Is Alcohol And/Or Drug Abuse A Mental Illness?
Medically reviewed byDr. Gerardo Sison
April 1, 2019
In recent years addiction has come to be known as a mental illness. Like other mental illnesses, addiction changes a person’s mood, thinking, and behavior, in a way that drastically impairs a person’s ability to take part in meaningful relationships, carry out their responsibilities, function within social settings, and even take care of themselves.
Both the National Institute of Mental Health and the National Institute on Drug Abuse agree that addiction is a disease. The latter entity puts it best; stating that “because addiction changes the brain in fundamental ways, disturbing a person’s normal hierarchy of needs and desires and substituting new priorities connected with procuring and using the drug. The resulting compulsive behaviors that override the ability to control impulses despite the consequences are similar to hallmarks of other mental illnesses.”
Understanding How Substance Abuse Is A Mental Illness
Some people may struggle with understanding how a drug or alcohol addiction can be a mental illness, after all, a person choose to use, did they not? That is, in comparison to a person who is depressed and did not choose this path of despair and hopelessness. The reality is, that it is far more complicated than this. Addiction is unique to each and every person who suffers from it, and it developed due to a specific set of risk factors that were present in each person’s life, however, to consider it a mental illness, we look not just at how it originated, but in how it permeates a person’s life.
Changes in Thinking
Instead of focusing on the needs and responsibilities of their life, a person’s scope of thinking becomes very narrow—their mind is constantly, and consistently focused on thoughts of obtaining or using drugs or alcohol. Due to this, they let other things slip, suddenly important mental tasks become second or nonexistent, and their life begins to follow suit.
A person’s cognitive function can become significantly impaired from drug or alcohol abuse and addiction. A person’s memory, judgment, reasoning, logic, decision-making abilities, ability to evaluate risk, and sense of inhibition may all become impaired. Due to this, you may commonly see a person exhibit behaviors that are uncommon to their typical, sober self.
In our ideal state, we are wired in a way that puts our health and well-being as our optimal pursuit. Generally speaking, aside from a bad day or poor decision here or there, people typically strive to live in a way that betters them and takes care of their basic needs, and those of their loved ones.
Enter a drug or alcohol addiction. Suddenly a person no longer cares about eating or staying hydrated. Their personal appearance goes out the window and it may go so far that they become uncleanly. Motivation, passion, fulfillment, and interest in activities or responsibilities may wane. What was once important—a successful career, educational pursuits, the care-taking of children, or other familial responsibilities begins to pale in their quest for drugs or alcohol. Slowly these things crumble, being replaced more and more by the fickle and highly unstable reality that is addiction.
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A person will also progressively begin to make worse choices. While under the influence of drugs or alcohol they may engage in risky behaviors, such as driving a car, or engaging in unsafe sexual practices, that could result in various transmissible diseases or an unwanted pregnancy.
Under this compulsive pursuit of substances, they may spend money they don’t have, finding that they are stealing or even selling their body for sex, in a pursuit of finances to back their addiction. They may use money for a mortgage or other bills, for drugs or alcohol, only to find they lose their house in the process of seeking a succession of fixes.
When you use drugs or alcohol, your body is not the only portion of your self to encounter negative effects and changes. Substance abuse and addiction imposes an intense toxic burden on your brain, in a capacity that actually changes the important chemical messengers within your brain. These chemical elements are called neurotransmitters.
Neurotransmitters are cornerstones of your mental and emotional health, to the capacity that when you talk of someone being chronically depressed or anxious, it is because they are suffering from an imbalance of certain neurotransmitters. Left to continue, this compulsive drug seeking can cause long-lasting and impactful changes
The Reality Of Co-Occurring Disorders
In order to understand the full impact of addiction as a mental illness, we have to understand it in relation to other mental illnesses. This is because this negative relationship is exceedingly prevalent in the world of addiction.
