Co-Occurring Disorders

What are they?

Individuals suffering from a mental health disorder and a substance abuse problem are said to have co-occurring disorders. It is important to understand the relationship between your mental health disorder and substance abuse problem because the symptoms of one likely impact the severity of the other. 

For some, the onset of anxiety or depression, for example, precedes their addiction issues. In this case, substances were likely used as a coping response to the uncomfortable mental health symptoms. 

For others, symptoms of anxiety and depression begin after the addiction has formed. Alcohol and other drugs have a vast impact on the brain's structure and function, specifically the part of the brain dealing with pleasure, emotional regulation, and mood. Prolonged use of substances will likely cause anxiety and/or depression due to the changes occuring in the brain.   

The two most common mental health disorders found in conjunction with addiction are anxiety and depression. Below are descriptions of what these disorders typically entail. 

Depression

Symptoms of depression commonly occur with substance abuse issues. Depression is often described as feeling empty, hopeless, or disconnected. You may experience low energy, lack of motivation, and isolation.

Depression also presents as issues with sleep, appetite, and physical pain or lethargy. 

More severe depression can include thoughts of suicide, self-harm, or a desire to simply disappear. If you are currently having thoughts of suicide or harming yourself in any way, it is crucial that you dial 911 or go to the nearest Emergency Room immediately to seek medical attention.

Anxiety

What does treatment look like?

When treating co-occurring disorders, it is important to look at each as a primary disorder. This means that each disorder comes with specific symptoms that need to be addressed.

 

It is also important to understand how your disorders are related and impact one another. It is common to see a correlation in the symptoms of your disorders, for example, an increase in anxiety can cause an increase in substance using behaviors. 

 

In our work together, I will assist you to gain insight to how your disorders progressed, the connection between the disorders, and the impact it has on your life.   

Addiction, Mental Health, and the Brain

Why Do I Feel Anxious and Depressed After Using?

There are many answers to the question, "Why do I feel anxious and depressed after using?"  One reason substance use has this effect on your mental health deals with the feel-good neurotransmitter, Dopamine. Dopamine is naturally released in the brain from food, sex, and other pleasurable life activities. However, alcohol and other drugs deliver a massive spike of Dopamine to the pleasure center of the brain- a much larger amount than daily life activities. For some, this increases your pleasure threshold, meaning, your brain now has a much higher expectation for what registers as a pleasurable experience. Activities such as eating, sex, or a laugh with friends are no longer pleasurable. The level of dopamine delivered does not compare to that of a chemical substance. You are now left feeling down and depressed and are obligated to use again to improve your mood.   

Another reason it is common to feel anxious after the use of substances is that anxiety is a main symptom of substance withdrawal. Alcohol withdrawal often presents with symptoms such as increased heart-rate and blood pressure, sweating, tremors, anxiety and even panic attacks. These symptoms are so uncomfortable that individuals often use more of the substance just to offset or avoid withdrawal. A vicious cycle begins characterized by use, intoxication, withdrawal, and continued use.  

*Important Note: Withdrawal from some chemical substances, alcohol included, can be life threatening and may require medical detox. If you are experiencing withdrawal symptoms, contact your doctor or seek medical attention. 

Anxiety is also incredibly common in conjunction with substance abuse. Symptoms of anxiety can range from excessive worry or fear to intense panic.

 

Anxiety is commonly felt physically in the body, and can even mimic symptoms of a heart-attack. 

Anxiety can feel so unbearable that you would do anything for momentary relief. Often, this is when individuals reach for substances as a way to escape their uncomfortable symptoms. 

© 2018 by Madeline Leitner

MSW, LCSW