Substance use and mental illness

By Megan Obert and Adina Smith Women in Action

Roughly 21 million American adults have an alcohol or drug addiction. Of these, nearly 50 percent also have mental health issues. The most common mental health issues that occur alongside substance addiction are depression and anxiety.

There is a chicken-egg debate about which is present first, the substance use or the mental illness. Some researchers propose substance addiction creates depression and anxiety because of the added work stress due to hangovers, substance use at work, difficulty concentrating, trouble sustaining relationships, increased financial problems, or constant worry about where to get the next fix. Others believe mental illness comes first, and to cope with the depression and/or anxiety some people self-medicate with alcohol or drugs.

Regardless, it’s apparent that a large and increasing number of people are suffering from both mental illness and substance abuse.

Doctors describe a person with both mental illness and substance addiction as having co-occurring disorders. The illness and addiction feed on each other, and having both often leads to a worsening of both if left untreated. Having these co-occurring disorders is also linked to having higher rates of chronic health problems and a higher mortality rate than the general population.

Seeking help for both disorders is more beneficial than just treating one. For example, a person could stop self-medicating with alcohol, but he or she might still feel depressed – in which case a relapse with alcohol is likely. In addition, alcohol and some illicit drugs exacerbate both depression and anxiety, decrease the effectiveness of anti-depressants, and make therapy less effective.

If you’re concerned about your alcohol or drug use, asking yourself the following questions can help determine if you need help:

– Have you ever felt the need to cut down on your drinking or drug use?
– Do you get annoyed at criticism by others about your drinking or drug use?
– Have you ever felt guilty about your drinking or drug use, or about something you did while drinking or using drugs?
– Have you ever felt the need for a drink or the use of drugs early in the morning?

One positive answer to any of these questions indicates you may be at risk for developing a problem with drugs and alcohol.

Megan Obert is the Big Sky Community Counseling intern. Adina Smith, Ph.D. is a psychologist and an Associate Professor in the MSU Department of Counseling.

Resources for substance addiction and mental illness
There are resources available in Big Sky for people suffering from substance addiction and/or mental illness.

The MSU Human Development Clinic, in partnership with Women In Action, provides low-cost counseling services on Mondays and Wednesdays. The clinic can help determine the presence of substance addiction and/or mental illness. It can also provide quality counseling for mental illness and when substance abuse treatment is necessary, counseling in conjunction with this treatment. Contact the Human Development Clinic at (406) 570-3907.

Another local resource, Alcoholics Anonymous, meets downstairs in the Big Sky Chapel on Tuesdays at 5:30 p.m., Thursdays at 8 p.m. and Saturdays at 7:30 a.m. These meetings are open and available to anyone interested in the AA program.