“Mental Illness and alcoholism or drug abuse interact in a complex dance,” says James Garbutt, M.D. professor of psychiatry at the University of North Carolina at Chapel Hill and research scientist at UNC’s Bowles Center for Alcohol Studies. “Mental Illness can increase the risk for alcoholism or drug abuse, sometimes because of self-medicating. On the other hand, alcoholism can lead to significant anxiety and depression that may appear indistinguishable from a mental illness. Finally, one disorder can be worse than the other.

There are other factors that could explain the frequent simultaneous occurrence of addiction and mental illness, including:

Genetics ~ Genetic factors seem to account for some of the co-morbidity (having both disorders at the same time) of substance abuse and mental disorders. Studies comparing identical and fraternal twins found more instances of having two disorders among the identical twins, indicating that genetics likely plays some role.

Chemical deficiency ~ Neuro-chemical factors were also found to be a common thread when mental disorders and addiction occur together. A reduction in the amount of serotonin, a chemical critical to brain functioning, may be the reason that alcoholism and anxiety disorders coincide so often. There is also evidence that addiction and mental disorders are associated with the dysfunction of a group of brain chemicals called monoamine oxidases.

People with mental health problems may use drugs and alcohol:

To feel normal they may use drugs or alcohol because it helps them feel normal and accepted. It may make them feel like they don’t have a mental health problem or are not different from others. To self-medicate they may use drugs or alcohol to reduce anxiety, depression, sleep problems, tension, hallucinations (like hearing voices), and to relieve the side effects of medication. Using drugs and alcohol may increase their thoughts of suicide.

The first step in getting sober is detoxification, or detox. During detox, they must not use any drugs or alcohol so their body can cleanse itself. They may experience withdrawal symptoms, so detox usually takes place while they are receiving medical care. If the problems are severe the person may require treatment at a hospital or other facility.

Detox is followed by therapy and sometimes medications. Most likely the person will attend individual or group therapy for both problems.

Treating two sets of symptoms ~ it is very important, but often difficult, to distinguish which symptoms are psychiatric and which are addictive. A person must be substance-free for at least two weeks in order to tease apart the various symptoms.

Alcoholism and chemical dependence are long-term illnesses, with symptoms that come and go in differing strengths and varieties over time. Such diseases are called relapsing/remitting conditions.

Relapse ~ if your relative does relapse try not to get frustrated or angry. For many people relapse is a part of the recovery process, and it doesn’t mean the treatment isn’t working. Be patient.

Newsletter June 2014