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Mood disorders and substance abuse are commonly correlated.
According to the National Institute on Drug Abuse (NIDA), people who struggle with mental illness are twice as likely as the general population to also struggle with substance abuse. Mood disorders, such as bipolar disorder, depression, and anxiety, are often found among people who struggle with addiction and substance abuse. When mood disorders are diagnosed with substance use disorder, this is called comorbidity.
Researchers have been investigating the comorbidity of mood and substance use disorders for decades. In the 1980s, the National Institute of Mental Health’s Epidemiologic Catchment Area (ECA) study found that, among individuals with a mood disorder, 32 percent also had an addiction or substance abuse problem. Among individuals specifically struggling with major depression, 16.5 percent had an alcohol use disorder, and 18 percent had a different drug use disorder. Among people with bipolar disorder, substance abuse disorders were found in 56 percent of the population.
In recent years, clinicians have found that it is less helpful to treat one disorder followed by the other than to treat the comorbid conditions together. Treatment programs are continually developing effective methods of helping people who struggle with comorbid mood and substance use disorders, although this is a relatively new phenomenon in the realm of substance abuse treatment.
Mood disorders are mental illnesses involving serious changes in a person’s mood. According to Mental Health America, 20 percent of the US population reports at least one symptom of depression in any given month, while 12 percent report two or more in one year. Bipolar disorder affects roughly 1 percent of the population. In most mood disorders, symptoms of depression are common, and these are often used as a tool to uncover the underlying condition; however, according to the Substance Abuse and Mental Health Services Administration (SAMSHA), anxiety is the most common mental illness, followed by depressive disorders.
Types of mood disorders include:
Substance abuse and mental health intertwine in ways that researchers are only recently beginning to understand, but there are some general causes or reasons behind the link:
Symptoms of Substance Abuse and Mood Disorders
Before understanding how these symptoms appear together, it is important to understand how symptoms present in the different disorders, separately.
Symptoms of alcoholism include:
Symptoms of cocaine abuse include:
Statistics on Mood and Substance Use Disorders Together
The correlation between mood disorders and substance use disorders is very strong. According to the Anxiety and Depression Association of America, once these conditions become comorbid, they feed each other. Statistically, 20 percent of people who struggle with an addiction have an anxiety or mood disorder, and 20 percent of people with a mood disorder also struggle with substance abuse.
In a study conducted by the authors of “Substance Use Disorders in Patients with Anxiety Disorders,” college freshmen with anxiety disorder had a greater chance of developing alcohol dependence than their peers without anxiety disorder, within 4-7 years. Another study found that 18-30 year olds with anxiety disorder were 2-3 times more likely to develop an addiction, compared to their peers.
A study reported on by Primary Psychiatry on substance abuse and mood disorders in general found that mood disorders accounted for 71 percent of mental health diagnoses among individuals struggling with methamphetamine addiction.
According to SAMSHA, in 2014, around 340,000 adolescents between 12 and 17 years old reported both a major depressive episode (MDE) and a substance use disorder (SUD). This age group was more likely than their peers without MDE to regularly use marijuana, psychotherapeutics like Xanax and Ambien, hallucinogens, and inhalants. About 1.6 percent of those with past-year MDE also smoked cigarettes, and 1.8 percent with past-year MDE were heavy alcohol drinkers in the past month.
When a person struggles with an addiction, long-term physical effects of leaving this condition untreated can damage the brain and internal organs.
For example, long-term effects of alcohol abuse include:
Long-term effects of cocaine abuse include:
Regardless of the drug of abuse – whether cocaine, alcohol, or any other substances – the long-term effects of continued use can be severe. They can also reach to all areas of life – health, relationships, finances, career, etc.
Although it is obvious that long-term abuse of intoxicating substances would damage the body, mental health issues can lead to physical and mental changes as well.
Long-term effects of untreated bipolar disorder include:
Long-term physical effects of untreated depression include:
The effects of untreated anxiety include:
Each of these conditions by itself, when left untreated, can pose long-term, chronic health risks and an increased risk of early death. When combined, these conditions exacerbate each other, and the risk of dying early increases.
Clinicians focus on behavioral approaches, in addition to pharmacological options as needed, when treating individuals with comorbid substance use and mood disorders. Cognitive Behavioral Therapy has been shown to be among the most effective treatments, as it addresses damaging thought patterns related to both the substance abuse and the mood disorder.
Whether a person struggles with depression due to withdrawal or substance abuse triggered by depression, most medical professionals will prescribe a small dose of an antidepressant to help ease those symptoms. Depression is one of the more successfully medicated mental illnesses, and it is easier to monitor symptoms of the mental health problem to see if the individual is improving. Though medications are often used in treatment, they do not “cure” either disorder; they must always be used in conjunction with therapy to manage the co-occurring issues.
Although attitudes toward comorbid conditions are changing, the overall healthcare system right now typically treats substance abuse and mood disorders separately. This is now viewed as inefficient, and medical professionals are pushing for change. Physicians tend to treat mental health concerns, while many types of providers will work with patients struggling with substance abuse. Finding a better way to get these two groups to work together will benefit people struggling with comorbid mood and substance use disorders.