When people hear that substance use disorders and mental health conditions frequently show up together, they may assume that people who use substances are causing themselves to become mentally ill. Not only is this inaccurate, but it is dangerously stigmatizing, as it can cause society to blame people who are struggling with mental health and substance use disorders for the pain they experience.
At Carolina Dunes Behavioral Health in Leland, North Carolina, we think it’s important for our patients, their families, and the wider community to understand why people with substance use disorders often have mental health conditions and vice versa, rather than assuming they are at fault.
Looking Deeper
Two things being connected does not mean that one caused the other to occur. There can be other explanations. In the case of mental illness and addiction, there are several popular theories for why one person might experience both:
Shared Causes
The same things that increase a person’s risk for mental illness also increase their risk for substance use disorder. These include:
- Structural differences in the brain: People with mental health conditions may have parts of their brains that developed differently, or their brain may make more or less of an important chemical that regulates their emotions or behaviors.
- Traumatic events: Natural disasters, abuse, witnessing violence, and living in a war zone are just a few examples of events that can be emotionally devastating for people to experience. These types of events can be a catalyst for addictive behaviors and mental illness.
- Stress: Losing a job, worrying about money, and being unhoused can be triggers for symptoms in both types of conditions.
- Genetics: People with blood relatives who struggle with a mental health or substance use disorder are at higher risk for developing these conditions.
Mental Illness Leading to Substance Misuse
“Self-medicating” is when people use alcohol, illegal drugs, or illegally obtained medications to try to get rid of their symptoms. This often backfires, however, as they may develop a dependency on the substances they are using and/or their conditions may be made worse by the substances they use. In addition, some mental health disorders make it difficult for people to control their impulses, which may put them at higher risk for using substances in the first place.
Existing Conditions Causing an Additional Mental Illness
A person may already have a mental illness and a substance use disorder, but due to not receiving effective treatment, an additional disorder emerges.
Mental Illnesses That Often Occur Alongside Addiction
There are some mental health disorders that are more likely than others to be present in a person with a substance use disorder. These include:
- Anxiety, depression, and other mood disorders
- Post-traumatic stress disorder (PTSD)
- Schizophrenia
- Bipolar disorder
- Conduct disorders
- Attention deficit hyperactivity disorder (ADHD)
Responding to Co-Occurring Conditions
At Carolina Dunes Behavioral Health, we take a whole-person approach to treatment, which means we don’t just attempt to detect or treat one condition or another. When completing assessments with our clients, we pay attention to signs that they could have co-existing conditions, and we offer integrated treatment that can include support for mental health and substance use disorders simultaneously.
We offer this to adolescents, ages 12-17, and to adults, ages 18 and up.
How Recovery is Different for People with Dual Disorders
Recovery is often more complicated for people who are attempting to address two or more conditions at the same time:
- Delayed or inaccurate diagnoses. When a person with dual diagnoses is assessed, their symptoms may be labeled incorrectly if the clinician assessing them is not knowledgeable about co-existing conditions or if their symptoms look a bit different because they have an addiction and a mental illness. This can cause the person to get sicker because it takes longer for them to get effective treatment.
- Medications. A med that would normally be used to treat a certain mental health disorder may not be recommended for people who are recovering from a substance use disorder. Medications that are used to support sobriety may cause a reaction with a med someone has been given for their mental health.
What Integrated Treatment Looks Like
When a person is being treated for co-existing mental health and substance use disorders, their treatment may have more components, such as:
- Detox. The person might need time to get alcohol or drugs out of their system and manage withdrawal symptoms
- Inpatient care. A person who has dual diagnoses is more likely to require a higher level of care than a person who is just managing a mental health condition or just a substance use disorder.
- Mental health therapy. Understanding their mental health and developing the coping skills that make mental health manageable is a key component of integrated treatment. This might include CBT, DBT, ACT, TC, or CM for adults. Children and adolescents might utilize other therapy modalities.
- Medication. There are medications for mental health, and also medications to make recovery more manageable, and a person may need one or both of these.
- A step down to a lower level of care. After a person completes inpatient treatment, they might be advised to follow up with outpatient care to solidify their recovery. This is more likely to occur in cases where a person is managing mental health and addiction simultaneously.
- Sober housing. This may be suggested to help a person get used to living outside of treatment, before they return home.
- Recovery groups. AA, NA, Celebrate Recovery, SMART Recovery, Double Trouble in Recovery, and other community-based programs will allow a person to meet peers who are also building sober lives.
At Carolina Dunes Behavioral Health, we want to give our patients the tools they need to have amazing lives in recovery. This means seeing all of the facets of who they are, what they want, and where they are going in their future.
