Tag Archives: two

How Mental Illness and Addiction Influence Each Other

Standard

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
Advertisements

Bipolar Disorder and Addiction

Standard

“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

bipolar

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.

 

The Ultimate Mood Tracking App: Optimism

Standard

“I am completely in love with this app called Optimism. It is incredibly useful for those that are struggling through addiction and co-occurring disorders. It keeps track of everything from sleep to triggers. I remember searching for some type of workbook where I could record my mood and all that nonsense to find patterns so as to prevent mania and depression. This app helps me do that and more! Not only does it just intake the information and allow for extra notes, it literally gives you data summaries over whatever period of time you want. It is simple, thorough and so convenient, I would recommend this for even people that are SANE! Please read the specs below and give it a try. I promise you won’t be disappointed!” -Love and light forever, Robyn

Image

ImageImageImage



Optimism is a mood charting app that helps you develop strategies for managing depression, bipolar or other mental health conditions.
*Note: a network connection is needed to use this app.*

The app helps you to:

  • Develop and monitor health strategies
  • Learn the “triggers” of a decline in your mental health
  • Recognize the early warning signs of a decline.

Detailed charts and reports are available within the app or by immediate email delivery. These form a feedback loop, providing concrete starting points for exploring things that are affecting your mental health.
The charts and reports can be invaluable for working with a health professional. They provide a detailed history that is fast and easy to review.
The Optimism app is not intended as a substitute for professional medical advice, diagnosis, or treatment. The advice of a qualified health professional should always be sought for questions regarding a medical condition.

In a nutshell, the purpose of self-tracking is to learn more about yourself and achieve better health.

  • By using the Optimism apps you can monitor the patterns in your life, to identify the negative influences (or “triggers”) that impact on your health, and the early warning signs that your health is deteriorating.
  • Optimism can help you find the small things, as well as the big, that help you to stay well. It can show you the impact of positive strategies that you adopt on your well-being.
  • It helps you to plan for better health. By bringing together your knowledge of your triggers, early warning signs and symptoms, and wellness strategies you can develop a plan for remaining well. That is the key. The purpose of the software is to plan for wellness, not just keep a record of illness.
  • Rather than be a passive recipient of treatment, or just seek treatment in reaction to a new episode, Optimism can help you to have more involvement in your health and a greater sense of control. In general people achieve better health outcomes when they educate themselves and are proactive with their health.
  • There are many health professionals who love Optimism. By tracking your mental health you can provide your clinician with a precise, detailed history. It removes the problem of memory recall and gives an accurate picture of what has been happening. It gets to the bottom of what is or isn’t working, which helps them to give more relevant, appropriate advice and treatment.

Every person’s illness is different. “One Size Fits One”. For many people treatment is difficult, a slow process, or not entirely successful. Optimism is designed to help increase your chance of success.

Why We Smoke SO Much!

Standard

” When I first started smoking, I thought I was cool. Then I stopped. When I picked up smoking several years later, it was a way to get high. Then I stopped.  It wasn’t until I found myself in recovery that I really started smoking like a chimney. My parents were concerned and frankly annoyed my this new habit. There was a sense of relief  however, when they discovered in their NAMI class (National Alliance on Mental Illness) that this was commonly seen in people who have mental disorders and addiction. So I went on their website and found the article that explains it all! So if your a smoker, you may relate to this bit of text! It does focus on mental illness but a lot of the information can be useful to all.” -Peace, Robyn

Smoking and Mental Illness

People living with mental illness have a very high rate of smoking. A study by The Journal of the American Medical Association reported that 44.3 percent of all cigarettes in America are consumed by individuals who live with mental illness and/or substance abuse disorders. This means that people living with mental illness are about twice as likely to smoke as other persons.

A positive note is that people who live with mental illness had substantial quit-rates, which were almost as high as the group without mental illness. NAMI has led many changes in our mental health system─getting access to the tools to quit smoking is a way to improve the quality and quantity of life. Improving lives is a new advocacy pursuit.

The Connection between Mental Illness and Smoking

There is no one single, certain reason why so many people who live with mental illness smoke. It may be a combination of brain effects, psychological effects and the social world in which we live.

