Substance use disorders often co-occur with other mental illnesses, let’s explore “why”!
Substance use disorders and mental illness go hand in hand, as people addicted to drugs have twice the risk of developing mood and anxiety disorders compared to the general population, and vice versa. According to the 2019 National Survey on Drug Use and Health (NSDUH), 24.5 percent (or 61.2 million adults) aged 18 or older had some mental illness (AMI) or substance use disorder substances (SUD) in the past year. Additionally, 16.8% (or 42 million people) experienced an AMI but not an SUD. The study also reported a 3.9 percent (or 9.7 million people) incidence of SUD but not AMI, while 3.8 percent (or 9.5 million people) struggled with both AMI and SUD .
Such a high co-prevalence of AMI and SUD forces one to wonder if the two are interrelated, and if so, then why?
Match: Match or more
The high incidence of co-occurring substance use disorders and mental illness is independent of a causal relationship between the two. Moreover, it does not show any particular sequence in the onset of the problem, simply because multiple factors can contribute to SUD and AMI, most of them independent of each other.
For example, it is important to see if symptoms have progressed to a certain level (according to the DSM) to confirm the diagnosis of any mental disorder. However, subclinical symptoms can also lead to drug use. Although it is always difficult to say which came first between AMI and SUD. However. three possibilities seem to exist.
- Drug use can lead to mental illness: The drug or drugs for use may be responsible for causing one or more symptoms of mental illness in the user. Evidence supporting the possibility comes from the known association between an increased risk of psychosis and marijuana in some users.
- Mental illness leading to drug use: Researchers talk about possible role of mental illness in causing drug use. Individuals reporting overt, mild, or even subclinical mental disorders are vulnerable to drug use as self-medication. Slowly, when a person feels stronger from using the drug, they become dependent on it, leading to addiction.
- Overlapping factors: There are certain factors, including genetic vulnerabilities, brain deficits, and/or early exposure to stress or trauma, that can cause both AMI and SUDs.
All three of these scenarios can be expressed (to varying degrees for different individuals) in the reasoning of concomitant AMI and CVD.
A study of common factors
Genetics play a role in both AMI and SUD. Genetic factors may be a significant common link between these two conditions, which are known to contribute to the development of both addiction and other mental illnesses. According to researchers, genetics contributes 40-60 percent to a person’s vulnerability to addiction. At the same time, genes may also act indirectly to contribute to the development of SUD by altering an individual’s response to stress or their propensity to develop risk-taking and novelty-seeking behaviors.
Similar areas of the brain are involved. It may be more than a coincidence that in both SUD and AMI, the same areas of the brain are affected. For example, addictive substances and mental illnesses such as depression and other psychiatric disorders affect dopamine, a chemical that carries messages from one neuron to another.
This overlap of brain regions affected by AMI and SUDs may indicate the possibility of some brain changes that may be caused by one and affect the other.
A report published in the National Institute on Drug Abuse (NIDA) suggests that the development of a mental disorder and subsequent changes in brain activity tend to increase sensitivity to substance use by reducing awareness of their negative effects, enhancing their positive effects or alleviating the unpleasant effects caused by the mental disorder.
Achieving mental health is all about timely treatment
Various behavioral therapies have been found to be effective in treating comorbid conditions. However, it is important to consider other related factors such as age of the patients and specific drug used, among other things, while proceeding with the planned treatment.
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