substance use disorder. This condition is characterized by a dependency on substances that disrupts normal life and leads to an abandonment of typical responsibilities at home and work, and in relationships. It’s a continuum of substance abuse that culminates in addiction.
A serious mental illness, as defined by the Substance Abuse and Mental Health Services Administration, is when someone age 18 or older has at any time during the past year had “a diagnosable mental, behavior, or emotional disorder that causes serious functional impairment that substantially interferes with or limits one or more major life activities.” As you can see, comorbidity can be incapacitating when it comes to leading a normal life.
It’s very difficult to say if mental illness causes substance use disorder, or vice versa. There are many factors at play. Some research states that certain mental health disorders, such as attention deficit hyperactivity disorder (ADHD), that are left untreated in childhood may lead to an increased risk of substance abuse, while other studies have found early drug use may lead to mental health issues. Alcohol, opiates, and many illicit drugs all have the power to alter brain chemistry, and some even change the shape of the brain, which may exacerbate any mental illness. Frequently, people with a mental health issue use drugs or alcohol as a coping mechanism. Co-occurring mental illnesses affect 53 percent of people who abuse drugs and 37 percent of people with a drinking problem.
Common mental health disorders that can co-occur with substance use disorder include depression, generalized anxiety disorder, bipolar disorder, borderline personality disorder, panic attacks, post traumatic stress disorder, psychotic illness, attention deficit hyperactivity disorder, and antisocial personality disorder. Schizophrenia also occurs at higher rates in people who abuse substances compared to people who don’t.
Signs and Symptoms of Co-Occurring Mental Illness and Substance Abuse
There are many signals to look for that indicate someone has co-occurring substance use and mental health disorders. However, these symptoms can vary from person to person, depending on the mental health disorder as well as the substance that is being abused. In general, be alert for the following signs that there could be a comorbidity issue:
- Dependency and tolerance of drugs or alcohol, to the point where substance use cannot be controlled
- Withdrawal symptoms when substance abuse is stopped or limited
- Lying or feeling guilty about rate and frequency of substance abuse
- Inability to function without substances, especially when dealing with pain, mood swings, or memory issues
- Abrupt behavioral shifts, including an increase in risk taking
- Avoidance of family and friends
- Calling in sick to work or not going to the office entirely, with resulting financial hardship
- A distinct correlation between using substances and experiencing poor mental health
- Symptoms of a mental health disorder occur even during sobriety
Understanding these symptoms will help you know if it’s appropriate to seek treatment for mental illness and substance abuse co-occurring disorders.
Treatment for Mental Illness and Substance Abuse Issues
It’s critical to address both issues at once; otherwise, you are still struggling with a disorder and that can increase your risk of relapse or hospitalization. This type of care is referred to as dual-diagnosis treatment.
A dual-diagnosis program integrates care for both issues in a comprehensive treatment plan that is holistic and individualized. Before any work can begin, however, you must undergo detoxification to clear substances from your body. This can be done at a facility such as Clear Sky Recovery, which focuses on detox to prepare clients for rehabilitation.
Once detox is complete, your treatment program will educate you on the physical and psychological factors involved in mental illness and substance abuse. You will also undergo therapy, in both group and individual settings, to work on both issues. Lifestyle changes will also be introduced so you can set a foundation of healthy habits you can continue to build upon once your treatment program ends. You will also be asked to take part in support groups, such as those modeled on 12-step programs. In certain cases, your mental health condition may require medication management. With this complex web of interlocking factors, it’s important to seek treatment with a facility that specializes in dual-diagnosis cases.
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