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How Mental Illness and Addiction Influence Each Other

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Many addicts struggle with mental disorders. I myself struggle with bipolar one and it is the cause of much of my use (read my journals for more personal accounts). Using drugs to defeat things like that or depression and anxiety most often make things worse. It can further offset the symptoms despite the immediate satisfaction. Its important to see a psychologist, being as honest as you can, to seek proper treatment. I have found that treating my illness with prescription drugs has controlled my mental/emotional state far better than any illegal substance I have ever used. The effects are long-term and with the help of medial professionals, I am able to stay sober and sane.” – Love, Robyn

There is a complex relationship between addiction, such as alcoholism, and mental illness. Treatment needs to focus on both conditions at the same time, once the right diagnoses have been made. 

The complexities of mental illness are often compounded by drug and alcohol abuse, making it a challenge to get the right diagnoses and treatment for both.

Drug Abuse and Mental Illness: A “Complex Dance”
“Mental illness and alcoholism or drug abuse interact in a complex dance, “says James Garbutt, MD, professor of psychiatry at the University of North Carolina at Chapel Hill and research scientist at UNC’s Bowles Center for Alcohol Studies. “Mental illnesses can increase the risk for alcoholism or drug abuse, sometimes because of self-medicating. On the other hand, alcoholism can lead to significant anxiety and depression that may appear indistinguishable from a mental illness. Finally, one disorder can be worse than the other.”

According to Stephen Gilman, MD, an addiction psychiatrist at New York University in New York City, “Alcoholism and drug abuse addictions and other psychiatric disorders often occur at the same time. However, they are distinct disorders that must be treated as such in order to get a good outcome for the patient.”

Rorschach Test Smoke

Drug Abuse and Mental Illness: Likely Conditions
Certain mental conditions are frequently associated with alcohol and drug dependency. They include:

  • Depression. In some cases, individuals may start to abuse a substance to mask the symptoms of depression. Female substance abusers are particularly likely to have depression, but it also occurs in male substance abusers.
  • Bipolar disorder. Those with bipolar disorder — a condition that causes alternating cycles of depression and an abnormally elevated mood — may attempt to smooth out mood swings with alcohol.
  • Anxiety. Alcohol abuse is more common in both men and women with anxiety disorders.
  • Schizophrenia. Psychotic symptoms, such as hallucinations and delusions, may lead to substance abuse as a way to ease the distress that these symptoms can cause.

Those with a mental disorder may also be less inhibited and more likely to show risk-taking behavior — like buying and using illegal drugs or drinking to excess — that could quickly lead to alcohol or drug abuse. “Individuals with a mental disorder could have impaired judgment and consume higher amounts of a drug or alcohol, says Dr. Garbutt.”

Drug Abuse and Mental Illness: Underlying Causes 
There are also other factors that could explain the frequent simultaneous occurrence of addiction and mental illness, including:

  • Genetics. Genetic factors seem to account for some of the co-morbidity (having both disorders at the same time) of substance abuse and mental disorders. Studies comparing identical and fraternal twins found more instances of having two disorders among the identical twins, indicating that genetics likely play some role.
  • Chemical deficiency. Neuro-chemical factors were also found to be a common thread when mental disorders and addiction occur together. A reduction in the amount of serotonin, a chemical critical to brain functioning, may be the reason that alcoholism and anxiety disorders coincide so often. There is also evidence that addiction and mental disorders are associated with the dysfunction of a group of brain chemicals called monoamine oxidases.
  • Shared environment. Studies surrounding twins also showed that environment plays a major role in having both a substance abuse problem and another mental disorder.

Drug Abuse and Mental Illness: What Is the Exact Relationship?
The answer is not entirely clear, but the connection works both ways. People with alcohol and drug addictions tend to develop mental illnesses. People with certain mental illnesses tend to develop substance abuse problems.

“Fifty percent of those with an addictive disorder will have a psychiatric disorder. And for those who have a psychiatric disorder, about 20 percent have an addiction problem,” says Dr. Gilman.

That number is even higher in those with certain mental conditions. “A variety of mental illnesses such as post-traumatic stress disorder, antisocial personality disorder [characterized by a lack of empathy toward other people], anxiety, sleep disorders, or depression, increase the risk of addiction. Those with the highest risk of addiction have bipolar disorder or schizophrenia — up to 50 percent [of people with these conditions] can have an addiction,” says Garbutt.

Researchers don’t yet know exactly why people with these particular disorders are at an increased risk for addiction, says Garbutt, but it has been noted that:

  • Abruptly stopping alcohol intake can lead to withdrawal symptoms — including hallucinations — that may look just like schizophrenic symptoms.
  • Alcoholism and drug abuse can cause changes in the brain, sometimes leading to changes in personality and mental disorders.
  • Alcoholics of both genders frequently suffer depression and anxiety disorders, while men are more likely to exhibit antisocial personality disorder than non-abusers of alcohol.

Drug Abuse and Mental Illness: Treating Two Sets of Symptoms
According to Gilman, “It is very important, but often difficult, to distinguish which symptoms are psychiatric and which are addictive. A person must be substance-free for a period of at least two weeks in order to tease apart the various symptoms.”

“Clinically speaking, you have to treat the addiction and the psychological symptoms at the same time. Misdiagnosis, and therefore under-treatment, is common, such as when an alcohol addiction is masking bipolar disorder,” says Garbutt.

Garbutt and Gilman both believe that treating an addiction and a mental illness at the same time is possible, and when you treat them together you can begin the process of unraveling the underlying causes of each.

