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Because the symptoms of substance abuse and mental illness often closely mirror one another, it can be difficult to get an accurate diagnosis and an effective treatment plan. Getting professional help from an experienced mental health expert is vital for those living with mental illness, substance abuse, or both. These conditions are also complex, particularly for those who have been living with one or both disorders for an extended period of time. In many cases, intensive treatment provided by a trusted treatment center is necessary.
Why Recognizing the Differences Between Substance Abuse and Mental Illness Is Important
Many people who develop substance use disorders are also living with a mental illness. According to the 2012 National Survey on Drug Use and Health, nearly 8.4 million adults in the United States have mental health and substance use disorders. Furthermore, several studies indicate that those with anxiety or mood disorders are about twice as likely as the general population to also experience a substance use disorder.
Oftentimes, substance use disorders evolve because an individual is attempting to self-treat an undiagnosed or unmanaged mental illness. The National Bureau of Economic Research reports that mental illness drastically increases the use of addictive substances. According to this study, those with mental illnesses are 20 percent more likely to use alcohol, 27 percent more likely to use cocaine and 86 percent more likely to smoke than those without mental illnesses. Nationwide, about 69 percent of all the alcohol, 84 percent of all cocaine and 68 percent of all cigarettes consumed are by those who have/have had a mental illness.
Mental Health Conditions and Their Link to Substance Abuse
While substance abuse may be a common coping mechanism for handling any kind of mental health condition, there are some mental illnesses that are more often tied to addiction.
Depression
Depression is among the most common gateways to drug and alcohol use. For those living with clinical depression, these substances provide an escape from negative emotions and temporarily bring feelings of peace or happiness. Unfortunately, abusing substances to relieve depression often causes even greater negative impacts on the person’s life, oftentimes bringing financial and relationship troubles.
Depression and substance abuse oftentimes have similar signs, making it difficult to discern one from the other. Both conditions may cause someone to:
- Withdraw from family and friends
- Have difficulty maintaining employment
- Give up hobbies and once-enjoyed activities
- Refuse to acknowledge that they have a problem and need help
Anxiety Disorders
According to the National Institute on Mental Health, nearly one in five adults in the United States experience anxiety in some form. In many cases, a person with anxiety perceives the world differently than someone without this condition, seeing danger in everyday circumstances and being overwhelmed with unfounded fears. For many, these fears can interfere with personal relationships, work, and social activities.
The symptoms of anxiety can be very difficult to live with, so it’s not uncommon for those with anxiety disorders to misuse alcohol or drugs. Unfortunately, while substance abuse can cause temporary relief, alcohol and drugs can worsen the symptoms of anxiety. As a result, the individual may feel the need to use more of the substance to feel normal again, thus creating a cycle of abuse that may lead to dependence and addiction.
Anxiety and substance abuse share many signs, including:
- Trouble concentrating
- Sudden oversensitivity or angry outburst
- Irritability or nervousness
- Jaw pain due to teeth grinding
Schizophrenia
Schizophrenia is a brain disorder that affects about 1 percent of the world population and roughly 3.5 million adults in the United States. Those living with this disorder generally have difficulty responding to social situations appropriately, which can cause problems with interpersonal relationships or school or work performance.
Unfortunately, about half of those living with this disorder don’t receive the treatment they need, a problem that often leads to substance abuse. In fact, the National Center for Biotechnology Information reports that up to 50 percent of individuals living with schizophrenia are dependent on illicit drugs or alcohol, and 70 percent are nicotine-dependent.
Schizophrenia is believed to be largely genetic, so while substance abuse can’t cause this condition, it can worsen the severity of symptoms. Because this illness shares so many symptoms with drug abuse, misdiagnosis is common. Common symptoms that both conditions share include:
- Delusional thinking
- Auditory or visual hallucinations
- Disorganized speech
- Lack of interest or motivation
- Disorganized movements or lack of impulse control
Borderline Personality Disorder
Borderline personality disorder is characterized by ongoing patterns of varying moods, self-image, and behavior. Individuals with this disorder often experience mood swings and display uncertainty with how they see themselves, which may cause their values and interests to shift on a regular basis. This can take a toll on relationships, as someone who’s considered to be a friend one day may be seen as an adversary the next.
Like depression, anxiety and schizophrenia, borderline personality disorder has several symptoms that are similar to drug abuse. These include:
- Risky behavior
- Dissociative feelings and paranoid thoughts
- Unstable personal relationships
- Intense and highly changeable moods
The Importance of Dual Diagnosis
Mental illness makes an individual more vulnerable to excessive drug or alcohol use, which can exacerbate the symptoms of the mental illness. Treating a mental illness, especially through drug therapy, without addressing the co-occurring condition may not only impact how effective the treatment is but may also present serious health risks. Taking certain medications such as mood stabilizers, antidepressants, and antipsychotics, along with alcohol and illicit drugs, can counteract the benefits of the medication or result in dangerous drug interactions. Furthermore, individuals living with mental health disorders and substance addictions face unique triggers and an increased risk of relapse if both conditions aren’t addressed.
4 Tips for Avoiding a Misdiagnosis
In the past, there was much debate over whether substance addictions or mental health illnesses should be treated first. Today, we recognize that these two conditions are deeply intertwined, and the best outcomes are achieved through comprehensive, integrated mental health and addiction treatment. Dual diagnosis treatment is effective in helping to identify the root causes of both illnesses and gain insight into how the addiction and the mental illness present obstacles to recovery. It also promotes effective therapies that support sobriety.
While correctly diagnosing a disorder is primarily the healthcare provider’s responsibility, there are a few tips that individuals can follow for a more accurate diagnosis.
1. Find an Experienced Mental Health Practitioner
Unfortunately, many clinicians are more likely to diagnose disorders that they feel more comfortable treating. In other words, if they are comfortable treating bipolar disorder but less experienced with treating borderline personality disorder, they’re probably going to diagnose their client with bipolar disorder. Finding a mental health professional who is experienced in treating a wide array of conditions may ensure a more accurate treatment plan.
2. Don’t Hide Personal History
Due to shame or embarrassment, many clients neglect to inform their health practitioners of all the symptoms they experience or of the extent of drug or alcohol use. This tendency can present significant challenges, though, when it comes to receiving an accurate diagnosis.
3. Record Symptoms
Individuals who log day-to-day symptoms are more likely to receive an accurate diagnosis and more effective treatment. This daily or weekly journal doesn’t need to be fancy; it only needs to include information like time of day, what triggered a symptom and how the individual responded.
4. Ask About the Extent of Testing
The most effective addiction and mental health treatment goes beyond minimizing symptoms. Treating one condition without also addressing the other is a common cause of relapse because it often leads to non-compliance. Diagnostic clarity requires extensive assessments by mental health professionals that specialize in addiction medicine and use auxiliary testing and psychological testing tools to establish an accurate diagnosis.
Getting Support from FHE Health
For someone living with a mental illness and addiction, treating both issues is essential for recovery. In many cases, treatment for mental health problems and substance use disorder includes individual and group counseling, medications, and therapy.
At FHE Health, we promote a comprehensive and multi-faceted approach to care, offering individualized strategies that address current symptoms and their underlying problems. Our full continuum care provides support for clients at each step of their journey, from the moment they walk through our doors to post-treatment alumni care. To learn about our programs, contact us today by calling 855-400-3156.
