Most people who struggle with a substance use disorder also have a co-occurring mental health issue, or a dual diagnosis. According to the 2014 National Survey on Drug Use and Health, about 3.3 percent of all American adults had a dual diagnosis of addiction and another mental health issue. [https://www.samhsa.gov/data/sites/default/files/NSDUH-FRR1-2014/NSDUH-FRR1-2014.pdf] Some mental health issues can multiply your risk of developing a substance use disorder by several times.
A preexisting mental health issue can increase your risk of addiction, addiction can increase your risk of developing a mental health issue, or both may be caused by some other factor, such as abuse, neglect, or trauma. Many people struggling with addiction aren’t even aware they have an untreated mental health issue. Unfortunately, unless the mental health issue is treated concurrently with addiction, it’s very hard to overcome a substance use disorder. That’s why it’s crucial to find a treatment program that has the staff and expertise to integrate addiction treatment and mental health treatment. The following are some of the most common mental health issues that require treatment along with addiction.
According to the National Institute on Mental Health, nearly 20 percent of Americans will experience an anxiety disorder in any given year and more than 30 percent of Americans will experience an anxiety disorder at some point in their lives. [https://www.nimh.nih.gov/health/statistics/any-anxiety-disorder.shtml] One reason anxiety disorders are so common is that it’s an umbrella term that includes many conditions such as generalized anxiety disorder, social anxiety disorder, panic disorder, OCD, PTSD, phobias, and others.
According to the Anxiety and Depression Association of America, about 20 percent of people with an anxiety disorder or mood disorder also have a substance use disorder. [https://adaa.org/understanding-anxiety/related-illnesses/substance-abuse] In other words, having an anxiety or mood disorder more than doubles your risk of addiction. Many people with anxiety disorders use drugs or alcohol to relieve their anxiety. For example, one common pattern is for people with social anxiety disorder to drink to relieve their social anxiety and eventually become dependent on alcohol. And benzodiazepines, a common anxiety medication, are extremely addictive and can lead to dependence in as little as two weeks of daily use.
Post-traumatic stress disorder, or PTSD, is technically an anxiety disorder but it increases your risk of addiction by so much that it deserves special attention. About seven or eight percent of people will develop PTSD at some point in their lives. [https://www.ptsd.va.gov/understand/common/common_adults.asp] About half of people seeking help for a substance use disorder meet the criteria for PTSD. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3466083/] That’s about five times the national average for substance use disorders. PTSD has a number of symptoms, including intrusive thoughts, anxiety, and insomnia that people try to treat with drugs or alcohol, especially alcohol.
According to the National Institute of Mental Health, more than seven percent of American adults, or more than 17 million people, experienced an episode of major depression in 2017 and that number has risen in recent years. [https://www.nimh.nih.gov/health/statistics/major-depression.shtml] According to the World Health Organization, depression is the number one cause of disability worldwide. [https://www.who.int/news-room/fact-sheets/detail/depression] As with anxiety, depression can lead to a substance use disorder or vice versa. Among people with lifetime major depression, 16.5 percent have had an alcohol use disorder and 18 percent have had a drug use disorder, both of those rates are significantly higher than average. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2851027/]
Women suffer from depression at about twice the rate as men but men are more likely to self-medicate with drugs and alcohol, less likely to seek help for depression, and more likely to die by suicide, making a dual diagnosis of depression and addiction especially dangerous for men. Since depression is so common in general and a common result of addiction, treating depression along with addiction is frequently necessary.
Attention deficit/hyperactivity disorder, or ADHD, is another condition that is highly correlated with addiction. One survey found that about 15 percent of people with ADHD also had a substance use disorder, about twice the national average. [https://www.additudemag.com/the-truth-about-adhd-and-addiction/] People with uncontrolled ADHD often have racing or intrusive thoughts, poor mood, or insomnia and about 70 percent of people with ADHD and substance use issues say they try to reduce these symptoms with the aid of drugs or alcohol. Many adults with ADHD aren’t even aware they have it, since the hyperactive aspect tends to diminish with age. However, the other symptoms can persist, so treating addiction requires getting ADHD symptoms under control.
Bipolar disorder is typically classified as a major depressive disorder but there’s such a high correlation between bipolar and substance use disorders that it deserves special mention. Of people with bipolar disorder, about 56 percent developed a substance use disorder at some point. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2851027/] And bipolar isn’t as rare as most people believe. About 2.6 percent of Americans will develop bipolar disorder and about 83 percent of those cases are severe. [https://www.nami.org/learn-more/mental-health-conditions/bipolar-disorder] What’s more, bipolar is one of the most commonly misdiagnosed conditions, often mistaken for depression, and it presents special challenges for addiction treatment, especially during manic episodes.
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