The past year has been stressful on all of us. Faced with months of isolation due to the global pandemic, many of us have been dealing with a variety of mental health issues. Increased levels of stress, bouts of depression, and general mental fatigue are rampant. For others, the current climate has compounded the effects of anxiety and panic disorders, clinical depression, personality disorders, and other mental illnesses. To alleviate their symptoms, some people turned to recreational drugs to self-medicate; others sought out stronger substances. Unfortunately, the use of drugs can exacerbate the symptoms of pre-existing mental illnesses, and mental illnesses can increase the chance of developing a substance use disorder.
Addiction itself is a mental illness. It is a chronic disease which physically alters the chemical structures of the brain. Drugs interact with the neurotransmitters which regulate levels of dopamine and serotonin; chemicals which are key in regulating our moods. Mental illness also affects these neurotransmitters. Because they affect similar parts of the brain, mental illness and drug abuse can co-occur, making it difficult to separate and treat them.
Studies conducted by the National Institute on Drug Abuse (NIDA) have shown connections between mental illness and substance abuse disorders. In surveys conduction, half of the people experiencing mental illness have also suffered from a substance use disorder. Many of the people surveyed reported that drug use temporarily alleviated the symptoms of their mental illness, leading them to continuously use drugs to make themselves feel better. The rates of crossover were particularly high amongst people suffering from anxiety and panic disorders, depression, bipolar disorder, ADHD, psychotic illness, borderline personality disorder, and antisocial personality disorder. Within these groups, there was an increased risk for nonmedical use of prescription opioids, such as OxyContin, Vicodin, and Percocet. Nearly 43% of people in treatment for opioid addiction also report having a diagnosed mental illness.
There is a strong link between the use of tobacco products and people suffering from a mental illness, with 30.5% of people reporting having smoked cigarettes in the last month. This was 66% higher than the rate among those not suffering from a mental illness. Among those suffering from depression and schizophrenia, the rate of tobacco use is five times higher than the general population. Many who use tobacco products while suffering from a mental illness reported that tobacco helps manage the stress, poor concentration, and bad moods associated with their mental illness. This relief leads them to continue their use. However, prolonged use of tobacco products can result in severe health problems, such as cardiovascular disease, lung cancer, and death.
Unfortunately, these studies have also shown a correlation between mental illness and increased substance use disorder in youth communities, with 60% of adolescences suffering from mental illness also reporting a substance use disorder. Continued and/or heavy drug use during early adolescence increases the risk factor for developing substance abuse later in life, because brain development is permanently impacted. Drug use during adolescence may also be a risk factor in developing mental illnesses later in life. For example, studies found a link between frequent marijuana use during adolescence and an increased risk of psychosis in adulthood. Untreated childhood ADHD has also been shown to increase the risk of an individual developing drug problems later in life. If you think your child may be suffering from ADHD, you can get them tested and talk to their doctor about treatment plans. Research proven that ADHD medication does not increase the risk of substance abuse disorder in children.
For people suffering from subclinical mental illness, it can often be hard to remember which came first: drug use or mental health issues. Many suffering from a subclinical mental illness, which is not severe enough for an official diagnosis, turned to drug use as a way to self-medicate and alleviate their symptoms. The need for relief led them to develop a substance use disorder. Some of the drugs which can cause or aggravate mental health problems are: cocaine, ketamine, kratom, LSD, marijuana, MDMA, methamphetamines, PCP, steroids, and some prescription drugs such as opioids.
It is important to note that genetics play an important role in the development of both mental illness and substance use disorder. Genetics influences the development of neurotransmitters in the brain, making some people genetically predisposition to be more suspectable to developing a drug addiction or a mental illness. Similarly, recent studies have discovered a link between genetic sequences and higher risk of cocaine dependence, heavy opioid use, and cannabis cravings and withdraws. Some genes interact differently with different drugs, predisposing people to alcohol dependence and cigarette smoking.
In conjunction with genetics, environmental factors can also increase the likelihood of developing mental illness and/or substance use disorder, and can impact multiple generations of the same family. These factors impact how an individual responds to stress and their risk-taking behaviors. Factors such as poverty; homelessness; physical, mental, and domestic abuse; and the lack of a support system all affect how individuals cope with stressors in everyday life. Studies have shown that exposure to chronic stress often associated with poverty, homelessness, and abusive households reduces activity in the prefrontal cortex of the brain, and increases responsivity in the striatum. This leads to decreased behavioral control and increased impulsivity; two factors which increase the likelihood of developing a substance use disorder. Similarly, exposure to traumatic experiences can trigger mental health issues and substance abuse problems. Studies of veterans suffering from PTSD upon their return from Iraq and Afghanistan found that 16% have untreated substance abuse. 1 in 5 veterans suffering from PTSD have a co-occurring substance use disorder. For those who seek treatment for their substance use disorder, exposure to high levels of stress can trigger relapses and hinder their progress towards a better life.
If you know someone who is suffering a substance use disorder, it is important to remember that it is a mental illness. Blaming the person for their illness will not motivate them to get better or seek help for their illness, and might push them further into their substance addiction. It can also promote feelings of shame and guilt that feed an addiction. Relapse cycles are normal as someone goes through a treatment plan as they work towards long-term remission.
