According to Dr. Scot Thomas at American Addiction Centers (AAC), it is remarkably common for people who misuse substances to have additional mental health issues that occur at the same time. However, not everyone understands exactly how to identify whether they are self-medicating or how they can stop. When drug and alcohol abuse and mental health issues coincide, a person is said to have co-occurring disorders or a dual diagnosis.
Mental health issues, including depression and anxiety, are often recognized as a driving factor behind a person’s misuse of drugs or alcohol, although the directionality or sequence of the two issues isn’t always clear. Early intervention is important in all cases of problematic substance use. A person can quickly cross the fine line between self-medicating and a full-blown substance use disorder (SUD), so catching the signs of an impending SUD early and treating it accordingly is crucial.
Below, some ways are outlined that may help you to identify self-medication of Mental Health Problems with drugs and alcohol in yourself or others, and address it before it develops into a clinically defined substance use disorder (SUD).
What is Self-Medicating?
Self-medicating refers to the misuse of drugs or alcohol in an attempt to manage the distressing symptoms of a mental health disorder or other health condition. Although many people that self-medicate may have a concurrently diagnosed health condition, such as a mental illness, cancer, injury, or chronic pain, it’s imperative to remember that you do not need to have a formal clinical diagnosis to have already started the act of self-medication of Mental Health Problems.
People tend to self-medicate for two fundamental reasons:
- First, substances may seem to make the symptoms of a distressing experience, such as an illness or mental health condition, feel more manageable in the moment, serving as a temporary way for them to cope.
- Second, many people who abuse substances can’t find another way to cope with their feelings or co-occurring health condition.
People commonly report using substances to try to cope with specific mental illnesses such as mood and anxiety disorders. In a review of various scientific literature, one study reported that approximately 22% of people with anxiety disorder, for example, report self-medication of Mental Health Problems with drugs and alcohol. Another indicated that more than 21% of people with post-traumatic stress disorder had used alcohol or drugs to cope with their disorder, along with approximately 23% of people with major depression and 41% of those with bipolar disorder (type 1).
As mentioned, self-medicating can occur even if someone doesn’t have a formally diagnosed mental health condition. Difficult life events, such as grief and abuse, can affect a person’s mental health and lead people to turn to alcohol or drugs to cope. Grief results in increased substance use according to a recent study. Furthermore, when someone is in an abusive relationship or has experienced some form of trauma as a result, they are also at increased risk of using substances to cope with their situation. In fact, adolescents with a substance use disorder (SUD) are 3 times more likely to have experienced a traumatic event than the average adolescent.
Forms of Self-Medication of Mental Health Problems
Alcohol tends to be the most common method of self-medication – as well as the most commonly abused substance – since it’s so widely available. It may be used to self-medicate stress as well as depression and anxiety, even though beer, wine, and liquor are all depressants and will therefore only make symptoms worse.
Prescription drugs, including opioid pain killers, ADHD medication, and anti-anxiety medication are also widely available. Their uses can range from numbing pain or relaxation to increasing focus and energy.
Recreational drugs, such as marijuana, cannabis, or stimulants like cocaine and amphetamines are used to manage uncomfortable emotions, situations, and memories. Their use can lead to drug abuse and addiction.
Food can be used by emotional eaters to self-medicate unpleasant feelings and deal with stress, anxiety, or depression. Since most people crave foods high in sugar, calories, and unhealthy fat, emotional eating can play havoc with your waistline as well as your mood.
The nicotine contained in cigarettes and other tobacco products helps some people focus, although in the long run tends to make symptoms of ADHD worse and can make it harder to quit smoking.
Why Self-Medication of Mental Health Problems is Harmful
Self-medicating might appear harmless at first or go completely undetected. A person might innocently use alcohol or drugs in an effort to feel better at that particular moment; indeed, our culture reinforces and normalizes the (sometimes excessive) use of certain drugs to “take the edge” off of their mood. But over time, self-medicating can complicate the management of mental health issues and can contribute to the development of a substance use disorder (SUD).
Cocaine use, for example, has been associated with an exacerbation of symptoms and worsened progression of bipolar disorder. Addiction and problematic substance use can, in some cases, also lead to brain changes that might predispose vulnerable individuals to develop additional mental health issues – including mood, psychotic, and impulse-control disorders.
Researchers associate the use of marijuana, for example, with a greater risk of experiencing earlier onset psychosis, with that risk increasing the younger people are at the time of their first cannabis use. Therefore, using substances to cope with a mental illness may increase the risk of someone developing a substance use disorder, exacerbate their pre-existing mental health condition, or even prompt the emergence of a new problem.
Self-Medicating for Depression and Other Mental Illnesses
As noted earlier, cocaine use in people with bipolar disorder can worsen the course of the mental illness. Likewise, abusing drugs or alcohol to self-medicate for other mental illnesses, like anxiety, depression, post-traumatic stress disorder, personality disorders, and more, can also have negative outcomes.
The use of marijuana among people with depression, for example, was associated with worse treatment outcomes for depression treatment. Treating depression and substance abuse at the same time can have positive outcomes for both disorders. Among people who suffer from anxiety and substance abuse issues, it is common to see that anxiety not only negatively impacts the person’s substance use, but that substance abuse can worsen anxiety.
Furthermore, in people with schizophrenia, the use of alcohol leads to worse outcomes than for those people who do not use alcohol. It is becoming increasingly recognized that, for optimal recovery outcomes, treatment of co-occurring conditions should simultaneously address both issues. Both anxiety and depression are also often side effects of drug withdrawal as well when a person abuses a substance regularly and becomes dependent on it.
How to Stop Self-Medicating
Compulsive self-medication of Mental Health Problems that is suspected to have emerged in association with an untreated (or undertreated) mental health issue can be stopped by adequately managing all underlying issues. The standard of care for people with a substance use disorder and co-occurring mental health condition is to enter a treatment program that addresses both issues simultaneously – a model referred to as integrated treatment. If you are using substances and also have a co-occurring mental health disorder, the relatively intensive levels of care found at an inpatient or residential treatment program may offer the most preferred treatment setting.
If you believe that you or your loved one is self-medicating with substances such as those mentioned above, it may be time to seek professional help. Only a substance use professional who is experienced in treating dual diagnoses can determine whether you are self-medicating, and what you ought to do about it.
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This article is provided by Dr. Ralph Kueche (Child Psychologist). Dr. Kuechle is a Child and Adolescent Clinical Psychologist who specializes in treating children and their families who may be struggling with mood and behavioral issues. Learn more about Dr. Kuechle.