Mental Illness and Substance Abuse: What is the connection between the two?

Do you have a friend or relative who, along with their mental health issues, is extremely anxious, depressed, or angry, and is also addicted to alcohol or other drugs? Sometimes we feel like these two things go hand in hand. In fact, in medicine, we see this condition as two very closely related problems. There is a special name for this called ``Dual Diagnosis``. This means that a person has both a mental health problem and a substance abuse problem. Let's talk about this in more depth today.

Why do these mental health issues and addictions come together?

This is a very important question. Simply put, a person with one of these two conditions is at a much higher risk of developing the other. Surveys have shown that more than 60% of people who suffer from one of these two conditions actually have both.

Think of it this way. A person has a genetic or biological predisposition to develop a certain mental problem. That means their body and brain are somewhat sensitive to it. At a time like this, if that person starts using alcohol or another drug, that hidden mental problem can suddenly surface.

Sometimes the other way around happens. When a person is unable to cope with the problems of daily life, loneliness, sadness, and anxiety, they turn to alcohol or drugs to temporarily relieve themselves of those feelings, that is, to "self-medicate." Although they may start with a small amount of use at first, over time it becomes an uncontrollable addiction.

Does the mental problem come first? Addiction?

This is like the question "Which came first, the chicken or the egg?" Sometimes it's really hard to tell.

• Mental health issues come first: Some people feel a "missing" feeling inside, an "emptiness" or constant anxiety. The reason for this may be a mental illness that they are unaware of. For example, a condition like ``Bipolar Disorder''. When these people use a drug, they temporarily feel "okay", "normal". This is because the drug changes the functioning of certain chemicals in the brain, `` Neurotransmitters ''. Once they get used to this "good" feeling, they are tempted to keep seeking it.

• Addiction comes first: Some people start using drugs for fun, peer pressure, or curiosity. But when used continuously over time, these drugs can alter the chemical balance of the brain and cause new mental health conditions (e.g., depression, anxiety).

Meanwhile, research has found that there is a very high correlation between a condition called ``Bipolar Disorder`` and alcohol addiction. In this condition, a person's mood fluctuates between two extremes. Let's look at it this way.

A person with bipolar disorder like this is very likely to resort to drugs without any judgment, especially during periods of mania.

So what is the best treatment for this?

This is the most important part. Since there are two problems, treatment should be given for both at the same time. Treating just one will not help.

Imagine that a person who is addicted to drugs has a mental problem. If we give him detoxification treatment to get him off drugs, he may have a very difficult time mentally afterwards. He has to fight with his emotions alone. Then, unable to bear the pressure, he is more likely to turn to drugs again.

This is why the best treatment method today is considered to be the "Dual Treatment Approach." That is, while undergoing drug treatment, the patient's mental health problem is identified and treated at the same time. This means that the patient receives support for both of their problems in the same place, from the same team.

Can everyone receive this treatment?

Unfortunately, such integrated treatment centers are not yet common in our country. But we should not give up hope. The best thing to do is to coordinate the patient's treatment.

That means establishing good communication between the doctor who is treating the patient's mental health and the doctor (or counselor) who is treating the addiction. The involvement of the family is essential in this process. If both parties are aware of the patient's information and the progress of the treatment, and work together, very good results can be achieved.

What to do if you relapse during treatment?

This is something that many people fear. But remember, relapse during treatment is not a failure. It can be part of the recovery journey. The important thing is not to let it discourage you, but to try again.

The best solution to this is to build a trusting, honest relationship between the patient and the doctor (a therapeutic alliance). The patient should be able to talk to the doctor about their true situation, their thoughts, and their urges to use drugs again without any fear or doubt.

If that happens, the doctor can identify a relapse before it happens and take the necessary steps. Perhaps even prevent it altogether.

Mental Health, Drug Addiction, Alcohol, Dual Diagnosis, Bipolar Disorder, Treatment, Sri Lanka