Alcohol and substance addiction can lead to mental illness, but mental illness does not cause alcohol and substance addiction

There is a clear relationship between the use of alcohol or substance and the development of mental illness. For example, the use of marijuana can result in the development of psychosis; an umbrella term for symptoms that affects the mind and leads suffers to lose touch with reality. On the other hand, the presence of a mental illness does not always lead to an addiction. In some cases however, people with mental illness have been noted to tend to rely on alcohol and drug use for relief, which can lead to an addiction. For example, some people with depression have been noted to use alcohol or marijuana to feel better.

Mood disorders like depression are known to affect the way we feel and subsequently our behaviour, and can be related to the use of substances. We often hear people say “I feel depressed” “I am so sad, I think I am depressed”. The term depression in these scenarios usually connotes sadness or describes a bad day, possibly as a result of home, work or relational stressors. In the everyday life, we experience low moods which typically go away when we experience or engage in activities that make us happy. This is however different in the case of a person who is depressed, their low moods usually have debilitating effects on their daily functioning and affect those closest to them.

A clinical depression is a severe mental state characterized by a loss of interest and enjoyment, and reduced energy leading to increased fatigue and diminished activity, usually present most of the day, nearly every day, for at least two weeks. According the International Centre for Diseases “ICD-10” , in the diagnosis of depression, other symptoms present include; reduced concentration and attention,  reduced self-esteem and self-confidence, ideas of guilt and unworthiness (even in a mild type of episode),  bleak and pessimistic views of the future, ideas or acts of self-harm or suicide, disturbed sleep, diminished appetite. Depression affects many people and hinders them from living happy normal lives. In a book by Dr Vivian Ikem, titled Shadows in the Mirror: the many faces of depression, as at 2015, 48million Nigerians were living with depression, a number that may have increased in present times.

The presence of depression can be a gateway to substance abuse, as the use of substance is common with people battling with depression, this is typically linked to the use of these medications to lift the individual’s mood or numb their pain or make them forget about their worries. For example, some people use marijuana, codeine, or alcohol to deal with their low moods. The co occurrence of depression and substance abuse is one that feeds each other, i.e. substance abuse can lead to depression and in the same measure, and people with depression may reach for substances. This is a relationship where the presence of one worsens the other. In addition to this, the combinations of substances like marijuana and alcohol with prescription medication can be lethal to the human body and can lead to possible death.

Substance abuse is the use of licit or illicit substances in a way that deviates from the recommended use or its intended purpose. These patterns of usage usually deviate from the societal norms and tend to result in destructive behaviour. Some of the most common substances in Nigeria include; Marijuana, Codeine, Nicotine, Alcohol Cocaine and crack cocaine, Rohypnol, Heroine, Tramadol, Pentazocine and Ketamine. The use of these substances have been linked to criminal and delinquent behaviour, misplaced priorities, family and relational disruptions, self  destructive and risky behaviour, financial loss, loss of sense of self and life, mental illness, damaged organs and depression of central nervous system, cognitive decline and sexual disorders/dysfunctions.

Treatment for depression includes psychotherapy by a psychologist and possible pharmacological intervention by a psychiatrist, depending on the severity of their depression. In treating addiction, rehabilitation which includes, isolation, detoxification and psychotherapy have been known to be more effective. The nature of addiction makes its treatment a life long journey where sobriety is aided by family support, outpatient follow up treatment, as well as outpatient group psychotherapy or support group sessions. In treatment where the presence of substance abuse and depression are evident (dual diagnosis), teasing out the illness that preceded the other is essential as the treatment plan will be tailored to address the underlying problem. For example, people who had depression for the addiction will require psycho-therapeutic intervention to deal with their depression (the root cause of the addiction) while treating the addiction. On the other hand, people whose addiction led to depression will need to deal with the addiction as a root cause of the depression, this means that is the addition is treated; the depression will be secondarily treated. 

If you or anyone you know is affected by the topic discussed in this piece, please contact Chinyereugo Udensi, a Clinical psychologist, for support or guidance.