Addiction and other mental health issues often go hand-in-hand, for several reasons. It’s important to understand that in a lot of cases, people who struggle with one mental illness may also struggle with symptoms pertaining to another mental illness, or they may have several codependent diagnoses. Addiction is considered a mental health issue by the DSM (Diagnostics and Statistical Manual of Mental Disorders), a book that generally reflects the opinion of most mental health professionals on the subject of what is and is not a mental health issue.
Mental illnesses begin in the brain, either as a result of external factors (factors such as nutrition, trauma, chronic stress, abuse, brain injury, tumors, hormonal irregularities, poisoning, and more), or internal factors (genetics and prenatal health conditions, including illnesses and viruses plaguing a pregnant mother). Both addiction and other mental health problems are often the effect of these factors, in one way or another.
Although many might argue that this takes personal responsibility out of the equation, the overwhelming majority of addiction cases don’t begin with a person willingly wanting to be an addict. Education and healthcare play a greater role in preventing and treating addiction than most people realize – and by identifying addiction as a mental health issue, more people can come to terms with understanding that addicts need treatment and compassion, rather than an approach that prioritizes incarceration and heavy judgment. Mental health and addiction go hand-in-hand – both need to be treated together, and either one can help cause or amplify the other.
Depression and Addiction
Depression is arguably one of the more common disorders diagnosed alongside an addiction. Characterized as a consistent low mood for more than two weeks without any apparent or reasonable cause, depression is set apart from normal episodes of sadness and sorrow by the fact that it often has no clear “normal” cause, such as loss or grief, and the fact that it can last for a very long time.
Sometimes, depression drives people to drink or use other drugs to cope with the empty or lonely feeling of being depressed, while on the other hand, it’s the effects and consequences of addiction that eventually leave some people feeling depressed and hopeless, to the point that they develop a clinical depression.
Anxiety and Addiction
Depression and anxiety are the two most common mental health issues in the United States, with anxiety being somewhat more prevalent. Anxiety disorders manifest in a wide variety of ways, including generalized anxiety, social anxiety, specific phobias, as well as PTSD and panic disorder.
Anxiety is characterized by fear, worry, and unease at inappropriate times or in excessive levels. Someone with an anxiety disorder may fear a certain situation or may constantly play out worst-case-scenarios in their mind despite no indication of any danger, or no particular reason for worry. They may experience hyperventilation and symptoms mimicking a heart attack during a panic attack, and they may feel extreme dread when facing a particular situation, such as having to enter a small space or speak in front of a crowd.
These extreme fears can be diminished and controlled through the use of anti-anxiety medication, which can be addictive, as well as alcohol, which mimics sedatives such as benzodiazepine (Xanax, Valium, etc.) by lowering inhibitions and cutting away at fears.
Addiction and Other Mental Health Issues
People with other mental health issues, including PTSD, OCD, personality disorders as well as body image disorders such as dysmorphia and anorexia may turn to drug use as a way to cope with their symptoms, feeling as though the euphoric feelings caused by drug use help them with their disorder.
Why Mental Health Issues Accompany Addiction
Drug use changes the way the brain works slightly. While all drugs are psychotropic in some shape or form, some of them are addictive. Using addictive drugs can be helpful in the treatment of certain illnesses and diseases – including terminal pain management, ADHD, and anxiety – but misusing a prescription or taking the drugs illegally for recreational purposes can lead to a physical dependence on the drug.
The brain begins to crave the drug as a way to maintain a newfound “normal” high, imposing withdrawal symptoms whenever usage is stopped, while reinforcing use with more cravings and thoughts of recurring drug use. It becomes harder and harder to stop the more a person takes the drug, and some drugs are more addictive than others.
This can lead to a variety of problems. People who are addicted to drugs tend to feel self-loathing, regret, self-deprecation, and anger. They tend to seek out drug use not only because they crave the high, but because it masks the pain they feel when sober. This is an emotional addiction, wherein drug use is not only reinforced by what the brain wants, but by what the mind needs as a way to cope with all the problems introduced before or after the drug use began.
Heavy drug use also has a series of other side effects, both physical and mental, including tardiness, aberrant sleep schedules, poor hygiene, skin problems, malnutrition, rapid weight gain/loss, and other issues contributing to a lower quality of life, loss of employment, broken relationships, and a decaying social life. All this heavily contributes to a person’s state of mind, pushing them to avoid living out a real life and seeking drugs either to feel better, or to “end it all”.
If addiction began as a way to cope with a pre-existing problem – such as an abusive relationship, sexual trauma, problems at work or school, or chronic stress from an inescapable situation – then it can amplify these problems and speed up the development of a mental health issue arising as a result of stress, including anxiety disorders such as social anxiety, PTSD, and more.
If someone has a genetic predisposition towards a certain mental health issue, drug use may cause them to get to the point where they trigger this issue, and let it grow and develop into a diagnosable disorder.
Furthermore, addiction can put someone in a situation where they engage in needlessly risky behavior, due to lowered inhibitions and a decreased capacity for critical thinking. This can lead to a number of physical consequences, including infectious diseases from unprotected sex, as well as injuries caused by accidents while under the influence. These can leave a lasting mental effect on someone with a history of drug abuse, including emotional scarring that takes years to properly process.
Chicken and Egg
Addiction and mental health issues such as depression and anxiety are ultimately intertwined in such a way that it’s hard for doctors and patients alike to properly identify which caused the other, and which came first. Either way, treatment has to address both. Treating a dual diagnosis – wherein someone struggles with a diagnosable mental health issue and an addiction – requires a program that addresses both usually through a combination of dedicated residential treatment, therapy with an experienced psychiatrist, and the use of non-addictive psychiatric medication, including antidepressants.