The Science Behind Mental Illness and Substance Abuse
Drug addiction is a mental illness. You may find that addiction is often present alongside other mental illnesses, but the relationship between the two a complicated one.
Addiction as an illness
According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), substance abuse changes the way the brain works, and it disturbs a person’s hierarchy of needs. This can cause a person to act upon impulse, losing control – a common thread underlying many mental illnesses.
DSM-5 distinguishes between two types of drug disorders: abuse and dependence. Dependence and addiction are interchangeable, occurring when the person compulsively needs to use a substance regularly, as their body and mind crave the substance of abuse. Substance abuse disorder refers to the consequences of repeated substance abuse. This includes symptoms, such as increased tolerance and withdrawal, that can be signs of addiction and/or dependence.
Comorbidity of drug addiction and other mental illnesses
DSM-5 describes comorbidity as any instance when two or more illnesses are present in the same person. It is common for people with other mental illnesses to be diagnosed with drug addiction, and the reverse is also true.
Although closely linked, the relationship between drug addiction and other mental disorders does not necessarily demonstrate that one causes the other. Research In an article by Health News from NPR, titled, “Pot Can Trigger Psychotic Symptoms for Some, But Do the Effects Last?” Dr. Nora Volkow, director of the National Institute for Drug Abuse at the National Institutes for Health, shed some light on the connection between substance abuse and mental illness:
- Drug abuse can trigger or exacerbate symptoms of another mental illness. For example, marijuana may trigger schizophrenic episode in those who are vulnerable to schizophrenia
- Self-Medication – In cases where mental illness leads to drug abuse, the afflicted person is often self-medicating, or using drugs to alleviate symptoms of anxiety and/or depression shortly.
Who is likely to suffer from drug addiction and another mental illness?
Even within the subset of the population that includes substance abuse and mental illness, there are factors that may increase a person’s vulnerability to both.
- Genetic – One is at greater risk for comorbidity when genetically predisposed to substance abuse and another mental illness.
- Environmental Triggers – Environmental triggers, such as abuse, may predispose a person to a comorbidity of substance abuse and other mental illness.
- Early Drug Exposure – Exposure to drugs at a developmentally important time may change the brain in ways that leave the person exposed to other mental illness.
- Brain Activity –In an article by Elements Behavioral Health, entitled “Poor Neurotransmitter Activity Linked to Mental Illness,” anxiety and depression can result from a disruption in moving neurotransmitters like serotonin or nor-epinephrine throughout the brain. Dopamine is another neurotransmitter associated with some mental illness, such as schizophrenia and attention-deficit/hyperactivity disorder.
If someone you know is struggling with substance abuse and another mental illness, encourage him or her to seek professional help for both. The two are so interrelated that if you treat the mental illness without treating the substance abuse issue, there is a chance you would be wasting your efforts. When substance abuse is present with another mental illness, a medical detox is necessary for the safety of the individual experiencing the issue.
American Psychiatric Association: The Diagnostic and Statistical Manual of Mental Disorders (DSM–5) https://www.psychiatry.org/psychiatrists/practice/dsm
Volkow, Nora D., M.D., National Institute on Drug Abuse, How Science Has Revolutionized the Understanding of Drug Addiction: https://www.drugabuse.gov/publications/drugs-brains-behavior-science-addiction/preface
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