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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.”

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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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Bipolar Disorder and Addiction

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“When I first got diagnosed with bipolar 1 disorder,  I was in denial. For months after hearing doctor after doctor telling me the same thing I would still hide my meds, take drugs and do anything to prove I wasn’t crazy. But the hospital visits and psych ward continued to prove I was wrong. I was crazy.

“But being bipolar doesn’t mean your crazy. The more I learn about my disorder (reading articles, books and even digging into my past) I notice that I am not alone. I notice that these moments of clear insanity have a purpose, they have a name. There are reasons to me madness and now I finally have an opportunity to treat it.

“Its important that we are knowledgable about our (or your loved ones) diagnosis because it gives us the power and courage to live with it. This is an article I have found very helpful to myself as I live with bipolar and co-occurring addiction. It’s informative and concise, clearly describing the highs and lows of bipolar disorder.” -Love, Robyn

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Bipolar disorder, once commonly known as manic depression, is a serious mental disorder that is characterized by sudden and intense shifts in mood, behavior and energy levels. Like substance abuse, bipolar disorder poses a risk to the individual’s physical and emotional well-being. Those afflicted with bipolar disorder have a higher rate of relationship problems, economic instability, accidental injuries and suicide than the general population. They are also significantly more likely to develop an addiction to drugs or alcohol. According to statistics presented by the American Journal of Managed Care:

  • About 56 percent of individuals with bipolar who participated in a national study had experienced drug or alcohol addiction during their lifetime.
  • Approximately 46 percent of that group had abused alcohol or were addicted to alcohol.
  • About 41 percent had abused drugs or were addicted to drugs.
  • Alcohol is the most commonly abused substance among bipolar individuals.

If you are struggling with bipolar disorder and with a drug or alcohol problem, you may have a Dual Diagnosis of bipolar disorder and substance abuse. Having a Dual Diagnosis, or a co-occurring disorder, can make recovery more challenging. Bipolar individuals may experience periods of intense depression alternating with episodes of heightened activity and an exaggerated sense of self-importance. This emotional instability can interfere with your recovery program, making it difficult to comply with the guidelines of your treatment plan.

Dual Diagnosis rehabilitation programs are designed to meet the needs of clients who are faced with this complex psychiatric condition. Staffed by specially trained and credentialed mental health professionals and addiction specialists, these centers offer care that integrates the best treatment strategies for bipolar disorder with the most effective treatments for addiction.

How Are Bipolar and Addiction Related?

There is no easy explanation for the high rate of substance abuse and chemical dependence among bipolar individuals. One reason for this phenomenon is that a large percentage of individuals attempt to self-medicate with drugs and alcohol in an effort to numb the painful symptoms of their bipolar disorder. Symptoms of bipolar disorder such as anxiety, pain, depression and sleeplessness are so alarming, that many individuals will turn to drugs and alcohol as a means for offsetting the discomfort, if only for a little while. On the other hand, the National Institute of Mental Health notes that drinking and using drugs may trigger depressed or manic moods in someone with bipolar disorder.

Age and gender may play a part in the relationship between bipolar and addiction. According to the journal, Bipolar Disorder and substance abuse is more common in young males than in other population groups.

Young men are more likely than females or older men to take dangerous risks or to act on serious self-destructive impulses. In elderly individuals with bipolar disorder, the incidence of substance abuse is much lower.

Clinical researchers believe that brain chemistry may influence both bipolar disorder and substance abuse. People with bipolar disorder often have abnormal levels of serotonin, dopamine and norepinephrine, according to WebMD. These chemicals affect vital functions like appetite, metabolism, sleep and your body’s response to stress. They also affect mood and emotions. Heavy use of drugs or alcohol can interfere with the way your brain processes these chemicals, causing emotional instability, erratic energy levels and depression. People with bipolar disorder may turn to drugs or alcohol out of an unconscious need to stabilize their moods. Unfortunately, substance abuse has the opposite effect, making the symptoms of bipolar disorder worse.

Symptoms of Bipolar Disorder

We all go through intense episodes of sadness, elation, anger or despair. But for someone who meets the diagnostic criteria for bipolar disorder, these episodes are all-consuming and uncontrollable. There are four major types of mood episodes that characterize bipolar disorder: mania, hypomania, depression and mixed episodes — each of which has a set of unique symptoms:

Symptoms of Mania

Mania is the “high” end of the mood spectrum for bipolar individuals. Symptoms may include:

  • Moments of tremendous optimism and significant pessimism
  • Grandiose feelings
  • Rapid talking
  • Little sleep
  • Impaired judgment, irrational behavior
  • Delusional behavior
  • Hallucinations

Symptoms of Hypomania

Symptoms are similar to those found in manic behavior but less intense. Hypomanic individuals are usually capable of managing their day-to-day lives, but they experience a higher than usual level of happiness, irritability or energy. You may feel that you’re capable of taking on more responsibility, or that you need less sleep. People in your life may find that you’re more talkative or sociable. You may also be more prone to engage in risk-taking behaviors, like substance abuse. Hypomanic periods are extremely productive for some people, and because psychotic symptoms do not occur in hypomania, it might seem that you don’t really have a problem.

