Most people are aware that addictions lead to mental health problems but not everyone is aware that mental health problems are often implicated in the onset and perpetuation of addictions.
When beset with debilitating anxiety or depression, or perhaps during an acute episode of a bipolar disorder, or if troubled by schizophrenia, a person may turn to mood-altering substances or behaviours. These appear to offer some measure of control over the more unsettling feelings and sensations that come with mental health disturbances. This response is sometimes referred to as self-medication.
People may seek relief, comfort, tranquility, courage, escape, stimulation, numbness or even oblivion. Potentially addictive substances and behaviours are attractive “solutions” because of their short-term positive effect on the brain whether they are substances like cocaine, alcohol, marijuana or heroin, or behaviours such as consuming pornography, gambling or binge eating sugar-laden foods. Tobacco smoking is prevalent among people with mental illnesses.
The rewarding regulating effect on dysfunctional mental states is what brings the person back for more. Through a pattern of habitual use, the risk of addiction grows. However, addiction can complicate matters by masking the mental health condition, often leading to an inadequate treatment response. Many people have struggled to recover from addiction due to the failure by treatment to identify and respond to significant underlying mental health conditions.
We can be sure that drug or alcohol or behavioural addictions produce symptoms consistent with mental ill health; degrees of depression and anxiety being most common. This has resulted in some people with addictions being misdiagnosed as primarily mentally ill rather than addicted and thus inappropriately treated. In many people who had no significant mental ill health prior to their addiction, such symptoms tend to fade and even disappear in recovery although there is no guarantee.
It is essential for treatment services of whatever kind, operating whatever model or programme to be alive to the possibility of co-morbidity, a term for when someone shows symptoms of mental ill health and addiction. Accordingly careful assessment is essential. At this stage, it doesn’t really matter which came first. Even if aiming for abstinence as the basis for recovery, it is particularly important not to rule out the possibility that medication may be required to treat conditions like anxiety disorders, depressive illness, obsessive compulsive disorders and forms of psychosis simultaneously with addiction. Treating the mental health disorder appropriately may be what actually makes the recovery from substance or behaviour-based addiction possible in the long term.
Integrative holistic medicine and integrative health therapies really come into their own for people suffering from dual disorders. While medication may be necessary in the short or even long-term, access to other therapies, including those involving exercise, mindfulness, sleep hygiene and nutrition will have something valuable to offer the recovery process.