Substance use disorders often co-occur with other mental illnesses. Let's explore the why!

Substance use disorders often co-occur with other mental illnesses. Let's explore the why!

Substance use disorders and mental illness go hand in hand, as people addicted to drugs are twice as likely to develop mood and anxiety disorders as normal people and vice versa. According to the 2019 National Survey on Drug Use and Health (NSDUH), 24.5 percent (or 61.2 million adults) aged 18 or older have had either a mental illness (AMI) or a substance use disorder (SUD) in the past year. Additionally, 16.8 percent (or 42 million people) suffered from an AMI but not an SUD. The survey also found an incidence of 3.9 percent (or 9.7 million people) of having an SUD but not AMI, while 3.8 percent (or 9.5 million people) struggled with both an AMI and an SUD.

Such a high co-prevalence of AMI and SUD forces one to assume that these two things are related and if so, why?

Meeting: A coincidence or more

The high incidence of co-occurring substance use disorders and mental illnesses is independent of a causal relationship between the two. Furthermore, it does not suggest a specific order of onset of the problem, simply because multiple factors can contribute to SUDs and AMI, with most of them being independent of each other.

For example, it is important to see whether symptoms have reached a certain level (per DSM) to confirm the diagnosis of a mental disorder. However, subclinical symptoms can also lead to drug use. Although it is always difficult to say which comes first between AMI and SUDs. However. Three possibilities seem to exist.

• Drogenkonsum kann zu psychischen Erkrankungen führen: Drogen oder Drogen können dafür verantwortlich sein, dass beim Benutzer ein oder mehrere Symptome einer psychischen Erkrankung verursacht werden. Die Beweise für diese Möglichkeit stammen aus dem bekannten Zusammenhang zwischen einem erhöhten Risiko für Psychosen und Marihuana bei einigen Konsumenten.
• Psychische Erkrankungen, die zu Drogenkonsum führen: Forscher haben über die mögliche Rolle psychischer Erkrankungen bei der Entstehung von Drogenkonsum gesprochen. Personen, die über offene, leichte oder sogar subklinische psychische Störungen berichten, sind anfällig für Drogenkonsum als Selbstmedikation. Langsam, wenn sich die Person durch den Konsum der Droge gestärkt fühlt, wird sie davon abhängig, was zu einer Sucht führt.
• Überlappende Faktoren: Es gibt bestimmte Faktoren, darunter genetische Anfälligkeiten, Gehirndefizite und/oder frühe Stress- oder Traumabelastung, die sowohl AMI als auch SUDs verursachen können.

All three of these scenarios can manifest themselves (to varying degrees for different individuals) in suggesting co-occurring AMI and SUD.

Explore common factors

Genetics play a role in both AMI and SUD. Genetic factors may be a significant common link between these two disorders, which are known to contribute to the development of addiction and other mental illnesses. According to researchers, genetics contributes 40-60 percent to susceptibility to addiction. At the same time, genes may also indirectly contribute to the development of SUD by influencing a person's response to stress or a person's tendency to take risks and seek new things.

Similar brain regions are involved. It may be more than a coincidence that the same brain regions are affected in both SUD and AMI. For example, addictive substances and mental illnesses such as depression and other psychiatric disorders affect dopamine, a chemical that transmits messages from one neuron to another.

This overlap of brain areas affected by AMI and SUDs may indicate the possibility of some brain changes caused by one of these areas that may affect the other.

A report published in the National Institute of Drug Abuse (NIDA) suggests that the development of a mental disorder and subsequent changes in brain activity tend to increase susceptibility to substance use by reducing awareness of their negative effects, increasing their positive effects, or alleviating the unpleasant effects caused by the mental disorder.

Becoming mentally healthy is timely treatment

Various behavioral therapies have been shown to be effective in treating comorbidities. However, it is important to consider other related factors such as the patient's age and the specific medication used, among others, when planning treatment.

Inspired by Barbara Odozi