Drugs and Mental Health: A Dangerous Connection

Anyone watching a loved one struggle with drug addiction – or struggling themselves – understands that substance abuse directly affects mental health.

People with a substance use disorder are more than twice as likely to suffer from a mental illness. Many don’t realize that substance use and mental health disorders play off each other in a devastating way. When someone with an existing mental health issue misuses drugs or alcohol, symptoms often get worse and both conditions become more confusing to treat.

Understanding this link between drugs and mental health is key to developing a comprehensive rehabilitation strategy focused on long-term health.

How Drug Use May Worsen Mental Health Disorders

Which comes first – addiction or mental illness? Unfortunately, it’s not that simple. To say that alcohol or drug use causes mental health problems (or vice versa) whitewashes these extremely complex conditions. While every person’s brain chemistry and substance use history are unique, the relationship between drug use and mental health tends to appear in three patterns:

  1. Self-Medication
    Someone who has an existing mental health disorder (depression, PTSD, anxiety, bipolar disorder, autism, OCD, etc.) and started using alcohol, prescription pills, or illicit drugs to self-medicate their symptoms.

  3. Being At-Risk
    Alcohol or drug use increased the person’s risk of developing an underlying mental health disorder. For example, opioids can deplete dopamine and GABA receptors in the brain and lead to depression.

  5. Exacerbation
    Someone who had an existing mental health condition with manageable symptoms, until alcohol or drug use caused the symptoms to get worse.

Addiction and mental health disorders both impact brain chemistry in unique ways. However, substance use and mental illness also act in the same locations in the brain – like serotonin, dopamine, GABA, and endorphin receptors. Alcohol, drugs, and mental health conditions also involve several risk factors like genetics, environment, life events, and other pieces researchers haven’t discovered yet.

What is Dual Diagnosis?

Dual diagnosis, also called co-occurring disorders, means that someone suffers from an alcohol or drug addiction along with at least one mental health disorder.

Someone may experience a combination of mental health disorders – like depression, anxiety, and a personality disorder – which can make it even harder to pick apart the effects of addiction from symptoms of mental illness. According to the Substance Abuse and Mental Health Services Administration, nearly 40% of all people with a substance abuse disorder suffer from an active mental health condition.

Since many substance abuse counselors aren’t professionally trained to identify and treat dual diagnoses, it’s possible that this figure is much higher. Sadly, many people don’t receive adequate treatment for their mental health disorders during recovery and eventually relapse.

Source: SAMHSA

Dual Diagnosis Treatment

Many people with dual diagnoses may not even realize they also have an underlying mental health disorder. Family members and even counselors may attribute symptoms of mental health disorders like apathy, irritability, or paranoia merely to the drug addiction.

Co-occurring disorders require an integrated approach. Doctors and therapists must treat both substance misuse and mental illness simultaneously and comprehensively. Similarly, counselors and therapists should understand to differentiate between symptoms of depression due to PAWS (post-acute withdrawal syndrome) and baseline depression.

No two cases of addiction and mental illness are the same, so dual diagnosis patients require personalized treatment plans.

Common Treatment Options

Although each case is unique, an average treatment plan may include the following:

  • Medical detox for a safe and comfortable withdrawal.
  • Evaluating a patient’s mental health history before, during, and after addiction.
  • Medication for mental illness(es).
  • One-on-one counseling and behavioral therapy.
  • Improving material conditions through housing, employment, and basic needs.
  • Building a healthy support system of family, sober friends, and others in recovery.
  • Adopting healthy lifestyle habits to manage symptoms cravings.
  • Long-term counseling throughout recovery to watch PAWS and baseline mental health.


Opportunities for Success

As treatment strategies progress, more attention is given to dual diagnosis and the relationship between drugs and mental health. One key to prevention may be the active education of professionals, struggling individuals and loved ones on the science of the connection. Awareness of how substance abuse affects one’s mental health can increase the successful treatment of suffering individuals.
Want to read more? Check out our recent, related article on the Opioid Epidemic in America.

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