One of the most frightening and stark realities of addiction is its common linkage to other mental health disorders. When addiction exists along with another mental health disorder, they are termed co-occurring disorders or dual diagnosis conditions.
The prevalence of these dual diagnosis concerns are high. According to NIDA, individuals who have a mood or anxiety disorder have a likelihood that is two times greater than their counterparts in developing substance abuse or dependence. This correlation is so high, in fact, that the NIMH tells us in 2014, of the 20.2 million adult Americans that experienced a substance use disorder, nearly 40%, or 7.9 million also had yet another mental illness. They further broke this statistic down, stating that “More than half of the people with both a substance use disorder and another mental illness were men (4.1 million).”
Why is there this connection? There are two main reasons.
- First, individuals who have preexisting mental health disorders commonly use drugs or alcohol to distract themselves or moderate their symptoms, in the absence of seeking professional treatment. This self-medication gradually gains momentum, progressing from misuse, to abuse, and many times, to addiction.
- Secondly, many drugs of abuse, alcohol included, often further exacerbate these mental health concerns. Thus, a person is in fact caught in a vicious cycle.
For example, alcohol is a depressant. A person may drink to forget or to numb the pain, seeking the immediate euphoric and social effects that this drug offers. However, once the alcohol exits their system, it leaves them feeling even more depressed due to its primary characteristic of being a depressant. Additionally, alcohol decreases your inhibitions and reduces your capability of making sound judgements, which may result in you making poor choices that have lasting results—yet another reason you might sink further into depression. In turn, you might drink more to further chase these blues, thus propelling the cycle with further intensity.
Lastly, many drugs may actually cause mental health disorders, due to the very way they alter the functioning of your brain. The reason why drugs feel good is because they alter your neurochemistry. But the unfortunate news is—is that in the long run, this is also the very reason why you feel bad and begin to experience the host of negative effects that accompany substance abuse and addiction. After excessive and constant substance use, your neurotransmitters have begun to malfunction in such a way (namely by depending on the substance) that you begin to develop these concerns.
These dual diagnosis situations are one of the most severe concerns facing an individual and their treatment team today. If you suffer from a co-occurring disorder, it is imperative that you seek treatment for not only your addiction, but also any mental health concern that is present in your life.
Treating Dual Diagnosis Concerns
Because of the way they are so closely interconnected, if a person has a dual diagnosis, and needs treatment, in order to have the best chance at success—and sobriety—they need to seek care that addresses both needs. If you only treat the addiction, a person’s mental health disorders will continue unchecked, irritating and overwhelming a person to the point where they may again turn to drugs or alcohol to quell the storm.
On the other hand, if you only treat the mental health disorder, you are not fully treating the problem. Mental health disorders are caused by imbalances in the brain and also by situational and environmental factors. Due to this, if the drugs are still present, the brain will still be imbalanced, and a person will continue to live their life in a way that fosters poor decisions and negative outcomes, which may propel a person back to the bottle or their drug of choice.
Fortunately, help exists. Today, a wide variety of rehabilitation programs, both outpatient, and inpatient, exist to help a person combat these dual concerns. It is worth noting, however, that when a person is facing an addiction, especially a severe one, paired with another mental illness, it is most commonly recommended that they seek an inpatient drug rehab center, that way they can fully immerse themselves in more prolonged, active, and intensive care.
Within this care, they may encounter, as part of this dual diagnosis care, various psychotherapies, family therapy to help reinvest and renew damaged relationships, and aftercare and relapse prevention, to help you learn how to continuously nurture your mental and emotional health and your sobriety. Prior to this, you may even be able to have a medical detox. Depending on the scope of your addiction, drug of abuse, and mental health disorder, you may also be prescribed various medications.
Recognizing that an addiction is a mental illness is a powerful and positive step towards better health, wellness, personal fulfillment, and sobriety.
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National Institute of Mental Health - Substance Abuse and Mental Health
National Institute on Drug Abuse - Is drug addiction a mental illness?