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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

Understanding Withdrawal Symptoms

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Going into a detox facility during withdrawal from drugs and alcohol is not only safer but highly recommended to those who are trying to stop using because you will receive a lot of support. Commonly, after one goes through detox, they will be able to work with staff to determine the next steps in their treatment. This can include inpatient or outpatient programs that will help educate and inspire a life of sobriety. 

“You don’t have to go through withdrawals alone. It can be scary not understanding whats going on with your body. Below are a list of symptoms to look out for to assure that, yes, you are going through withdrawal and yes, you need to seek help. 

“I know that I had no idea that I was going through withdrawals when I first experienced it. I was in denial about my addiction and I wish I sought help immediately before I decided to simply replace my drug of choice, thinking they weren’t as bad as the ones I was using before. ” -Love and light, Robyn

withdrawal

When it comes to alcoholism and drug addiction, going cold turkey is not the right option. Supervised detox is usually safer and may be the best route for you or your loved one.

Treatment for alcoholism or drug addiction involves undergoing therapy to help you mentally and physically recover from theaddiction. In order to get better, you must physically “cleanse” your body of the substance. To avoid a life-threatening reaction brought on by withdrawal from alcoholism or drug addiction, it’s best to seek professional help instead of trying to go it alone.

Ending Drug Addiction: Withdrawal and Detox
Withdrawal — stopping alcohol or drug use — can be extremely dangerous if done on your own, which is why a carefully administered plan for detoxification is the safest way to end your drug or alcohol addiction.

According to James Garbutt, MD, professor of psychiatry at the University of North Carolina in Chapel Hill, and research scientist at the Bowles Center for Alcohol Studies, “Everyone is going to have to go through detoxification to withdraw from a substance. The question is, when is it medically dangerous and when does it require medical oversight?”

Withdrawal from many drugs can bring symptoms such as agitation, sweating, an inability to sleep, and high blood pressure. Opiate and narcotic withdrawal symptoms can be among the most difficult. Opiates and narcotics are classes of drugs that include heroin, codeine, Demerol (meperidine), and Oxycontin (oxycodone), which are taken to achieve a sense of euphoria in those who abuse them.

Other substances that tend to cause more severe withdrawal symptoms, and potentially life-threatening symptoms, are barbiturates, alcohol, and benzodiazepines, according to Stephen Gilman, MD, an addiction psychiatry specialist in New York City. “Withdrawal from these substances should be handled in a hospital.”

Drug Addiction: Symptoms of Withdrawal
Symptoms of withdrawal depend on the object of the addiction. The following symptoms may result:

  • For alcohol: sweating, anxiety, tremors, fluctuations in blood pressure and heart rate, seizures, delirium tremens (the “DTs” — a state of extreme agitation, hallucinations, hyperactivity, tremors, and confusion), psychosis and, adds Dr. Gilman, “ultimately death if not treated by a professional.”
  • For opiates/narcotics: anxiety, insomnia, dilated pupils, increased heart rate, elevated blood pressure, nausea, and vomiting.
  • For stimulants, such as cocaine: excessive tiredness and depression.
  • For barbiturates (such as Amytal, Nembutal, Seconal): nausea, fast breathing, increased heart rate, tremors, muscle pain, insomnia, hallucinations, convulsions, and delirium. If withdrawal is not monitored, the consequence could be death.
  • For benzodiazepines (such as Xanax, Librium, Valium): delirium, muscle twitches, hallucinations, sensitivity to light, sound, taste, and smell, ringing in the ears, tingling, numbness, and insomnia.

Ending Drug Addiction With Medication
Another reason detox in a controlled setting is important: Medical professionals can administer medications to ease withdrawal symptoms. Ironically, sometimes these are the same drugs that are being abused.

From http://www.webmd.com by Linda Foster, MA and medically reviewed by Cynthia Haines, MD

Titanium by David Guetta featuring Sia

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This is a really great song that is so uplifting, especially in those time when you feel like giving up. It’s all about strength and courage. The video is a little odd in my opinion. At first I thought the kid was a serial shooter like we see from time to time in the news… But he’s not. You can give it a watch but I seriously suggest just giving it a listen and reading along with the lyrics.

Lyrics:

You shouted out
But I can’t hear a word you say
I’m talking loud not saying much
I’m criticized but all your bullets ricochet
You shoot me down, but I get up
I’m bulletproof, nothing to lose
Fire away, fire away
Ricochet, you take your aim
Fire away, fire away
You shoot me down but I won’t fall
I am titanium
You shoot me down but I won’t fall
I am titanium
Cut me down
But it’s you who’ll have further to fall
Ghost town and haunted love
Raise your voice, sticks and stones may break my bones
I’m talking loud not saying much
I’m bulletproof, nothing to lose
Fire away, fire away
Ricochet, you take your aim
Fire away, fire away
You shoot me down but I won’t fall
I am titanium
You shoot me down but I won’t fall
I am titanium
I am titanium
I am titanium
Stone-hard, machine gun
Firing at the ones who run
Stone-hard as bulletproof glass
You shoot me down but I won’t fall
I am titanium
You shoot me down but I won’t fall
I am titanium
You shoot me down but I won’t fall
I am titanium
You shoot me down but I won’t fall
I am titanium
I am titanium