From a brain-based perspective, research is being done to determine if and how nicotine is involved in some of the brain’s memory functions. If nicotine is a factor, then this could explain why so many people living with an illness like schizophrenia or other illness involving cognitive deficits may smoke. Even though smoking is thought to enhance concentration and cognition, the effects are short in duration.

Researchers and the medical community have a great deal to learn about how smoking impacts the brains of those living with mental illness. It is known that people diagnosed with schizophrenia often smoke before the onset of symptoms and that they smoke more often and inhale more deeply than smokers without schizophrenia.

While we still have a lot to learn about why people smoke, there is plenty of information to support the serious health risks of smoking. So while there may be good reasons why you were attracted to smoking, the key is to figure out ways to increase rates of quitting. Nicotine isn’t a health problem on its own, but when smoked and combined with hundreds of other chemicals that are present in cigarettes the practice of smoking is toxic.

Psychologically, all addictions soothe cravings. People often find themselves relaxed and less tense when their addiction is fed. This is true of cigarette smoking. Smoking can also be part of a social norm, one where people in your social circle all hang out and smoke. Some people who live with mental illness learned to smoke in a hospital or in group-living settings. These examples help illustrate how the mental health culture needs to move forward to reduce the tie between socialization and smoking.

Image

Facts About Smoking

People die from smoking-related illnesses. Every year, smoking kills about 200,000 people who live with mental illness. Smoking harms nearly every organ of your body and diminishes your overall health. Smoking is a leading cause of cancer and of cancer-related death.

Smoking also causes heart disease, stroke and lung disease. With the increased risk of heart disease from second-generation atypical antipsychotic medications (SGAs), individuals living with mental illness must try to quit.

Inhaled cigarette smoke is made up of 4,000 chemicals, including cyanide, benzene, ammonia and carbon monoxide to name a few. There is no safe tobacco product, so switching to a smokeless or chew product will not eliminate your risk of smoking-related diseases.

People are finally waking up to the fact that smoking is a true health hazard, and people need to quit in order to live longer. More psychiatric facilities are going smoke-free, and NAMI is advocating for access to smoking cessation in outpatient settings.

State mental health commissioners and state medical directors are committed to changing the way the public mental health culture relates to smoking. Check out their toolkit (http://www.nasmhpd.org/general_files/publications/NASMHPD.toolkitfinalupdated90707.pdf) to see what policy changes and strategies they are using to create a healthier mental health system environment.

Smoking’s Effects on Symptoms and Medications

Research shows that people living with mental illness do not have worse symptoms after they quit. It is understandable that this is a concern with quitting smoking. Quitting is hard work, and it may take many efforts to be successful. Be sure to get support, talk with your doctor, set a quit date and explore the tools for success (Link to tools for success section) that are available to help you quit.

If you are a smoker and you quit, you can usually get the same treatment results from lower doses of psychiatric medications. Smoking increases the breakdown of medicines in your body, so smokers need to take higher doses to get the same results as someone who does not smoke. Without cigarettes you may need to take less medication. An additional benefit is that a dose reduction will likely reduce side effects of medicines, such as weight gain and other side effects.

Film Pick: Drug Abuse, Mental Illness and Co-Occuring Disorder

Video

“This is a a great old video that offers a lot of information regarding substance abuse and mental illness. It brings up questions like, “Which came first?” This is a common topic many people struggling with co-occurring disorders ask. The speakers and stories shared in this film explore topics like those and many more. Go ahead, get educated and take an hour to learn something new!” – Robyn

Panelists:
Patricia Ordorica, MD – Associate Chief of Staff, Mental Health & Behavioral Sciences Central, James A. Haley Veterans Administration Hospital; Associate Professor Dept. of Psychiatry & Behavioral Sciences, University of South Florida College of Medicine; Director Addictive Disorders Department of Psychiatry & Behavioral Sciences, Univ. of South Florida College of Medicine. Deirdre Forbes – Intake Coordinator for Madison East, part of Mount Sinai Hospital in New York. Ms. Forbes is in recovery from a co-occurring disorder.
Hosted by:
Mary E. Larson, Vice President of Communications and Membership for CADCA