Substance abuse and comorbidity

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Dual diagnosis
The Hader Clinic
The Hader Clinic
February 10, 2020
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What makes addiction a mental illness?

There are so many theories surrounding addiction, alcoholism, and how to recover. How can an addict stop using or drinking? Where did the problem start? Was the addict born to use, or is substance abuse inherited?

Answers to these questions bounce between extremes, depending on who you ask. And these answers probably won't yield any worthwhile information. However, there is one question that is worth answering: How do other mental health issues tie in with addiction and alcoholism?

The Hader Clinic is here to help you understand the intrinsic link between substance abuse and comorbid mental health issues. We treat these conditions in tandem, leading to better future outcomes for our patients.

Understanding the link between mental health and substances

Addiction or alcoholism – whichever term is more applicable to you — are actually classified as mental illnesses, in the same way as depression or bipolar are. The disease of addiction alters the brain in some very fundamental ways similar to other mental health conditions and mood disorders.

Here's how to understand the relationship between mental health and addiction in two key steps.

  1. Addiction disturbs a person’s normal hierarchy of needs and desires, which ultimately means substituting new priorities connected with procuring and using substances.
  2. The resulting compulsive behaviours override the ability to control impulses, despite the often wholly negative consequences associated with ongoing addiction.

This is actually quite similar to that of many other forms of mental illness.

What are the criteria for addiction and alcoholism?

Medically, the diagnostic criteria for mental disorders also includes drug related disorders. There are two definitive types of drug addiction criteria: abuse and dependence.

  • Drug dependence is tantamount to addiction — the physical and emotional reliance on substances.
  • Drug abuse is the harmful use of substances, but without the physical tolerance and withdrawal.

Frequently, abuse leads to full-blown dependence.

What is comorbidity?

man being treated by a psychologist

Suffering from two or more medical conditions at once is known as comorbidity, dual diagnosis, or a co-occurring disorder. These terms essentially all mean the same thing (in terms of drug and alcohol addiction) — that the client suffers from addiction and another mental health condition. People who regularly abuse drugs or alcohol are also diagnosed with other mental disorders, and vice versa.

[feature_link]The high incidence of comorbidity has been well documented in multiple national population surveys since the 1980s. Research shows that people diagnosed with mood or anxiety disorders are about twice as likely to suffer from a drug or alcohol misuse disorder (abuse or dependence).[/feature_link]

This is also true for those diagnosed with an antisocial syndrome, such as antisocial personality or conduct disorder. Similarly, persons diagnosed with drug disorders are roughly twice as likely to suffer also from mood and anxiety disorders.

Issues with treating comorbidity

Treating any addiction and mental health condition in tandem is highly technical. In the most extreme cases, the patient can present with more than one mental health condition and multiple substance addictions.

The key to helping people find long term recovery is accurate diagnosis and this can be difficult for the following reasons:

  • Substance use can often develop to mask an underlying mental health condition
  • Drugs and alcohol exacerbate mental health conditions
  • Some patients find that once they stop using, that the symptoms of their mental health issues vanish

As is often the case, the negative effects of addiction can mimic the symptoms of disorders like depression, anxiety, and psychosis.

How we treat comorbidity effectively

A residential treatment centre provides the best place to treat comorbid conditions, because both conditions can be monitored by the same team. Residential rehab means a fully integrated approach and 24-hour care and support.

When people treated in the community have different care providers looking after separate elements of their needs, things can fall through the cracks. This can lead to lapses in treatment, which can, in turn, lead to relapses.

The best way to treat comorbidity is to holistically address all elements of addiction and mental health issues simultaneously. These include symptoms that are:

  • Physical, including symptoms present in detox and withdrawal
  • Emotional, including anger, sadness, anxiety, and depression
  • Psychological, including psychosis, obsession, and fear
  • Social, including risky behaviour and romantic issues
  • Spiritual, including dependence, and damaged self esteem

The Hader Clinic addresses these issues in tandem, allowing patients the greatest possible chance at success. By treating the whole self, patients can learn to manage their addiction and mental health issues, allowing them to return to a normal life, free from relapse.

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