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The relationship between substance abuse and mental illness is a complicated one. In most cases, it’s difficult or impossible to determine which came first — the substance use problem or the mental illness. Experts agree that these co-occurring disorders, as well as other comorbid health conditions, should be treated simultaneously for the best chances at a complete, lasting recovery.
Understanding Co-Occurring Disorders
The existence of both a mental illness and a substance use problem is an example of comorbidity, which occurs when a person has two or more disorders at the same time. Treating a comorbid substance use and mental illness can be complex, as the two conditions can make each other worse and often share the same risk factors.
It’s important to find treatment programs where professionals are experienced in treating co-occurring mental illness and substance abuse problems. These professionals can turn a challenging diagnosis into an opportunity for true recovery.
With a proper diagnosis and holistic approach, comprehensive programs allow for a deeper examination of behavioral and mental patterns. They work to get to the root causes of both conditions and find practical solutions and effective coping tools. These programs treat the whole person, and they cater treatment to each individual, ensuring all issues are effectively addressed.
Which Mental Illnesses Are Most Often Connected to Substance Use?
Anyone can develop a substance use disorder, but people with existing mental health issues are more likely to abuse substances. Some mental illnesses are more commonly linked to substance use disorders than others, including:
- Depression
- Anxiety
- Bipolar disorder
- Attention deficit hyperactivity disorder (ADHD)
- Schizophrenia
- Post-traumatic stress disorder (PTSD)
Depression and Addiction
Mood disorders like depression are frequently connected to substance use problems. It’s estimated that 20 percent of individuals with a depressive disorder also have a substance use disorder, and 20 percent of those with a substance use disorder suffer from depression. For many reasons, including the fact that many cases of depression are undiagnosed or dismissed by the person struggling with it or even by medical professionals, it’s often difficult to determine whether a person turned to a substance because they were depressed, or if they became depressed as their dependence on a substance became more severe.
Depression and substance use often form a dangerous, symbiotic relationship. A person may turn to a substance to soothe their feelings of depression, and they then feel ashamed or hopeless about their condition. In addition to the negative feelings they face after using a substance, many will also deal with physical symptoms that can worsen depression. Alcohol, for example, is a depressant, and many other substances cause an emotional and physical crash after using them. This only compounds the depression issue, and this often leads to further substance abuse.
Anxiety and Addiction
Like depression, anxiety is a common mental health disorder that many people may seek to alleviate with the use of alcohol or drugs. Some people may seek refuge from their anxiety-ridden thoughts with a downer or depressant, like alcohol or prescription painkillers. Others may seek the aid of a stimulant or upper to help them overcome their anxiety and take on daily tasks, dreaded events, or stressful interactions. Again, this can become a harmful cycle. In the aftermath of taking a substance, the person may experience physical and emotional side effects that can make their anxiety worse. They are then tempted to turn to the substance for relief.
Bipolar Disorder and Addiction
Bipolar disorder is a commonly misunderstood and misdiagnosed mental illness that leads to extreme mood swings and drastic changes in energy and personality. Many people may self-medicate with drugs and alcohol to smooth out the tumultuous phases of their disorder, which often include manic highs and depressive lows. For this reason, bipolar disorder and addiction are common co-occurring disorders.
The connection between substance abuse and bipolar disorder is even stronger than the connection between substance abuse and depression. People who have bipolar disorder are estimated to be at least four times more likely to use alcohol and recreational drugs than those who don’t struggle with mental illness.
ADHD and Addiction
The link between Attention deficit hyperactivity disorder (ADHD) and substance use is undeniable. Some estimates indicate that as many as 25 percent of people with a history of substance abuse may also have ADHD, and that almost a third of juveniles diagnosed with ADHD will experience a substance use disorder later in life.
Some factors contributing to these high numbers include depression that a person with ADHD may feel as a result of feeling inadequate or incapable due to the symptoms of their condition, and the increased impulsiveness that many people with ADHD experience, which may make them more likely to experiment with substances. Both of these factors can be exacerbated by a misdiagnosis or dismissal of their ADHD symptoms by family, friends, and even medical professionals.
Schizophrenia and Addiction
Recent studies have indicated that up to half of people with schizophrenia also struggle with substance use problems. Many with psychotic disorders, such as schizophrenia, seek to self-medicate with alcohol or drugs to ease the feelings of depression and isolation they experience as a result of their mental state. This may be especially true in cases of undiagnosed or mismanaged schizophrenia.
PTSD and Addiction
After a traumatic event or repeated exposure to trauma, many individuals may feel unable to cope with normal life. For this reason, people struggling with post-traumatic stress disorder (PTSD) may turn to alcohol or drugs to manage their high levels of depression and chronic stress. In the case of veterans with PTSD, many also become dependent on narcotic painkillers originally prescribed to manage pain from injuries sustained while serving.
