Many people who suffer from an addiction also have a co-occurring mental health disorder. The DSM-5 uses the term substance use disorder to describe anyone who’s use of drugs or alcohol causes significant life problems as well as continued use despise decreased quality of life in several areas. There are eleven criteria used to determine the diagnosis of a substance use disorder. You can read them here.

A co-occurring disorder means someone with an addiction also has a mental health disorder. Estimates for having both are around 45 percent. However, some might say it’s even higher than that. In fact, I’ve read its around sixty percent for children or teens who start using a substance at an early age in an attempt to ‘treat’ a mental health issue. Unfortunately, the earlier a person starts using, the more likely they are to develop a full-blown addiction later in life. This is partly because the use patterns are being developed at the same time as their brain.

A teenager who starts drinking or using drugs at a young age may be attempting to sooth an anxiety disorder, regulate a chemical imbalance, or sooth emotional pain from abuse or trauma. If you think about it realistically, it’s actually an understandable reaction to pain. They are trying to fix what is wrong, they are just going about it in a maladaptive way.

For instance, I’ve struggled with anxiety and insomnia since I was five years old and I can remember times as a child when my mind would go blank. In addition, I was diagnosed with dyslexia around the same age which caused problems with my self-esteem and self-efficacy. Self-efficacy is a person’s belief in their ability to achieve an outcome. When I took my first drink at fourteen all those feelings melted away. I was funny, cool, social, and connected. And there were times when I really was the life of the party.    

This is where it gets challenging as many anxiety disorders and personality disorders are not diagnosed until an individual is in their early twenties. The question becomes which came first, the addiction or the disorder? When I turned 21, at the start of my radio career, I began having panic attacks. The self-esteem and self-efficacy challenges caused extreme performance anxiety. It was then I was diagnosed with generalized anxiety disorder and prescribed Xanax, a highly addicting benzodiazepine which is also dangerous when mixed with alcohol. I was not evaluated for a substance use disorder by the doctor.

Many individuals in this situation begin self-medicating so early in life they either don’t know they have an underlying psychological issue, or they don’t know if it was there before their addiction. This needs to be worked out by the individual or with a good counselor or therapist. The first thing to do is detox from the substance, re-evaluate the symptoms and go from there.

Some of the more common mental health disorders that co-occur with addiction are anxiety disorders, depression, bipolar, attention deficit disorder, psychotic illnesses like schizophrenia; and personality disorders like borderline or antisocial personality disorder. Diagnosing these things can also be tricky as substance use and substance detox can mimic the effects of all the disorders just mentioned. This is why it is important to detox from the substance before making a determination. Trauma, PTSD, or child abuse (adverse childhood experiences) also puts individuals at higher risk for developing an addiction.

Once I stopped drinking, I began the introspective work of recovery and realized I was self-medicating an anxiety disorder and other challenges I mentioned previously. If you or a loved one is struggling with substance use, abuse, or addiction, the best thing to do is get a full assessment from a mental health provider and seek treatment for the addiction as well as any underlying mental health or psychological issues.

I dig into this topic more in the latest podcast episode of Genuine Life Recovery. You can listen to it by clicking here.

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