Dual diagnosis treatment program

Multiple theories have been put forward to explain the connection between mental health and substance use disorders. The propensity for people to experience co-occurring disorders suggests that there is a link between them. It may be possible for one to drive the other, but does mental illness lead to addiction, or does addiction lead to mental illness?

Substance-induced mental health disorders
The first theory to connect mental health and addiction suggests that substance use disorders can lead to the development of mental illness. The withdrawal symptoms and side effects of substance use often parallels mental health disorders and can include symptoms such as:

• Chronic fatigue
• Sleep difficulties
• Weight loss
• Paranoia
• Feelings of hopelessness or despair
• Elevated levels of anxiety

The exact set of consequences that a person with a substance use disorder experiences varies significantly between individuals. Factors like overall health, drug of use, and environment can all contribute to whether they develop clinically significant mental health symptoms after addiction.

Scientific studies have found associations between addiction and mental health disorders. In some cases, substance use precedes the development of mental health symptoms, which may indicate a causative link. People with alcohol use disorder, for example, are at increased risk of developing depression.

The self-medication hypothesis
An alternative theory to the link between mental health and substance use disorders suggests that people use substances to treat the symptoms of mental illness. Known as the self-medication hypothesis, this theory suggests that some people who experience mental health disorders turn to drugs or alcohol to reduce their negative symptoms.

Studies suggest that between 21.9% and 24.1% of people with anxiety or depressive disorders use self-medication as a coping mechanism. This method can result in the development of an addiction.

Ultimately, whether substance use influences the development of mental health disorders or results from a person attempting to cope with a pre-existing mental disorder, each theory accounts for some of the relationship between mental health and addiction.

Identifying whether you or a loved one is experiencing a substance use disorder depends on a few key factors. There are 11 main criteria for diagnosing a substance use disorder. Each one looks at specific ways that substance use affects your everyday life. These symptoms come from the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR). They include:

1. Using substances in greater amounts or more frequently than intended
2. Repeated, unsuccessful attempts to quit or cut down on substance use
3. Spending a great deal of time using, recovering from, or seeking out substance use
4. Experiencing cravings for your substance of choice
5. Substance use interferes with your obligations at work, school, or home
6. Continued substance use despite social or interpersonal consequences
7. Giving up on favored activities or hobbies due to substance use
8. Repeatedly using substances in situations where it is dangerous to do so
9. Continued substance use despite worsening mental health symptoms
10. Increasing tolerance, meaning you need to use more of the substance to achieve the desired effect
11. Withdrawal symptoms when you suddenly stop using the substance

Substance use disorders occur on a spectrum, which means people can have mild, moderate, or severe substance use disorders. Meeting just two of the criteria above can result in a diagnosis of mild substance use disorder. Having four to five symptoms is considered moderate, and six or more is severe.

Depression is a common mental health disorder. 8.4% of adults in the United States experienced a major depressive episode in 2020. Depression can cause people to feel hopeless, irritable, and fatigued, and it can last weeks, months, or years if left untreated.

Anxiety is one of the most common mental health concerns in the United States, with nearly a third of adults being diagnosed with an anxiety disorder within their lifetime. Anxiety and substance use disorders are frequently associated with each other, which can ultimately make the symptoms of anxiety even worse.

Bipolar disorder is a mood disorder characterized by bouts of severe depression followed by periods of elevated mood known as manic or hypomanic episodes. People living with bipolar disorder swing between these two extremes and may turn to substance use to try to offset the effects of their illness.