All substance abuse has the potential to impact mental health in some way because of their ability to affect the way you see, think, and experience things, as well as your mood, and behavior.

When used extensively over a prolonged period of time, alcohol and recreational drugs alter brain chemistry, which can lead to long-term mental health problems such as anxiety, depression, schizophrenia, or psychosis. They can also lead to addiction if you become dependent on them to help you relax, cope with painful feelings, or increase your self-confidence.

Disordered mental health and substance abuse may exist independently or they may co-occur. When they do co-occur, it is difficult to establish the cause of any symptoms because both of them share common risk factors such as genetic vulnerabilities, biological predispositions, and what areas of the brain are affected. Both are similarly influenced by life circumstances, trauma, and the way you process and manage your emotions.

In some cases of dual diagnosis, it is chronic substance abuse that causes the mental health disorder. In others, it is the mental health disorder that leads to substance abuse by driving a person to use drugs or alcohol to self-medicate. Likewise, there are instances where a person may experience both disordered mental health and substance abuse without the one having caused the other.

According to the Substance Abuse and Mental Health Services Administration (SAMHSA), more than one in four adults living with serious mental health problems also has a substance abuse problem.

While studies have been able to establish a clear and irrefutable link between mental health disorders and substance abuse and have consistently shown that having one condition increases the risk of developing the other, studies have been unable to conclusively determine which prompted the other. Determining which came first is difficult, whether it’s the mental health issue that leads to substance abuse or it’s the substance abuse that leads to the mental health issue.

How substance abuse alters your brain

Your brain consists of a network of neurons that send, receive and process signals. Alcohol and drugs are chemicals that can affect the way this communication system functions. Prolonged, repeated substance abuse alters your brain’s chemistry and damages neurotransmitters such as serotonin and dopamine.

One of the main changes this produces is the rewiring of circuits to your brain’s reward center where dopamine is responsible for feelings of happiness, motivation, and satisfaction. As this pathway is hijacked by your substance you start to experience mood swings, a loss of pleasure in things you used to enjoy, and a lack of incentive.

You become driven by a growing need to increase your substance use in order to get the same effect you did before and there is a gradual shift in your focus and priorities. Your primary concern, above all else, becomes to obtain and use your substance.

The other major disruption that takes place is in the executive function part of your brain, located in the frontal cortex, which regulates cognitive activities such as decision-making, impulse control, planning, judgment, and memory. The National Institute on Drug Abuse (NIDA) says: “We now know that many of the drugs of abuse target not just those aspects of the brain that alter things like emotion, but also areas that affect our ability to control cognitive operations.”

As you become addicted to your substance of choice, a negative feedback loop is formed. The chemically driven dopamine surge provides an initial sense of comfort, relief, and well-being, but when the effects wear off you feel worse than you did before, and your brain sends you urgent signals to use it again. You feel compelled to continue using your substance despite the negative effects. Likewise, you start to feel guilt and shame over your loss of control.

The good news is that this loop can be broken. Because of its neuroplasticity, the brain has a remarkable ability to create new pathways and circuits for its damaged functions to be restored. The earlier the intervention, the greater the chances of successful treatment and recovery.

Treatment options

The most effective treatment for co-occurring mental health and substance abuse disorders is a comprehensive, integrated approach that addresses both conditions and includes a combination of detox, psychotherapy, support groups, and self-care practices. It should focus on healing the whole person rather than just the mental health condition or the substance abuse issue alone.

If you have questions or would like to set up an appointment to meet with one of the faith-based counselors at our location, please don’t hesitate to give us a call.

References:

“Mental Health and Substance Use Co-Occurring Disorders.” SAMHSA. Updated April 24, 2023. samhsa.gov/mental-health/mental-health-substance-use-co-occurring-disorders#.

Peter King. “The Substance Use and Mental Health Connection.” Sandstone Care. October 11, 2021. https://www.youtube.com/watch?v=CFOGZpSw83M

Photo:
“Shadows”, courtesy of Jill Burrow, Pexels.com, CC0 License

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