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Understanding Substance Use and Mental Health

Substance use and misuse often go hand in hand with mental health issues. Extensive research has investigated the connection between substance use and mental health.

Often, unresolved trauma and emotional dysregulation lead to excessive and problematic substance use. Mental health issues may drive a person to use substances to cope, and substance misuse can make mental health issues worse.

What Is Comorbidity?

Comorbidity is also known as dual diagnosis or co-occurring disorders. Comorbidity refers to the presence of two conditions that affect a person at the same time. According to the Journal of Substance Abuse Treatment, mental health conditions that often co-occur with Substance Use Disorder (SUD) include:

  • Depression
  • Anxiety
  • Unresolved trauma
  • Post-traumatic Stress Disorder (PTSD)
  • Bipolar Disorder
  • Borderline Personality Disorder

In comorbidity, one condition exacerbates the other, which complicates treatment. As such, treatment for co-occurring SUD and mental health conditions requires integrated treatment to target both conditions together. This reduces the risk of relapse into substance misuse, as treatment for one condition, but not the other, reduces treatment’s effectiveness.

What Is Self-medication?

Many people who struggle with mental or behavioral health issues struggle to cope, and the symptoms can be challenging and overwhelming. Those struggling may seek to escape or mask the symptoms by self-medicating.

Common symptoms of mental health issues include:

  • Social withdrawal
  • Physical health problems
  • Emotional dysregulation
  • Poor distress tolerance
  • Strained relationships
  • Neglect of personal responsibilities due to stress and overwhelm

Common legal and illegal drugs people use to self-medicate include:

  • Alcohol
  • Cannabis
  • Cocaine
  • Prescription opioids
  • Prescription stimulants
  • Heroin

This need to escape often manifests as substance misuse, as drugs or alcohol may offer some temporary relief from one’s mental health symptoms.

For example, a client struggling with depression might self-medicate with marijuana or alcohol to alter their mood. A person with social anxiety might use alcohol to increase their confidence and self-esteem in social situations. Someone struggling with panic disorder might use prescription drugs to ease their symptoms.

Self-medication is a health-risk. While using substances may offer some temporary relief from one’s symptoms, the effects soon wear off. The individual must then deal with the come-down, and this can be overwhelming, especially when there is a pre-existing mental health condition.

To ease the symptoms of a come-down, a person may use more of the substance to prolong their ‘high.’ Such behavior leads to an increased tolerance of the drug’s effects.

Tolerance refers to the body’s ability to process a given substance. With greater tolerance comes the need to use more of a substance to achieve the desired effects. This is a precursor to dependence and addiction.

What Treatments Are Available for Co-occurring SUD and Mental Health Conditions?

Integrated treatment is essential to help those struggling with co-occurring SUD and mental health issues overcome both conditions. Evidence-based behavioral therapies are effective in treating co-occurring disorders. Evidence-based behavioral therapies include:

  • Cognitive Behavioral Therapy (CBT)
  • Contingency management
  • 12-step program
  • Motivational enhancement therapy
  • Life coaching/skill development

Medication is a frontline treatment for co-occurring conditions. Antidepressants, anti-anxiety, and sleep-aid medications can help clients manage their symptoms. This promotes more effective addiction therapy and rehabilitation engagement.

Integrated treatment takes a multi-pronged approach to addiction and mental health recovery. When clients enter treatment, providers support their recovery through:

  • Individual psychotherapy
  • Group and family-based therapies
  • Experiential therapies
  • Medication-assisted treatment (MAT)

If you or a loved one struggles with substance use or mental health issues, seek professional help. Reach out to a professional treatment provider as soon as possible. Addiction and mental health issues are progressive. They worsen the longer a person goes without treatment. Early intervention and treatment are crucial for long-term recovery success.

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