“I have absolutely no pleasure in the stimulants in which I sometimes so madly indulge. It has not been in the pursuit of pleasure that I have periled life and reputation and reason. It has been the desperate attempt to escape from the torturing memories, from a sense of insupportable loneliness and a dread of some strange impending doom”
Edgar Allan Poe
Individuals with mental illness are twice as likely to have a co-occurring substance use issue than individuals without mental illness. Conversely, people with substance use issues are more likely to have co-occurring mental health problems.
The most common association is that people with mental health issues use alcohol and drugs to self-medicate to manage distressing symptoms. For example persons with social anxiety might drink to relax. People with panic disorders might rely on drugs like valium or xanax to prevent or manage attacks. Individuals experiencing low energy or motivation might use stimulants such as methamphetamine, cocaine or adderall to improve their drive. And others might take drugs like marijuana or opiates to numb or cope with emotional pain.
Even though these substances might initially provide temporary relief from the symptoms associated with mental illness, their use can ultimately lead to a worsening of symptoms. Some drugs can trigger symptoms of pre-existing mental health disorders. Others can directly cause symptoms of mental illness, including depression, paranoia and delusions. Sometimes these symptoms go away when a person is not using substances. In other instances, these symptoms can persist and develop into a mental health disorder over time.
Our brain is our most complex organ. It regulates our body’s basic functions like breathing. Our brain enables us to interpret and respond to our experiences. It shapes our thoughts, emotions and behaviours. Drugs can significantly alter the way we think, feel and act by interfering with the brain’s communication system-the way it sends, receives and processes information. Some drugs like marijuana and heroin, activate neurons in the brain by mimicking the brain’s naturally occurring chemical messengers. However, although they mimic, they don’t activate neurons in the same way and can lead to abnormal messaging. Other drugs like cocaine and methamphetamines can cause neurons to release excessive amounts of the brain’s chemical messengers or prevent the normal recycling of these chemicals. Ultimately the brain’s communication system becomes significantly disrupted.
Many drugs produce pleasure by increasing the chemical messenger, dopamine. Dopamine regulates movement, emotion, motivation and pleasure. Overstimulation of dopamine leads to euphoria. Our brains adjust to surges in dopamine by producing less dopamine. Consequently, naturally occurring dopamine levels can become abnormally low, and the ability to experience any pleasure is significantly decreased. Eventually a person who abuses drugs can become depressed, flat and lifeless. This person then becomes reliant on the drug just to feel normal.
The relationship between substance use and mental illness is complex. Substance use can temporarily alleviate symptoms of mental illness. However, regular substance use can lead to dependence and can trigger or worsen symptoms of mental illness.
“Addiction isn’t about substance-you aren’t addicted to the substance, you are addicted to the alteration of mood that the substance brings.” Susan Cheever