by Lisa Frederisken
I’m not sure how the email “conversation” started, but it had to do with the concept of what’s meant by “self medicating” a mental illness with alcohol or drugs. I thought I’d share the conversation here because “adults with mental illness (depression, PTSD, bipolar, to name a few) are four times more likely to develop alcohol dependency than adults without mental illness,” according to a SAMHSA study finding reported on Mental Health America’s Mental Health in the Headlines: Week of June 6, 2011 .
Q. Self-medication?
A. Yes… the alcohol triggers the dopamine pathways, which are the ones that make people feel good. So drinking produces that feeling — in a sense, acting like medicine, in this case, to counter the negative thoughts, feelings, anxiety, etc. caused by the brain changes caused by the mental illness. In time, a person abusing alcohol (wanting more of that feel-good feeling) further changes the chemical and structural make-up of their brain, which is why a mental illness and an addiction (two brain diseases, aka dual diagnosis or co-occurring diseases) must be treated, together, at the same time. Unfortunately, the traditional (and often still used) model of treatment was/is to stop the drinking for a month and then “see” about the mental illness. If someone takes away a person’s “medicine” without replacing it with something else, it is very likely that person will go back to what makes them feel good (in this case, alcohol). Then, that person “fails” in treatment, exacerbating their negative feelings of shame, inadequacy, etc., and the cycle begins, again.
Q. “Well, then the question is “What replaces the need for alcohol in a treatment plan?”
A. Depending on the mental illness, it can be a combination of medications, CBT, therapy, exercise, nutritious eating, adequate sleep, mindfulness activities — anything that kick-starts the dopamine pathways in natural ways, AS WELL AS treatment for the brain changes caused by their mental illness, and in this manner, repairing the brain’s damaged/changed neural networks. In other words, treatment for both is a combination of “things” that help a person to re-wire their brain (override their current embedded, brain maps; take a right instead of a left, if you will) so the individual gets pleasurable feelings without the substance AND relief from the symptoms of the mental illness – both at the same time.
For more information on dual diagnosis (co-occurring disorders), read Mental Health America’s “Dual Diagnosis .”
by Lisa Frederisken
I’m not sure how the email “conversation” started, but it had to do with the concept of what’s meant by “self medicating” a mental illness with alcohol or drugs. I thought I’d share the conversation here because “adults with mental illness (depression, PTSD, bipolar, to name a few) are four times more likely to develop alcohol dependency than adults without mental illness,” according to a SAMHSA study finding reported on Mental Health America’s Mental Health in the Headlines: Week of June 6, 2011 .
Q. Self-medication?
A. Yes… the alcohol triggers the dopamine pathways, which are the ones that make people feel good. So drinking produces that feeling — in a sense, acting like medicine, in this case, to counter the negative thoughts, feelings, anxiety, etc. caused by the brain changes caused by the mental illness. In time, a person abusing alcohol (wanting more of that feel-good feeling) further changes the chemical and structural make-up of their brain, which is why a mental illness and an addiction (two brain diseases, aka dual diagnosis or co-occurring diseases) must be treated, together, at the same time. Unfortunately, the traditional (and often still used) model of treatment was/is to stop the drinking for a month and then “see” about the mental illness. If someone takes away a person’s “medicine” without replacing it with something else, it is very likely that person will go back to what makes them feel good (in this case, alcohol). Then, that person “fails” in treatment, exacerbating their negative feelings of shame, inadequacy, etc., and the cycle begins, again.
Q. “Well, then the question is “What replaces the need for alcohol in a treatment plan?”
A. Depending on the mental illness, it can be a combination of medications, CBT, therapy, exercise, nutritious eating, adequate sleep, mindfulness activities — anything that kick-starts the dopamine pathways in natural ways, AS WELL AS treatment for the brain changes caused by their mental illness, and in this manner, repairing the brain’s damaged/changed neural networks. In other words, treatment for both is a combination of “things” that help a person to re-wire their brain (override their current embedded, brain maps; take a right instead of a left, if you will) so the individual gets pleasurable feelings without the substance AND relief from the symptoms of the mental illness – both at the same time.
For more information on dual diagnosis (co-occurring disorders), read Mental Health America’s “Dual Diagnosis .”