Understanding the intersection between addiction and mental health

In the realm of substance addiction and mental health, there are intersecting points where the two may meet. Disorders occurring at the same time can compound the challenge of returning to a sober life with stable mental health.

Understanding the relationship between the conditions is critical for recovery and lasting treatment. This blog will illustrate what co-occurring disorders are and break down the complex relationship between addiction and mental health.

Understanding the dual challenge of addiction and mental health

An addiction is a condition in which a person takes a substance despite its harmful consequences and has limited to no control over stopping. Clinicians have recently strived to rephrase and reframe addictions as “substance use disorders” to develop the understanding of addiction as a treatable mental disorder.

A mental health disorder is defined in the DSM-5 as a condition involving disruptions in thinking, emotional control and biological processes. Mental health disorders cause distress in everyday life, such as jobs or relationships and can wreak havoc on a person’s confidence and self-worth.

If a person has an SUD as well as a mental health condition, medical professionals classify this as a co-occurring disorder or a “dual diagnosis.” Being addicted to a substance while having a mental health condition requires complex treatment and care to get to the core of both conditions simultaneously.

How addiction and mental health fuel each other

Many medical professionals and researchers see the connection between SUDs and mental health disorders as non-coincidental. Living with a mental health disorder can drive a person to substance use as a form of self-medication. Adversely, a person with a drug addiction may, at least partially, feel that returning to the drug makes their mental health worse.

The very nature of using a substance to the point of disorder means mental health problems frequently develop with drug use over time. Some research indicates more than 50% of people with an SUD will experience a mental health disorder at some point in their lives.

A dangerous relationship can start relatively innocuously for a person, such as having a few drinks on a night out to feel more confident and sociable. A person may have a more mild mental illness like anxiety or ADD and find that drinking in social situations helps to deal with this stress. Over time, they may come to rely on alcohol as the only way to manage feelings of anxiety. As their tolerance increases, they need more alcohol to “feel okay” on a night out, creating a cycle of dependence.

Other research suggests that current definitions of co-occurring disorders are lacking, as “severe mental illnesses” (SMIs) such as schizophrenia and bipolar disorders present different challenges than mild mental disorders. Regardless of the severity of a person’s mental health disorder, being addicted to a substance can impair your ability to make decisions, your memory and your overall mental health.

What are the associated risks of addiction and mental health?

Even the most extensive research struggles to identify whether mental health disorders develop mostly as a consequence of substance use or vice-versa.

There is no single measurement that pinpoints the origin of SUDs and mental health disorders. Yet research shows some common risk factors between developing an SUD and a mental health disorder. These include:

Adverse childhood experiences (ACEs)

A survey of 10,000 adults explored how childhood abuse and household dysfunction increased the likelihood of addiction-forming and mental health disorders in adulthood. The research found that people who had adverse childhood experiences were 4 to 12 times more susceptible to alcoholism, drug abuse, depression and suicide attempts. These experiences were interconnected and significantly impacted later health.

Genetic disposition

There may be genetic factors in people that can make them more likely to develop both an SUD and a mental health disorder. Recent research on over a million people identified shared genetic factors between addiction and mental health disorders, particularly in regulating dopamine signaling. This study found that addiction is linked to increased risks of psychiatric disorders. It is one of the largest studies of its kind and highlights how genomic patterns are strong predictors for co-occurring substance use disorders and other mental health conditions.

Feelings of isolation, depression and stigmatisation

Another trait that SUDs and mental health disorders have in common is that they are sometimes seen as illnesses of isolation. In general, a person struggling with their thoughts, emotions and behaviours wants to keep themselves private. In many cases, this leads to self-imposed isolation which tragically makes the problems deepen. A person might cut themselves off from friends and family for fear of troubling or burdening them. This time spent in isolation does not often improve the person’s outlook or self-belief, instead making them more likely to take drugs alone and spiral into a worse mental state.

How integrated treatment supports recovery

When a person has an SUD and another mental health disorder, it is generally best to treat both simultaneously rather than separately. This is called “integrated treatment” and it focuses on using multiple approaches to treat two or more conditions.

The same practitioner or treatment team provides mental health and substance abuse interventions. Research shows that integrated treatment is effective in increasing motivation for treatment in people with anxiety or depression together with an SUD.

At the beginning of integrated treatment, assessments screen for both mental illness and substance abuse. Receiving integrated treatment stops a patient from feeling lost, excluded or confused going back and forth between treatment programmes for substances and mental illness.

An integrated treatment programme uses practice principles to meet the needs of people with co-occurring disorders, including:

• Trained specialists who treat both substance use disorders and serious mental illnesses.
• Treatment follows a stage-wise approach, offering different services at each stage of recovery.
• Motivational interventions are used across all stages, with a focus on the persuasion stage.
• Cognitive-behavioral substance abuse counseling is applied during active treatment and relapse prevention stages.
• Services are offered in multiple formats, including individual, group, self-help and family sessions.
• Medication services are integrated and coordinated with psychosocial support.

Integrated treatment is a holistic approach that addresses both addiction and mental health disorders simultaneously. The coordinated efforts of integrated treatment set a stronger and longer-lasting foundation for complete recovery.

I need help removing an addiction from my life

Battling drug and alcohol addiction with a mental health disorder can often feel like an insurmountable challenge. At times it can feel like an unfair fight against more than one adversary. If you or a loved one have been affected by the issues raised in this article, we’d like to reach out to you.

Here at UKAT, we specialise in alcohol detox programmes. Our trained professionals offer medical support to remove the damaging effects of substance addiction. Our personalised care plan gets to the core of the physical and psychological aspects of drug and alcohol addiction.

Get in touch with us today to start your journey toward a healthier life free from addiction.