Neither substance abuse nor mental illness is a new condition in the treatment world. In fact, both of them date back a great many years. Millennial Magazine notes the treatment of mental illness dates back as far as 5000 BC. Fortunately, medical science and the treatment field have evolved in conjunction with one another a great deal over the years. It is now widely recognized by treatment professionals that these two issues — substance abuse and mental illness — often occur alongside each other. As co-occurring disorders, they are best treated in the same way – with integrated treatment that addresses both issues simultaneously.
Co-occurring Mental Illness
There are over 200 forms of mental health diagnoses categorized by the Diagnostic and Statistical Manual of Mental Disorders today, and some are diagnosed more frequently than others. Furthermore, certain disorders are more often seen alongside addiction and substance abuse than others. They include:
- Bipolar disorder
- Social anxiety disorder
- Post-traumatic stress disorder
- Panic disorder
Bipolar disorder is common in general. Around 5.7 million adults in America struggle with bipolar disorder every year, per WebMD. Addictions occur in as many as 60 percent of them, Everyday Health reports.
Depression may very well be the most common mental health disorder among people with addictions, and anxiety disorders come in a close second. The Anxiety and Depression Association of America notes approximately 20 percent of people with anxiety or mood disorders have drug or alcohol use disorders. Likewise, 20 percent of people with substance use disorders suffer from co-occurring anxiety or mood issues.
Schizophrenia is less common overall. Roughly 3.5 million people are diagnosed with this disorder, and about half of them never receive any kind of treatment, according to the Schizophrenia and Related Disorders Alliance of America. Interestingly, the most common addiction among people with schizophrenia is nicotine addiction. Substance use disorders affect about 50 percent of people with schizophrenia, the Schizophrenia Bulletin reports. Around 25-30 percent of Americans smoke, but among those with schizophrenia that figure is nearly tripled, per Psych Central.
Treating Mental Illness
The most common disorders to co-occur with substance abuse often benefit from the most commonly prescribed treatment modules. Cognitive Behavioral Therapy (CBT) is likely the most frequently used style of therapy. CBT focuses on triggers and helping the individual to change the way they react to certain stimuli. The National Institute on Drug Abuse reported on a study comparing CBT against Interpersonal Psychotherapy (IPT) in people with cocaine dependence; 43 percent of the CBT group remained abstinent for at least four weeks following treatment while only 19 percent of the IPT group did.
In many cases, substance abuse behaviors are used as coping mechanisms to medicate the symptoms of illnesses like anxiety. Therefore, treating the mental health component often removes a lot of the desire to abuse drugs or alcohol.
Exposure therapy is great for individuals who suffer from phobias and other types of anxiety. It involves slowly preparing the client to confront the thing they fear most. For example, someone who is agoraphobic and afraid to leave their home may slowly pretend to engage in the practice. One day, they may be encouraged to get dressed to leave, put on their shoes, and then stop at the front door. The next day, they might be encouraged to open the door and walk out onto the front porch. On the third day, encouraging them to walk to their car or the mailbox would be the next step and so on.
Therapy is an effective approach toward almost all forms of mental illness, but it isn’t enough for every illness; certain disorders require medication. Depression is most commonly treated with antidepressant drugs. Fortunately, few of these substances are addictive in nature. Still, dependence can form.
Addiction is more common in individuals who take benzodiazepines to treat issues of anxiety. These drugs are potent and should only be used on an as-needed basis, but many people take them daily or even several times each day. Furthermore, they are to be used no longer than a few weeks at a time, but many people go on using them for years on end. The Royal College of Psychiatrists notes that individuals who take benzodiazepines, like Klonopin or Xanax, every day for longer than six weeks will form a dependence on them. If addiction has formed to a benzodiazepine, switching to another type of anti-anxiety drug, like buspirone, is usually still an option for treatment of anxiety.
Bipolar disorder typically requires medication to stabilize moods. Lithium is a commonly prescribed since roughly 75 percent of patients experience an improvement in symptoms while using it, Everyday Health states. Moving forward from addiction treatment, bipolar disorder must continue to be treated or the risk of relapse will grow increasingly. The same is true of schizophrenia. Both of these illnesses have the tendency to spring into action at any given time. Their unpredictable nature makes them more causative factors in the case of relapse.
The cause of schizophrenia is not fully understood, but it is known that environment and genetics both seem to influence it. Treating the symptoms of this disorder, such as lack of restraint, disorientation and delusions, typically makes life easier for the individual. Still, a prescription isn’t a cure, and therapy is often necessary in conjunction with medications like chlorpromazine and trifluoperazine.
Healing from Addiction
A quality rehabilitation center will employ professionals who are trained and licensed to treat co-occurring substance abuse and mental illness. Beyond treating mental health disorders and their side effects, other medications and therapies can be used to mitigate the temptation of returning to substance abuse. Talk therapy can be highly therapeutic for those who suffer from mental illness and abuse drugs and alcohol as a way of coping with traumas or past events that have left them with lingering discomfort, guilt, or anxiety.
The discomfort of withdrawal can be eased with medications like antidepressants and over-the-counter pain relievers. More holistic care modules may also take advantage of treatments like acupuncture, chiropractic care, and massage therapy. In addition, support groups can help people suffering from co-occurring disorders to realize that they are not alone in their struggles, and recovery is possible.