Infections tend to develop beneath skin that’s been pierced or torn by an injury. That’s a condition that’s easy to unravel, as the injury simply must come first in order to give the infection room in which to grow. But when a person has a mental health condition and an addiction, the puzzle of this Dual Diagnosis can be a little more challenging to solve. In some, the drug use comes first. In others, the mental health condition plays a primary role.
When Mental Illness Comes First
In an article in the American Journal of Psychiatry, authors suggest that people with difficult mental health conditions use drugs of abuse as a form of medication. They choose their substances with care, looking for the chemicals that can ameliorate the difficult symptoms they deal with on a daily basis. Someone with rage disorders, for example, might lean on opiate drugs, as they’re soothing and sedating, these experts suggest, while those with depression might appreciate the mood boost of cocaine.
While these users might feel as though they’re making savvy decisions regarding their drug use, they’re also leaning on substances that can be remarkably addictive, and they can deepen the symptoms of mental illness they were once meant to cure. For example, a person with depression might struggle with feelings of sadness due to a low production of the neurotransmitter dopamine. Taking heroin, day in and day out, can reduce dopamine production yet further, plunging this person into an even more profound sense of depression. For people like this, the mental illness came first, but the addiction certainly makes things worse.
When Addiction Comes First
While addictions can sometimes deepen a mental illness that’s already in place, some people develop symptoms of mental distress only after they’ve amended their brain cells with drugs. This problem is often most striking among people who abuse marijuana.
According to the National Institute on Drug Abuse (NIDA), people who are dependent on marijuana often have other mental health disorders, including:
- Anxiety disorders
- Mood disorders
But research also suggests that people who have a family history of schizophrenia and a propensity to develop the disease may find that the mental illness is triggered by the use of marijuana, the NIDA says. In other words, the drug seems to awaken the illness and bring it to life, and people who experience this schizophrenia awakening may have never experienced the full force of this disease unless they took in marijuana. The drug has the power to put them under the full spell of the disorder.
It’s possible that other drugs can cause these sorts of chemical changes that lead to mental health disorders. People who take in stimulants, for example, may experience intense brain changes that lead to depression that lasts for months or even years after sobriety takes hold. But much more research must be done before that link between drug use and persistent mental health problems is made clear.
Breaking the Connection
No matter whether the addiction came first or the mental illness was the first to arrive, treatment can make a big difference. In a Dual Diagnosis program, patients can learn more about how they can keep both conditions under control, and they’ll have the support that allows them to make changes that will last. Please contact us, and our admissions coordinators can tell you more.
Further Reading About Which Comes First: Addiction or Mental Health Disorders?
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David W. Newton is a board certified pharmacist and also has been a board member for boards of examiners for the National Association of Boards of Pharmacy since 1983. His areas of expertise are primarily pharmaceuticals as well as cannabinoids. You can read an article about his expertise in CBD on the National Library of Medicine.