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Why do substance use disorders often co-occur with other mental illnesses?

Why do substance use disorders often co-occur with other mental illnesses?

Substance use disorders and mental illnesses often go hand in hand as people addicted to drugs have twice the higher risk of developing mood and anxiety disorders as compared to general people and vice-versa. According to the 2015 National Survey on Drug Use and Health (NSDUH), around 8.1 million adults (3.3 percent of all adults) reported co-occurrence of any mental illness (AMI) and substance use disorder (SUDs) in the past year, while 2.3 million adults (1.0 percent of all adults) were suffering from co-occurring serious mental illnesses (SMI) and SUDs in 2015.

The high incidence of co-occurring SUDs and mental illnesses is sometimes due to the causal association between the two. However, it does not indicate any particular sequence in the onset of the problem because multiple factors may contribute to SUDs and AMI. It is important to see if symptoms have progressed to a specific level to confirm the diagnosis of any of the two. However, subclinical symptoms may also lead to both drug use and mental health issues. Although it is always difficult to tell which comes first between AMI and SUDs, three possibilities seem to exist.

1. Drug abuse may lead to mental illnesses: Abusing one or more drugs during a lifetime may be responsible to cause one or more mental illnesses. Multiple research studies and clinical evidence support the theory as in the case of association between increased risk of psychosis and marijuana in some users.

2. Mental illnesses leading to drug abuse. Time and again, researchers have talked about the possible role of mental illnesses in causing drug abuse. Individuals reporting symptoms of mild or severe mental disorders are vulnerable to drug abuse as self-medication. Studies have reported onset of drug use in adolescents and young adults suffering from depression and anxiety.

3. Overlapping factors. There are certain factors including genetic vulnerabilities, brain deficits and early exposure to stress or trauma, which are known to cause both AMI and SUDs.

All three scenarios may express themselves (in different degrees for different individuals) in making a case for a co-occurring AMI and SUD.

Exploring common factors for their occurrence

Some common factors are responsible for causing AMI, SUD or both. These factors can range from genetic, environmental or biological. Two of the most important common factors that can result in the development of SUD and AMI are:

  • Genes: Genetic factors can be a significant common link between the two conditions, which is known to contribute to the development of both addiction and other mental illnesses. According to researchers, genetics make a 40-60 percent contribution to one’s vulnerability to addiction. At the same time, genes can also indirectly contribute to SUDs by altering an individual’s response to stress or one’s tendency to develop risk-taking behaviors.
  • Similar brain regions: It may be more than a coincidence that both SUDs and other mental illnesses affect some common areas of the brain. For example, addictive substances and mental illnesses such as depression and other psychiatric disorders affect dopamine, a neurotransmitter that controls reward and pleasure centers in the brain. This overlap of brain areas affected by AMI and SUDs may indicate a possibility of some brain changes that may be caused from any one of the disorders affecting the other.

Road to recovery

Different behavioral therapies are effective in treating comorbid conditions. However, it is important to tailor these approaches according to patients’ age, specific drug abused, frequency of use and other factors. The first step to treatment is identification of existing symptoms and making the right diagnosis of the underlying problem simultaneously.

The Florida Dual Diagnosis Helpline is a credible go-to resource to seek information about effective dual diagnosis treatment in Florida. You can contact us over an online chat session or call us at our 24/7 helpline number 866-337-7631 to know about good rehab programs in Florida.

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