An article published in The American Journal of Drug and Alcohol Abuse suggests that about one-third of people admitted to psychiatric programs have concurrent substance abuse concerns. Studies like this suggest that many people who head to their doctors for assistance with a mental health concern may have a substance abuse problem lurking in the background. Healing is possible, but the approach must be tailored based on the needs dictated by the mental illness.
Issues of Depression and Anxiety
Depression is sometimes defined as the complete absence of hope. For people immersed in a deep pool of depression, the future doesn’t look bright at all, and as a result, it can be hard to motivate these people to even participate in a treatment program. Reaching out is vital, however, as addictive substances can sometimes boost impulsive tendencies, and impulsivity mixed with depression can lead to an increase in the risk of suicide. People with depression simply must be convinced to get help.
Depressive episodes like this are sometimes augmented by feelings of nervousness and anxiety, particularly in people who have endured some type of traumatic episode in the past. Any disorder on the anxiety spectrum can also make patients resistant to the idea of therapy, as they might feel as though getting help might make life worse, not better.
Therapeutic approaches for these types of patients tend to be gentle and slow moving. Each little step forward is highly praised, and patients are provided with therapies that can boost their motivation to build on their prior successes. Skill building might also play a role, but the early stages of therapy tend to stress compassion and understanding.
Special Considerations for Eating Disorders
While dealing with depression and anxiety can be difficult, it can be even more challenging to assist a patient that combines an eating disorder like bulimia with a substance abuse problem. Unfortunately, the two issues tend to go hand in hand, as both tend to stem from inconsistencies in self-soothing and impulse control. There is a silver living here, however, as the therapies that can assist with an eating disorder might also help a substance abuse problem to abate.
In therapy, patients might learn a variety of techniques they can use when the urge to binge on food or drugs appears, such as:
- Progressive muscle relaxation
The more adept patients become at utilizing these skills, the less likely they might be to medicate with very dangerous substances that could cause them long-term harm.
Help for Patients with Schizophrenia
People who have schizophrenia often turn to addictive drugs in much the same manner as others who have mental illness, but the schizophrenic disease process tends to be swift and severe, meaning that patients often present with a significant need for in-depth services. According to an article in Schizophrenia Bulletin, the most effective addiction programs understand this, and they provide:
- Assertive outreach
- In-depth case management
- Motivational interviewing techniques
- Long-term care
- Phased care, based on a patient’s progress
With this sort of in-depth and long-lasting care, patients have the best opportunity to leave substance abuse behind and really gain control of their schizophrenia-related symptoms for good.
If you’d like to know more about any of these issues or you have specific questions about a mental illness not mentioned here, please call us.
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.
Reviewed by: Kim Chin and Marian Newton