Symptoms of Depression

At the “low” end of the bipolar spectrum is depression, an emotional state that is often characterized by sadness, tearfulness and despair. Depression in bipolar disorder may last for days or weeks, depending on your mood cycle. These periods are dangerous for Dual Diagnosis individuals, who have a higher risk of self-injury and suicide when they’re using drugs and alcohol during a low period. When you’re depressed, you may experience:

  • Hopeless feelings
  • Loss of interest in things that used to make you happy
  • Fatigue
  • Changes in appetite
  • Self-loathing
  • Suicidal thoughts

Symptoms of Mixed Episodes

The symptoms of bipolar disorder aren’t always clearly defined. In a mixed episode, behaviors reflect a combination of mania and depression. For example, you may have suicidal feelings and a loss of interest in your daily activities, combined with racing thoughts, pressured speech and a loss of sleep.
You may feel the urge to drink or take drugs in an attempt to balance out these unpredictable mood swings, but intoxication is only a temporary fix that won’t provide permanent relief. To achieve a full recovery, you need professional treatment that helps you stabilize your moods as you deal with the cravings and destructive impulses that characterize addiction.

 

Drug Addiction and Disease

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Drug addiction leads to a host of diseases – particularly chronic conditions that affect the body’s vital organs. However, drug addiction can also increase the risk of certain cancers, strokes or heart attacks. Though some physical conditions associated with drug addiction may be treatable but incurable, vast majority of physical damage incurred by drug-addicted individuals can be healed during the drug rehabilitation process.

“Take a scroll down and see what your fate is if you continue your addiction or what your fortunate to have gotten away with while in recovery.”- Love, Robyn

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Diseases and Conditions Associated With Drug Addiction

Below, you’ll find an overview of some of the most serious conditions and diseases initiated by drug addiction. While not every drug-addicted individual experiences such conditions, chronic drug use will increase the risk of development of serious disease and chronic adverse physical conditions.

Damage from Marijuana Addiction

Marijuana can cause a host of lung problems, particularly chronic bronchitis and emphysema. Marijuana has also been associated with an increased risk of lung cancer. Depression and amotivational syndrome can also be counted among the damaging effects of smoking the drug.

Diseases and Conditions Arising from Cocaine Addiction

Cocaine addiction can cause chronic pulmonary conditions that increase the risk of heart attack. Heart disease in itself is common to chronic cocaine users, due to the overexertion of the heart as a result of the drug’s stimulant effects. Cocaine users also experience perforated or deviated septums, strokes and heart attacks (the latter two conditions a result of exceeding high blood pressure and tachycardia overtaxing the heart). Additionally, cocaine can also lead to a heightened risk for cancer and associations have been made between the drug and lung cancer, particularly in freebasing users.

Conditions Associated with Benzodiazepine Addiction

Benzodiazepines — also known as “benzos” — are sedating drugs given mainly for anxiolytic purposes. Chronic users of benzodiazepines can experience abdominal problems and fatal blood clots. Additionally, the reproductive system becomes affected by benzodiazepine addiction, and can lead to loss of sex drive, erectile dysfunction and birth defects in children of addicted and pregnant mothers.

Physical and Mental Illness from Hallucinogen Addiction

Ketamine, a powerful dissociative narcotic, can also lead to physical and psychological damage after long-term use. With chronic abuse, ketamine addiction can cause a condition known as “Olney’s lesions,” where vacuoles begin to form within the brain, affecting cognition, learning and memory. Ecstasy can cause psychological conditions, such as severe depression, dissociative disorders, and Hallucinogen Persisting Perception Disorder (HPPD), a flashback-producing condition that also occurs with LSD use and can persist long after Ecstasy addiction subsides. PCP can cause Irritable Bowel Syndrome (IBS), seizures and paralysis with chronic use.

Diseases Resulting from Opiate Addiction

Opiates — a class of potent narcotics spanning from heroin, morphine and codeine to prescription painkillers — can cause a host of long-term physical diseases and conditions. Opiate users, particularly those who inject, are at high risk for hepatitis and HIV transmission from needle-sharing. Collapsed veins can also result from chronic injection of opiates. Heroin use can cause long-term digestive issues, including a form of chronic constipation that is highly dangerous while addiction persists.

Diseases Caused by Amphetamine Addiction

Amphetamines take an unimaginable toll on the body. Common conditions associated with amphetamines addiction include insomnia, anorexia and eyesight degradation. Amphetamine-addicted individuals also can experience stunted growth, hypertension, frequent urinary tract infections (UTIs) and hyperactivity. Amphetamines can also cause a condition known as dermotasis, the development of skin disease. Liver and heart disease are also associated with amphetamine addiction.

Conditions Caused by Meth Addiction

Methamphetamines can cause a host of physical conditions, ranging from liver damage to lung disease. Meth can irreparably damage the brain’s blood vessels, incite hypertension (high blood pressure), and create an immunocompromised state (making the body more susceptible to diseases, infections and cancers). Methamphetamine abuse can also cause heart disease, stroke occurrence, and severe depression or mania in users.

Diseases and Conditions Arising from Abuse

Inhalant abuse — the inhalant of household and industrial chemicals colloquially known as “huffing” — can also lead to a host of chronic physical conditions. In addition to instantaneous death caused by Sudden Sniffing Death Syndrome, inhalant abuse can lead to tachycardia, heart disease and an array of damage to the vital organs, including diseases of the liver, kidney and lungs. Chronic bronchitis can arise from inhalant abuse, and some inhalant-addicted individuals also encounter tremors and chronic grand mal seizures.

Source: Axis Residential Treatment