Mental Illness and Substance Dependence

Mental illness and substance abuse combined may have devastating effects on patients battling them. Referred to as dual diagnosis, a mental illness together with substance abuse may leave people gasping for control over one’s life. People living with substance use disorders (SUD) are more vulnerable to develop anxiety or depression or any mental health disorder, and vice versa.

Interrelationship between Substance Abuse and Mental Illness

Different national population surveys suggest that nearly 50 percent of people experiencing a mental health disorder during their lives tend to develop a substance use disorder, with the reverse also being true. Further, over 60 percent of adolescents participating in community-based substance use disorder treatment programs also qualify for diagnostic criteria for another mental illness.

Evidences reflect high incidence of correlation between substance use disorders and anxiety disorders such as panic disorder, generalized anxiety disorder (GAD) and post-traumatic stress disorder (PTSD) among others.

Substance use disorders may also co-exist with mental illnesses, including depression and bipolar disorder, attention-deficit hyperactivity disorder (ADHD), as well as psychotic illness, antisocial personality disorder and borderline personality disorder. People with schizophrenia, as data suggests, may co-occur with tobacco, alcohol, and drug use disorders.

Overall, there is a significant overlap between mental health problems and substance use disorders, representing a vicious cycle between mental health and substance abuse problems.

Cause and Effect

While the absolute contributing factors for co-morbid addiction and mental health disorders are unknown, people living with mental health issues tend to self-medicate using alcohol or drugs, which ultimately leads to dependence and then addiction.

Children and adolescents battling psychiatric problems such as ADHD, conduct disorders, and learning disabilities are more likely to abuse drugs than other youth. Conversely, as the National Institute on Drug Abuse (NIDA) suggests, drug abuse early in life is associated with increased risk of psychiatric disorders or accelerates their progression.

People with co-occurring disorders are vulnerable to severe and chronic medical, emotional and social problems. Since they have two disorders, there are higher chances of relapse and aggravation of psychiatric symptoms. People struggling with dual disorders are also vulnerable to challenges including symptomatic relapses, frequent hospitalizations, social isolation, sexual and physical victimization, relationship problems, performance issues, and of course, financial problems.

However, substance abuse in adolescence, which is a major determinant of developing dual diagnosis later, may be controlled by timely screening and treatment of ADHD in childhood. Similarly, addressing substance abuse related problems early could be an effective strategy to prevent the onset of psychiatric disorders as well as improving treatment outcome. Behavioral treatments including cognitive behavioral therapy (CBT) and motivational enhancement therapy have been found efficacious in treating co-occurring substance abusers and psychiatric conditions.