According to the National Institute of Health, almost 50% of teens and young adults who are admitted to a psychiatric hospital meet the criteria for both mental health disorders and substance use disorders. In the behavioral health world, this is called a co-occurring disorder or dual diagnosis. When it comes to mental health and addiction, families wonder what should be treated first: the mental health diagnosis, or the substance use diagnosis.
There are several pathways and approaches that can effectively relieve symptoms of both mental health disorders and substance use disorders. However, you cannot successfully treat one without managing the other. In this article, we’ll explore how mental disorders can contribute to drug abuse and treatment options for a successful recovery.
How Mental Disorders Impact Substance Use Disorders
Mental illnesses can take a toll on individuals both physically, and mentally. These struggles can be challenging to cope with and can push individuals in a direction that eventually leads to drug and alcohol abuse. Whether it starts with prescription medication, self-medication, or experimenting with substances, feeling any sort of relief from a mental disorder can motivate individuals to pursue that feeling. As soon as drug abuse enters the picture, it is possible that pre-existing conditions will develop into more serious mental illnesses.
According to the Substance Abuse and Mental Health Services Administration, a serious mental illness is defined as a diagnosable mental health disorder, behavioral, or emotional disorder that causes serious functional impairment that limits one or more major life activities. This, coupled with substance use disorder can place individuals at an increased risk for the progression of current conditions and the development of other mental disorders.
For example, if your child is prescribed Xanax for their panic disorder and anxiety, they may begin using the medication as prescribed, but escalate into abusing the drug. Once this abuse begins, the underlying anxiety combines with the drug dependence to become a new, separate issue. It’s no longer just the anxiety or just a Xanax addiction– It’s both, together, working off one another. As you treat the combined problem, you will have to treat both the original panic disorder and anxiety, the drug dependence, and all the symptoms and changes that have emerged as a combination of the two conditions exacerbating each other.
Trauma and Drug Use
When looking at a patient or client with co-occurring disorders, we must look at the common factors that would ignite a mental health disorder that would then lead someone to seek substances to cope with the stress. The most significant link is trauma.
What is Trauma?
Many people believe trauma is something really scary or upsetting that happens to you. However, trauma is less related to what happened and more related to how the people around you responded to that scary or upsetting event, including yourself. This trauma could be as major and widely impactful as a war or genocide, but it can also be as narrow and personal as dealing with a childhood bully.
It is also important to note that trauma doesn’t necessarily have to manifest into clinically diagnosable Post Traumatic Stress Disorder, or PTSD. The official diagnosis of PTSD has a certain set of requirements that must be met in order to qualify. However, all trauma and all traumatic reactions don’t fit neatly into the PTSD box. Trauma isn’t any less valid just because it does not warrant a PTSD diagnosis.
Types of Trauma
Now, this presence of trauma can “activate” mental health disorders, which then lead those who are suffering to find ways to cope. Acute trauma, or trauma that happens from a one-off event such as a car accident or witnessing a murder, can be so profound that the one event is enough to push someone to scramble for coping mechanisms.
Chronic trauma, or any trauma that happens repeatedly or over a period of time, such as living in a war zone or with an abusive parent, compounds its effects. If you’re unable to utilize or develop coping mechanisms while you remain in this unsafe mental space, your brain begins to make accommodations to help you survive in these environments. For example, if your father has been verbally abusive and controlling your whole life, you will only know the anxiety of preparing for him to have another outburst. When that outburst happens, you will experience the current outburst happening, and the pain of every other previous time he has been cruel to you.
These dangerous conditions are a breeding ground for mental illness, and by extension, substance abuse. A person who has experienced trauma might find comfort and relief in using opiates to dull the hurt of past experiences or use alcohol to quiet the tension of survival mode. These unhealthy coping mechanisms can quickly turn into opiate addiction or alcohol dependence and place individuals at risk.
Anxiety and Drug Use
Anxiety, clinically speaking, is a persistent feeling of worry, distress, concern, or unease. An anxious person may frequently think about their fears and worries, which can cause them to have more fears and worries. There are a number of types of anxiety disorders, including phobias, panic disorder, and social anxiety. Typically, substances like benzodiazepines and medical marijuana are used to treat the overwhelming concerns. At first, they are used as a direct response to a stimulus, but as the dependence and desire for the substance grows larger, the anxiety-provoking stimulus won’t have to be present. Additionally, individuals may struggle to live life without benzodiazepines or marijuana in this case and can experience heightened anxiety if they do not have access to the drug.
Depression and Drug Use
Depression causes a loss of interest in various aspects of life and is often met with long-lasting feelings of sadness. There are many causes of depression, but using substances to alleviate these symptoms occurs even without a known, direct cause. There are no substances directly associated with depression. Largely, it is a personal choice on how the depressed person chooses to self-medicate. There are also cases of high-functioning depression which can be difficult to notice, especially when symptoms are numbed by substances. In this case, frequent intoxication to cope with depressive symptoms can lead to the development of clinical depression over time.
ADHD and Drug Use
ADHD is marked by difficulties in paying attention and focusing, keeping still for extended periods of time, and taking action without considering the consequences. This impulsivity can lead those with ADHD, particularly young people, to try highly addictive substances without thinking about the longer-term outcomes. Those with ADHD may use substances to slow down the mind and hold on to some of that energy or maintain focus. Cocaine, nicotine, cannabis, and opioids counteract the already excessively-stimulated mind. Additionally, ADHD medications are most commonly prescribed as a first-line treatment in the form of stimulants like Adderall. While these medications can be a revolutionary treatment for some, Adderall is addictive and can be detrimental for individuals who have a predisposition or genetic history of addiction.
Treating Mental Illness and Substance Use Disorder
It is critical to treat both mental health issues and substance abuse issues together when entering recovery. The treatment process for coming off of drugs or alcohol can intensify feelings of anxiety or depression and there can be a sense of loss when the substance can no longer play a role in someone’s life. Additionally, if the underlying mental health concerns are not addressed, the treatment will be incomplete. Essentially, it would be taking away someone’s faulty life raft without giving them the tools they need to get onto a proper lifeboat. Someone may always struggle with their mental health, but sobriety is possible, regardless of mental health concerns. However, this person must be set up for success as they shift from relying on substances as a coping mechanism.
Mental illness commonly co-exists with drug problems indicating the importance of treatment programs that address both conditions. Integrated treatment facilities provide individuals with the most effective treatment for co-occurring disorders. Whether someone is struggling with major depression, bipolar disorder, or other mental illnesses that lead them to substance use, finding the right program can make a huge difference.
Sober Living for Mental Health and Addiction
At New Life House, we help young men overcome the challenges of mental health and substance use disorder through peer support, accountability, life skills development, and clinical care. Our team is committed to an integrated approach to help our young men maintain a healthy lifestyle and achieve long-term sobriety. If you or a loved one is struggling with mental health and addiction, call New Life House to learn more about our sober living in Los Angeles.