Mental Health and Substance Abuse
40 – 65% of people in drug and alcohol treatment suffer co-occurring mental health issues. The most common underlying factor is a childhood history of trauma and violence.
The reality is that substance use disorders and mental health problems are closely linked. Sometimes they co-exist. Other times, one precipitates the other. And too often, one is dominant and masks the existence of the other, so that only one is treated.
It is important to recognize that not all mental health issues have a clinical diagnosis. In addition to the frequently diagnosed mood, personality, dissociative, anxiety, and psychotic disorders, there are also other challenges, including:
- PTSD
- ADHD
- Fetal Alcohol Syndrome or Fetal Alcohol Effects
- Maternal depression
- Undiagnosed grief and loss issues
Mental health problems first, drugs and alcohol second
For some people, mental health issues come first. In these situations, substance users may turn to alcohol or drugs:
- To self-medicate for mood or anxiety disorders, or to deal with the side effects of psychiatric medications
- Because impaired judgement leads to use of substances
Primary substance use disorder, psychiatric symptoms secondary
For others, the use of drugs or alcohol causes psychiatric symptoms. Psychiatric sympoms, particularly anxiety and depression, may be caused by detoxification and withdrawal from drugs. People who use cocaine or other stimulants may experience a rebound depression after using their drug of choice. People who use PCP or LSD may suffer from a drug induced psychosis. For some people, psychiatric symptoms are short term. For others, they are longer-lasting.
Parenting
Descriptions of parents with co-occurring mental health and substance use disoders are similar to descriptions of chronically neglecting parents. Those who struggle with both mental health issues and substance use disorders often face additional challenges including:
- Social isolation
- Stigma
- Problems accessing community services
- Loss of custody
- Trauma of hospitalization
- Complicated support systems
These parents may:
- Engage in inconsistent discipline
- Role reversal with children during crises
- Feel guilty about subjecting their children to their symptoms
- Experience limitations in providing care and nurturing for their children
- May not see how their own past trauma impacts on their ability to parent
- Have child/parent relationship problems that heighten decompensation and relapse.
- Feel helpless and hopeless