By Linda Foster, MA from Everyday Health
Medically reviewed by Lindsey Marcellin, MD, MPH
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Holistic Approach to Alcoholism

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“Having only drank for one year of my life, I hardly consider myself an alcoholic. But I know how important it is for me to see it as any other drug so I am welcomed to AA as NA/CA just the same. I wanted to understand holistic approaches to alcoholism just as I understand the addiction. Turns out their not really much different. This blog can help not only a drunky but a junky too.” -Love, Robyn

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Alcohol addiction is a multifaceted brain disorder which is one of the reasons it is so difficult to treat and why a holistic approach to alcoholism is the prescription needed for craving-free and long-term sobriety

The roots of alcoholism lie in an imbalance or depletion of neurotransmitters in the brain that is caused by the alcohol itself, nutritional deficiencies, low blood sugar, allergy, poor diet, hypothyroidism, toxins in the environment, childhood abuse,chronic stress or many of the other things that disrupt neurotransmitters.

However, these biochemical roots affect every aspect of an individual’s life. It alters personality, cognitive functioning and spiritual connections. It impacts the physical, emotional, social, cognitive and spiritual levels deeply.

We’ll call these other issues, secondary contributors to alcoholism. Although they are not the core root, if they are not addressed they have the power to sabotage recovery.

The physical, emotional and spiritual elements are deeply intertwined. The biochemical/physical impacts the spiritual and the psychological and the spiritual affects the biochemical and psychological and vice versa.

When an individual addresses the true biochemical roots of their addiction with a holistic approach to alcoholism, physical healing begins and biochemical repair is essential to success in long-term sobriety. Deep spiritual and emotional healing can’t be complete without it. However, if one only addresses the biochemical and neglects the spiritual and emotional then they are still at risk of relapse or relapse.

The damage that is done on the physical level has a great impact on the psychological and the spiritual. When your brain and body systems aren’t functioning properly, it has a profound impact on emotional and spiritual health which is often exhibited in a variety of negative psychological symptoms.

Incorporating a holistic approach to alcoholism into your recovery plan helps the individual to heal on all these levels and therefore increases the success rates of long-term sobriety quite drastically.

Unique Aspects of a Holistic Approach to Alcoholism

Alcoholism is unique from other diseases in that it often destroys marriages or relationships or alienates family and friends. Family members and friends must often distance themselves from the alcoholic in order to save their own sanity and in some cases protect themselves emotionally and/or physically. When this occurs, the alcoholic is left in a position without much support. For those who stick around, there is usually a great deal of damage done to the relationship and healing is required.

Another unique component to alcoholism, is that after one engages in the alcoholic lifestyle for an extended period of time, it then becomes a learned behavior to some degree. They learn to respond to stress, pain, sadness, anger etc. by taking a drink or a drug. It becomes a habitual response without thought. These types of behaviors must be unlearned and replaced with healthier behaviors. Habits and routines must be broken. A new lifestyle needs to be embraced.

Alcoholism recovery is also unique in that there is likely to be a great deal of shame, guilt and remorse for actions and behaviors that the alcoholic engaged in while intoxicated, which must be dealt with in a healthy manner to keep them from interfering in sobriety.

Depending on factors such as each individuals background and how long one has been living with alcoholism, there can be a variety of other secondary factors that need to be taken into consideration and addressed, such as relationship issues, childhood sexual or physical abuse, impact on marriage, parenting issues and interpersonal skills. Many people who’ve lived with alcoholism for a long time may be lacking in a variety of social skills that are necessary to get through life. These factors will not apply to everyone, but for those who it does, this is where traditional counseling is called for.

And yet another exclusive aspect of alcoholism is that sometimes the individual goes through a grieving period when they begin recovery. Giving up alcohol is like losing a very good friend or a loved one. Emotional support is a crucial for those who have this experience.

With all these different factors weighing in the alcoholism recovery equation, to address only one aspect will not lead to successful long-term sobriety. All issues must be addressed simultaneously or they become possible triggers for relapse and undermine recovery.

A holistic approach to alcoholism may include the following:

1. Biochemical repairs that addresses the physical as well as the psychological:

  • Identify neurotransmitter imbalances and metabolic disorders
  • Nutritional support during detox and later
  • Changes in diet and nutrition
  • Recognizing environmental factors
  • Addressing nutritional deficiencies
  • Individualized diet plans
  • Dietary and nutritional counseling
  • Exercise

2. Counseling, groups or seminars for social and emotional issues:

  • Childhood physical, emotional or sexual abuse and neglect
  • Dealing with loss and grief of alcoholism
  • Coping skills
  • Parenting skills
  • Lifestyle adjustment
  • Communication skills
  • Assertiveness training
  • What to do with loneliness, boredom, too much time on your hands
  • Repair relationships

3. Discovering spiritual connections:

  • Developing a relationship with yourself
  • Connecting more deeply with yourself
  • Healing relationships
  • Engaging in spiritually fulfilling activities
  • Forgiveness of self
  • Activities that make you feel whole, complete and connected
  • Deep and meaningful activities
  • Mindfulness based meditation
  • Deep breathing exercises
  • Communing with nature

Another very important component in the holistic approach to alcoholism is that treatment is individualized and personalized according to each persons needs and issues.

One person may have many secondary issues while another individual may have none or only one. Treatment approaches will vary to some degree in the biochemical aspect as well as the emotional and spiritual aspects.

Someone who has been drinking for 20 years may have a lot more complex biochemical and social issues than someone who become an alcoholic two years ago after their husband died.

An individual who lived with childhood sexual, emotional or physical abuse or neglect may have more challenges to face than someone who had a loving childhood. Their alcoholism recovery plan would likely include a lot more focus on the counseling aspect.

One person may need a great deal of counseling and training in areas such as communication and assertiveness while others may be quite competent in these areas. Some people may adjust easier to a new lifestyle while another may struggle a great deal. All these details need to be taken into account and adjusted for specifically for the individual.