Drug Addiction, Mental Illness or Both? The Complexity of a Dual Diagnosis

Drug addictions and mental illnesses are still stigmatized in modern society, which often prevents affected individuals from seeking treatment. Even worse, in many cases, patients actually suffer from both of these debilitating diseases, which further alienate them from society. Studies show that a third of mentally ill individuals also suffer from substance abuse. Those with severe mental illness have an even higher rate of substance abuse at 50 percent. 

Similarly, when groups of substance abusers are analyzed, half of them also have a diagnosable mental illness. The National Alliance on Mental Illness (NAMI) reports that certain groups of mentally ill individuals are at a higher risk of abusing drugs. These risk factors include being male, having a lower socioeconomic status, being a military veteran and having other general medical illnesses. Other risk factors for developing both issues are genetic predispositions and environmental triggers such as extreme trauma.

These numbers reveal the importance of seeking professional treatment for both mental illness and drug addiction. They also reveal the importance of personalized, individual treatment programs for each condition rather than assuming that one condition is the result of the other.

How Drugs and Mental Illness Feed Off Each Other

When individuals suffer from multiple ailments, called comorbidity, it is often difficult to determine which affliction occurred first. It is even more challenging to identify whether the drug abuse is a result of the mental illness or simply a separate ailment that would have occurred anyway. These challenges are due to the complex way in which drugs mimic mental illness. For example, drug use can worsen the symptoms of existing mental illnesses. Those who suffer from depression may become suicidal when they are abusing or withdrawing from drugs. Additionally, drug use can cause a mental illness to exhibit itself for the first time. For example, a drug abuser who becomes paranoid when they are high may actually be experiencing their first episode of schizophrenia.

Extended drug use also changes the way that the brain works, thus causing a mental illness in itself. The drugs change a person's ability to prioritize basic human needs, such a food, water and sleep. These life-sustaining elements are replaced with a constant search for, and use of, drugs resulting in an inability to control impulses.

Self-Medication By the Mentally Ill

Often, drug abuse is simply a way of self-medicating for individuals who suffer from mental illnesses. Individuals who suffer from anxiety, depression or other illnesses find that drugs alleviate their symptoms and make them feel great. Unfortunately, the effects are temporary, and the drug use worsens the patient's mental illness. This leads to a harmful downward spiral in which both the mental illness and the drug use gets worse.

Comorbidity Treatment Complications

Individuals who suffer from both mental illness and drug abuse require very different treatment programs than individuals who suffer from only one of these issues. Those who have both are more likely to skiptreatment appointments, are less likely to take prescribed medication regularly and are less likely to follow other treatment plans recommended by their physicians. Statistics also reveal that these groups are more likely to attempt suicide than other groups, and they often succeed. Other complications result when mentally ill drug abusers get into legal trouble which can interrupt or derail their treatment programs altogether.

Because of the high occurrence of both mental illness and drug use, patients seeking treatment for one should always be evaluated for the other as well. If individuals are diagnosed with both, physicians must treat each condition with a personalized treatment plan. The complexity of causes and interdependency with the illnesses means that some patients respond well to behavioral therapies, while others require medication.