3 Mental Health Disorders That Often Co-Occur With Substance Abuse

Many people who struggle with substance abuse usually have to deal with a co-occurring mental health disorder as well. In fact, the two issues are interconnected, making it more difficult to treat one or the other when addressed individually.

Knowing which mental health disorders are most related to substance abuse, and how, is one of the ways to understand why some people don’t get better even when they seek help for their addiction. Here are three of the most common mental health disorders that co-occur with addiction and how to treat them.

Depression and Alcohol or Drug Dependance

Depression usually occurs with substance use disorders. In fact, there’s a 40% chance that a person with major depressive disorder (MDD) will have an alcohol use disorder at some point in life. Similarly, MDD patients are 4.5 times more likely to become alcohol and cannabis dependent than those without depression. It means that depression might drive a person to substance use, and substance use might make a person’s depression worse in the future. 

To understand the connection, it’s vital to approach this issue through neurochemistry. When dealing with depression, your brain’s reward system gets all out of whack. Dopamine and serotonin production get stalled, and you feel empty, unmotivated, and emotionally hurt. 

Alcohol and drugs trigger dopamine release and often provide temporary relief. However, using these substances frequently actually suppresses your brain’s natural ability to produce dopamine and serotonin on its own, compelling you to take more of a substance to feel normal. Some of the most obvious signs that depression and substance use are feeding off each other include:

• Using substances to lift your mood or alleviate emotional numbness
• Feeling worse, hopeless, and irritable when you don’t use substances
• Increasing the amount of substances used without a corresponding improvement in your mood
• Withdrawing from relationships and responsibilities as substance use and depression get worse
• Experiencing depression that starts or gets worse after using substances, especially after heavy or prolonged use

To break the cycle, you have to address both problems simultaneously, not sequentially. A good option is to stick with some programs that combine evidence-based treatments, such as CBT and DBT with sound psychiatric care. 

Networks like Banyan Treatment Centers can really help in this regard with programs offered at 16 facilities nationwide. These programs are designed to treat dual-diagnosis patients and focus on resolving physical symptoms through medical detoxification. This approach reduces the chances of relapse as it treats your mood disorder in tandem with the addiction.

PTSD and Substance Use: A Self-Medication Spiral

The connection between PTSD and drug use primarily stems from self-medication. PTSD is exhausting and disrupts your balance. Many people turn to alcohol and drugs to help control the situation. Their goal is not to get high, but to find some relief from anxiety and hyperarousal that trauma triggers. 

Alcohol slows down the central nervous system and reduces the level of emotional intensity of a traumatic event. People take it even when the results are only temporary. The problem is that using substances normally makes PTSD worse over time instead of making it go away. Here’s why:

• Alcohol and sedatives interfere with sleep patterns, directly affecting deep sleep needed to process and desensitize traumatic memories
• Using substances reduces your ability to control your emotions, making PTSD-related outbursts and hyperreactivity more difficult to cope with
• Substance use causes dependency, resulting in severe withdrawal symptoms that involve anxiety and panic attacks
• Avoidance patterns associated with substance use prevent you from seeking trauma-related therapy
• Cognitive abilities get impaired over time, making it harder to cope even when you're taught to do so

To get the best results, it’s vital to treat PTSD and substance use disorder at the same time. The most effective approach is to combine trauma-focused therapy and substance use disorder therapy.

The models, like Concurrent treatment of PTSD and Substance Use Disorders Using Prolonged Exposure (COPE), use a combination of CBT for substance use and prolonged exposure therapy for trauma. This allows the brain to actually work through the trauma, not simply numb it with drugs. Once trauma is addressed and treated within a program, the main cause of the substance use disorder will gradually lose its hold.

Anxiety Disorders And Chemical Coping

Anxiety activates the body’s stress response, resulting in more cortisol, increased heart rate, difficult breathing, and non-stop thinking. Alcohol depresses the central nervous system and temporarily counteracts the stress response with its calming effects. The same is true for people abusing benzodiazepines and marijuana.

However, with repeated use of any of these drugs, the brain adapts by decreasing its natural relaxing chemicals and increasing its stress response even more. It means you feel more anxious when you don’t load up on that addictive substance. If addiction is treated without addressing anxiety, there is a strong chance of relapse. Here’s why:

• The underlying cause of addiction remains active
• Withdrawal from depressants, such as alcohol has a rebound anxiety effect
• Untreated anxiety causes people to go back to their coping chemicals within days or weeks after detoxification
• Panic attacks in early recovery are often misdiagnosed, delaying proper psychiatric evaluation

Dual-diagnosis programs help break this cycle with tools to manage anxiety effectively. The most popular choices are mindfulness, cognitive-behavioral therapy, and exposure therapy, all of which are often combined with medically supervised detox to manage withdrawal symptoms more effectively.

Endnote

Something that connects all three of these co-occurring conditions is that substance use never occurs in isolation. It’s always doing something for you, like numbing pain, reducing anxiety, relieving trauma, and it stops working only when the underlying issue is treated. To resolve these challenging situations, it's vital to stick to an integrated dual-diagnosis treatment approach. Be sure to work with an expert to identify the best way to manage your addiction and mental health