How Can Specialized Treatment for Co-Occurring Disorders Help In Recovery?
While each individual is unique and requires a treatment plan that is designed with their specific history, condition, and behavioral patterns in mind, most medical professionals experienced in dual diagnosis care take a comprehensive approach to recovery that includes the following:
- A consideration of underlying issues related to both disorders: The connection between mental illness and substance use disorders is often linked to common underlying issues that include genetics, chemical imbalances and deficiencies, trauma, and environmental factors, such as growing up in a household where substance abuse or mental illness was present. By identifying these issues, the person can begin to understand their patterns of behavior and emotional responses. Then, they can work to change them.
- Integrated treatment: Concurrent mental health and substance abuse problems are often so deeply intertwined which is why recovery professionals see the value of working through the issues together rather than treating each as a separate issue. Integrative treatment is proven to help individuals address the underlying issues, as well as the behavioral and thought patterns, that may be behind both problems or play a part in the relationship between the two issues. Across the board, experts agree that integrated treatment is preferable. Co-occurring disorders are treated simultaneously.
What To Expect During Treatment For Co-Occurring Disorders
While specific treatment plans will vary, most plans for dual diagnosis treatment combine some of these services:
- Psychiatric medication management
- Medication-assisted treatment
- Mental health therapy
- Holistic therapy
While specific treatment plans will vary, most plans for dual diagnosis treatment combine some of these services:
- Psychiatric medication management
- Medication-assisted treatment
- Mental health therapy
- Holistic therapy
Psychiatric Medication Management
Treating concurrent mental illness and substance use disorders sometimes requires the use of prescription medications. The specific medications used will depend on the particular mental health disorder, but options include antipsychotics, anti-anxiety medications, antidepressants, and other mood-stabilizing drugs. If you are taking medications to manage certain mental illnesses, you may remain on these indefinitely.
Medication-Assisted Treatment (MAT)
Medication-assisted treatment (MAT) may be used to address withdrawal from and addiction to certain types of drugs, particularly opioids, alcohol, and benzodiazepines. Some MAT medications may be used to alleviate severe withdrawal symptoms, while others may be used throughout treatment and beyond to address underlying chemical imbalances or ongoing symptoms. Most often, a tapered approach is used with MAT. The supervising physician may start you on an initial dose, which is then lowered over time as you adjust to life without any substances. The ultimate goal is to get you off the maintenance medication.
Mental Health Therapy for Co-Occurring Disorders
Mental health therapy can help to address both mental illness and addiction during recovery. Therapists can provide support and guidance as you work through any underlying issues that may have contributed to your addiction. They can also help you develop healthy coping mechanisms and provide a safe space for you to process your emotions.
Common examples of therapies offered during treatment for co-occurring disorders include:
- Group therapy: By communicating honestly with others who have similar experiences or backgrounds in a supportive environment, individuals are reminded that they’re not alone in their struggles. Group therapy can also encourage accountability and positive social behavior.
- Cognitive behavioral therapy (CBT): CBT is a form of psychotherapy that focuses on modifying dysfunctional beliefs, behavioral patterns, and thoughts. Unlike some other forms of therapy, CBT is more solutions-oriented, to help an individual develop life skills and coping mechanisms to guide them through recovery and real life. CBT is often used as part of individual therapy.
- Expressive therapy: Expressive therapy, such as art therapy or journaling, may help an individual to release pent-up feelings or work through emotions or trauma through creative expression. It may also help to change negative behavioral patterns and create feelings of accomplishment.
Holistic Therapy for Co-Occurring Disorders
Holistic therapy activities help address both substance abuse issues and mental health problems. They promote overall wellness, increase an individual’s sense of physical well-being, and also aid in changing harmful behavioral and thought patterns. For this reason, your treatment plan may also incorporate holistic healing practices such as:
- Yoga
- Exercise
- Mindfulness practices
The skills learned in these sessions can be effective tools in navigating everyday life during and after recovery. Since these holistic practices can be done alone or in a group setting, they can both foster a sense of self-reliance and encourage positive social interactions. Ultimately, they help to promote a healthy lifestyle, and this is supportive of recovery from co-occurring conditions.
Find Help For Co-Occurring Mental Illness and Substance Use Disorders
If you or someone you care about is struggling with co-occurring mental illness and substance use disorders, remember that help is available. Taking the first step towards recovery can be daunting, but you don’t have to do it alone. Getting integrative dual diagnosis treatment for co-occurring disorders, you’ll receive the support, guidance, and the necessary tools to manage both conditions effectively.
Don’t let another day go by without seeking the support you deserve. Reach out to Footprints to Recovery’s specialized treatment centers to explore your options. Start your path to healing today.
Our admissions team is available 24/7 to listen to your story and help you get started with the next steps.
