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Is Substance Use a Mental Health Disorder?

Substance use and misuse, whether the substance is alcohol or a drug, is extremely common, with substance use disorders affecting over 48 million people in the United States. At the same time, more than 59 million people in the United States suffer with a mental health disorder.

But how are the two related? Is a substance use disorder a mental health disorder? Can you have a substance use disorder and another mental health disorder at the same time? Is any substance use considered a substance use disorder?

Substance Use Vs. Substance Use Disorder

Substance use can occur without that use being considered a substance use disorder (SUD). For example, someone who drinks alcohol occasionally may not have a substance use disorder. Someone who is prescribed opioids temporarily may not have a substance use disorder.

A substance use disorder is defined as physical dependence on a substance that leads to continued use of the substance despite severe consequences in the user’s life. These consequences can be physical issues, or they can be interference with the person’s ability to function normally in life and handle responsibilities.

Is a Substance Use Disorder a Mental Health Disorder?

An SUD is considered a mental health disorder. Chronic substance use causes changes in the brain which affect how the brain functions. Substances that are abused affect pleasure mechanisms in the brain, and the brain eventually comes to expect these substances and does not produce pleasure without it.

The part of the brain that controls decision making is also affected, which affects the substance user’s ability to solve problems and resist impulses.

Many treatment therapies for SUDs and mental health disorders overlap, meaning that they are used to treat either or both SUDs and mental health disorders because they are intended to change the way the brain works.

Co-Occurring Disorders

A co-occurring disorder, also known as a dual diagnosis, occurs when a person has both an SUD and another mental health disorder, such as anxiety or depression, at the same time. In the case of a co-occurring disorder, both disorders are treated simultaneously.

About half of all people who have a serious mental health disorder also have an SUD. This is often due to people with mental health disorders “self-medicating” to relieve their symptoms. However, some people with SUDs develop other mental health disorder symptoms while they are abusing substances, but symptoms go away when they are in recovery from the SUD.

Causes of Substance Use Disorders and Mental Health Disorders

The causes of SUDs and other mental health disorders are similar and can include:

  • Genetics that affect how the brain functions and responds to certain factors
  • Environmental factors, such as family disfunction or access to substances
  • Stress
  • Severe trauma, including childhood trauma

Genetically, some people process dopamine or serotonin incorrectly, or they may react differently to certain substances.

Environmentally speaking, people who suffer childhood trauma or grow up with a poorly functioning family may have a higher risk of mental health disorders. People who grow up with access to drugs or alcohol may be more likely to develop an SUD.

Often, it’s a combination of both genetic and environmental factors that lead to the co-occurring disorder.

In some cases, the underlying mental health disorder leads to substance abuse. For example, someone with bipolar disorder may turn to alcohol to ease their symptoms. While this may bring relief in the short term, over time, substance use makes the mental health disorder symptoms worse.

In other cases, substance abuse leads to other mental health disorder symptoms. For example, a person with an alcohol use disorder may develop feelings of depression when they drink.

Treatment for SUDs and Co-Occurring Disorders

Fortunately, treating an SUD alone and treating other mental health disorders have many similarities. The treatment of co-occurring disorders thus involves an integrated approach to treating both disorders at the same time. This may include medications for the mental health disorder combined with different types of therapy to treat both disorders.

An SUD also requires a period of medically supervised detox, during which time the medication treatment of the other mental health disorder also begins.

Cognitive behavioral therapy (CBT) is commonly used to treat substance abuse disorders and other mental health disorders and has also proven to be quite effective in treating the disorders when they co-occur. In CBT, patients learn how to recognize and control negative or destructive thoughts, and coping strategies to deal with challenges in a healthy way.

Dialectical behavior therapy (DBT) is similar to CBT but focuses on challenging intense emotions with reality-based reasoning.

Group therapy is a critical part of SUD treatment, and the treatment of co-occurring disorders. This allows peers who are facing similar challenges to share their emotions and experiences and to develop mutually supportive relationships. This reduces the feelings of isolation that people with SUDs and co-occurring disorders often experience.

All of these therapies are provided in comprehensive treatment programs that start with inpatient treatment, followed by a partial hospitalization program (PHP) and an intensive outpatient program (IOP).

After the treatment program, ongoing regular individual therapy is recommended. Many people also find SUD support groups, such as Alcoholics Anonymous or Narcotics Anonymous, helpful in preventing relapses and dealing with the challenges of both disorders.

Making the First Call

Treatment for an SUD or other disorders can seem like a long, daunting process, but you’ll find that, with each day that passes, you’ll regain a little more control of your life.

Health Service Alliance provides treatment for both substance abuse and other mental health disorders, regardless of your ability to pay. We offer a safe environment without judgment, and care that can lead you to a healthier, happier future. Make that first call to speak to a member of our compassionate team, and we can help you start your path to recovery.

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