Addiction, mental illness closely linked
The list of risk factors for substance abuse disorders and mental illness look noticeably similar.
Though the two don’t necessarily cause one another, genetics and environmental factors, such as stress or trauma, can contribute to the development of a mental disorder or a substance use disorder, according to the National Institute of Mental Health.
A mental disorder can then contribute to substance use as some look to drugs or alcohol as a form of self-medication, while substance use disorders can trigger changes in brain structure and function, leading to a mental disorder, the federal agency for research on mental disorders reports.
“People who have a mental illness … they're frustrated, they don't know what to do, and they reach out to cope with something,” said Bette Peoples, executive director of the Grapevine Center in Butler. “And unfortunately, some people reach out and pick the wrong thing to cope with.”
Peoples helped form the Grapevine Center in the mid-1990s partly as a result of her own struggles with postpartum depression. The Grapevine Center is a drop-in mental health recovery facility which provides support for those suffering from both mental health issues as well as substance abuse disorders and homelessness.
“People in addiction can be addicted to anything,” Peoples said. “People think of it as drugs and alcohol, but it can be food, it can be work, it can be a multitude of different types of addiction.”
One recent study shows that there is a positive correlation between substance abuse and other mental health disorders, such as generalized anxiety disorder, depression, attention deficit (hyperactivity) disorder, bipolar disorder and others.
According to the National Institute for Drug Abuse, 7.7 million adults were diagnosed with both a mental health disorder and a substance abuse disorder as of 2018. Of the 20.3 million adults dealing with substance abuse disorders, more than a third — 37.9% — were also dealing with a mental disorder. Likewise, among the 42.1 million adults with a mental illness, 18.1% were also battling a substance abuse disorder.
Research also suggests some pathways from mental disorder to substance abuse. For example, one study led by Eric P. Zorrilla in 2014, suggests that stress increases the release of a corticotropin-releasing hormone. Numerous illicit drugs also have been found to increase the release of that same hormone, suggesting a connection of some kind.
The similar risk factors for mental health and substance abuse disorders range from stress to trauma to adverse childhood experiences.
“No one wakes up one day and says, ‘I think I’ll do XYZ to excess and maybe become addicted,’” said Natalie Drozda, assistant professor at Slippery Rock University. “Many have unprocessed trauma in their history.”
According to Donna Lamison, executive director of the NAMI of Butler County, substance abuse and mental health disorders are sometimes hard to tell apart.
“Chronic drug abuse often goes hand-in-hand with various mental health conditions recognized by experts in the field,” Lamison said. “Those diagnosed with mood or anxiety disorders are approximately twice as likely to also grapple with a substance use disorder compared to the general population. In parallel, those diagnosed with substance use disorders are roughly twice as likely to also contend with mood and anxiety disorders.”
She cited statistics from the National Institute of Mental Health, showing that there are three separate mental disorders with a correlation of 10% or higher with substance abuse. These are anti-social personality disorder (15.5%), manic episodes (14.5%) and schizophrenia (10.1%).
Indeed, numerous disorders — such as depression, anxiety, PTSD and bipolar disorder — can lead sufferers to “self-medicate” for these problems with drugs or alcohol. One scientific review from the University of Manitoba reported that approximately 41% of those suffering from type-1 bipolar disorder used alcohol or drugs to cope, along with 21% of people suffering from PTSD and 23% of major depression sufferers.
In fact, as far back as January 2002, the National Institute on Drug Abuse issued a “Community Drug Alert Bulletin,” alerting professionals to then-developing research on the relationship between stress and substance abuse.
Those dealing with both a substance abuse disorder and a mental disorder are said to be dealing with “co-occurring” issues, and the two are interminably linked. To treat one issue requires treating the other at the same time, Peoples said.
“Once they get formal treatment, they have a much better chance of recovery,” she said.
The most effective way to treat both types of disorder at the same time is to work at the common risk factors that lead that increase the likelihood of both of them occurring. This most often involves one of several types of behavioral therapy, local experts said.
“Simply refraining from substances is not enough for sustainable recovery from addiction, especially if someone has a co-occurring mental illness,” Drozda said. “It’s as if you would take away a person’s primary coping strategy and expect things to ‘be fine.’ That time and energy once devoted to substance use needs to be replaced with something else.”
One example of that “something else” is Dual Recovery Anonymous, a 12-step recovery session for those who suffer from both a chemical dependency and an emotional or psychiatric illness.
Led by Bill Keller, Dual Recovery Anonymous began holding meetings at the Grapevine Center in Butler on Feb. 24.
Meetings take place Mondays at 7:30 p.m. and Saturdays at 11:30 a.m.
According to a flyer, there are only two requirements for membership: “a desire to stop using alcohol and other intoxicating drugs,” and “a desire to manage our emotional or psychiatric illness in a healthy and constructive way.”
“Bit by bit, even seemingly insurmountable obstacles can be worked through when trust is built with a counselor,” Drozda said. “The road may not be smooth, but it is possible with help.”
