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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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Addiction and the Role of Family History

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Addiction is due 50 percent to genetic predisposition and 50 percent to poor coping skills.This has been confirmed by numerous studies. One study looked at 861 identical twin pairs and 653 fraternal (non-identical) twin pairs. When one identical twin was addicted to alcohol, the other twin had a high probability of being addicted. But when one non-identical twin was addicted to alcohol, the other twin did not necessarily have an addiction. Based on the differences between the identical and non-identical twins, the study showed 50-60% of addiction is due to genetic factors.(1) Those numbers have been confirmed by other studies.(2)

The children of addicts are 8 times more likely to develop an addiction. One study looked at 231 people who were diagnosed with drug or alcohol addiction, and compared them to 61 people who did not have an addiction. Then it looked at the first-degree relatives (parents, siblings, or children) of those people. It discovered that if a parent has a drug or alcohol addiction, the child had an 8 times greater chance of developing an addiction.(3)

Why are there genes for addiction? We all have the genetic predisposition for addiction because there is an evolutionary advantage to that. When an animal eats a certain food that it likes, there is an advantage to associating pleasure with that food so that the animal will look for that food in the future. In other words the potential for addiction is hardwired into our brain. Everyone has eaten too much of their favorite food even though they knew it wasn’t good for them.

Although everyone has the potential for addiction, some people are more predisposed to addiction than others. Some people drink alcoholically from the beginning. Other people start out as a moderate drinker and then become alcoholics later on. How does that happen?

Repeatedly abusing drugs or alcohol permanently rewires your brain. If you start out with a low genetic predisposition for addiction, you can still end up with an addiction. If you repeatedly abuse drugs or alcohol because of poor coping skills, then you’ll permanently rewire your brain. Every time you abuse alcohol, you’ll strengthen the wiring associated with drinking, and you’ll chase that buzz even more. The more you chase the effect of alcohol, the greater your chance of eventually developing an addiction.

Your genes are not your destiny. The 50% of addiction that is caused by poor coping skills is where you can make a difference. Lots of people have come from addicted families but managed to overcome their family history and live happy lives. You can use this opportunity to change your life. (Reference: www.AddictionsAndRecovery.org)

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What Is Your Family History?

Most people don’t know their family history of addiction very well. Addiction is not the sort of thing that most families talk about. Not too long ago you could have a raging alcoholic in your family and nobody would talk about it. Or they would make some quaint remark like, “Oh he drinks a little too much.” There was so little people could do about addiction before that there was no point in talking about it.

But now that you can do something about addiction, a family history is worth talking about. Once you stop using and tell your family that you’re in recovery, that’s often when they will tell you about the family secrets. That’s when family members will sometimes come out of the closet and tell you their stories.

Let your coping skills be the legacy you pass on to your children. Don’t let your genes be the only legacy you pass on to your children. Your children are more likely to have an addiction because of your addiction. But their genes don’t have to be their destiny. You can help your children lead happy lives by teaching them healthy coping skills – by being an example with your recovery.

Is Addiction a Disease?

Addiction is like most major diseases. Consider heart disease, the leading cause of death in the developed world. It’s partly due to genes and partly due to poor life style choices such as bad diet, lack of exercise, and smoking. The same is true for other common diseases like adult-onset diabetes. Many forms of cancers are due to a combination of genes and life style. But if your doctor said that you had diabetes or heart disease, you wouldn’t think you were bad person. You would think, “What can I do to overcome this disease?” That is how you should approach addiction.

Addiction is not a weakness. The fact that addiction crosses all socio-economic boundaries confirms that addiction is a disease. People who don’t know about addiction will tell you that you just need to be stronger to control your use. But if that was true then only unsuccessful people or unmotivated people would have an addiction, and yet 10% of high-functioning executives have an addiction.

If you think of addiction as a weakness, you’ll paint yourself into a corner that you can’t get out of. You’ll focus on being stronger and trying to control your use, instead of treating addiction like a disease and focusing on stopping your use.

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Cross Addiction

You can become addicted to any drug, if you have a family history of addiction. If at least one of your family members is addicted to alcohol, you have a greater chance of developing an addiction to any other drug. Cross addiction occurs because all addictions work in the same part of the brain. If your brain is wired so that you’re predisposed to one addiction, then you’re predisposed to all addictions.

This is especially important for women who may come from alcoholic families, but who often develop addictions that go undetected, like addictions to tranquilizers, pain relievers, or eating disorders.

One addiction can lead to other addictions, and one drug can make you relapse on another drug. That’s one of the consequences of a brain that’s wired for addiction. Suppose you’re addicted to cocaine. If you want to stop using cocaine then you have to stop using all addictive drugs including alcohol and marijuana. You may never have had a problem with either of them, but if you continue to use alcohol or marijuana, even casually, they’ll eventually lead you back to your drug of choice. Recovery requires total abstinence.

How does cross addiction cause relapse:

  1. All addictions work in the same part of the brain. Addiction is addiction is addiction. Therefore one drug can lead you back to any other drug.
  2. Even moderate drinking or smoking marijuana lowers your inhibitions, which makes it harder for you to make the right choices.
  3. If you stop using your drug of choice but continue to use alcohol or marijuana, you’re saying that you don’t want to learn new coping skills and that you don’t want to change your life. You’re saying that you want to continue to rely on drugs or alcohol to escape, relax, and reward yourself. But if you don’t learn those new skills, then you won’t have changed, and your addiction will catch up with you all over again.

(Reference: www.AddictionsAndRecovery.org)