Hesperian Health Guides
Chapter 6: Alcohol and drug addiction are mental health problems
HealthWiki > Promoting Community Mental Health > Chapter 6: Alcohol and drug addiction are mental health problems
Addiction to alcohol or drugs can be a lifelong challenge. Treatment can help people get beyond their addictions, though recovery is rarely âone and doneââa person may have ups and downs for a long time. For many people, alcohol and drug problems become like other chronic diseases where you can stay well but it requires lifestyle changes and perhaps medication.
Thereâs no one solution for a person with an addiction and there isnât one path to find it. Harm reduction is an approach that helps some people where they are at right now, opening the door to other support or treatment further on. Most importantly, people dealing with addiction need community support for healing and finding alternative ways to have meaning and pleasure in their lives.
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When does use become misuse?
Alcohol and drug addictions can be hard for us to recognize or speak about. We may fear criticism, blame, or shame because these responses are so common. It can be hard to know that we need help and hard to ask for it.
When alcohol and drugs cause problems in a personâs life, usually it is related to how much is used, how often, and how much a personâs life is affected by alcohol or drug use. Here are some questions that can help someone identify when their alcohol or drug use is interfering with their relationships and daily life, and becoming a problem:
- Is it hard for me to get through the day without having a drink or using drugs? Do I think about it all the time?
- Do I hide my use from others?
- Do I find I canât stop drinking or using once I start?
- Have friends, family, or a health worker shown concern about my drinking or drug use?
These signs are more serious:
- Has my alcohol or drug use made it hard for me to work, keep a job, pay bills, or carry out family or other expected responsibilities?
- Has my drinking or drug use ever caused injury to me or someone else?
- Have I ever done something unsafe or illegal to get alcohol or drugs?
Signs of addiction
Addiction is when a person is unable to control their alcohol or drug use, even though it is causing harm in their life. Signs of addiction that a person may feel or show include:
- physical problems when they stop using (called withdrawal), such as shaking, feeling irritable, or nausea; or more serious ones, such as mental confusion or seizures
- the need to use increasingly more of something to feel the same effect
- continued use of alcohol or drugs despite the harm it causes
As with alcohol and drug use, other common activities can become a problem if they become too hard to stop or take over life in a way that is harmful. Most people handle video and computer games, shopping and collecting things, sex, eating, and even gambling in ways that remain healthy. But for some people, these activities become too much. Consider if you are hiding the behavior from others or if you canât stop thinking about it.
Look at the questions that help people evaluate if their alcohol and drug use have become a problem. For example: Do you spend so much time playing video games that you have let people down, ignore school, work, or family responsibilities, have new financial problems, no longer sleep well, or stopped caring for your health? As with worries about alcohol or drug addictions, saying âyesâ to such questions may show it is time to get help. If you are looking out for someone else, tell them you are worried about what you see them going through. It may help them to get together with others who have faced the same situation. Support groups for these addictions exist for in-person meetings and online, and include 12-step programs (following the Alcoholics Anonymous model), such as Gamblers Anonymous.
Addiction and mental health challenges can occur together
In addition to being a mental health condition for which a person needs support and treatment, problems with alcohol and drugs can make it difficult to tell if someone also is facing challenges with other aspects of their mental health. When a person is going through both, they are often connected. They can both be a result of the same life circumstances or hardships, one could have helped caused the other, or one makes having the other worse.
Mental health challenges can lead to alcohol or drug misuse. Feeling anxious, sad, numb, or having physical pain can lead to alcohol or drug use to get through the day. Using alcohol or drugs to self-treat current or past pain or trauma is also common. The causes of these problems can be difficult to identify and hard to solve, and people may try to avoid feelings and thoughts about them by drinking or using drugs.
Alcohol and drug use can cover up the mental health challenge or a mental illness. Alcohol or drugs might make a person feel better for a short time by stopping their emotional pain, but the cause of the pain remains. Meanwhile, their ongoing use of alcohol or drugs creates new problems.
Alcohol and drugs can make a mental health condition worse. Feeling anxiety, for example, can make someone want the good feeling that comes with drinking, but instead of going away, the anxiety could get worse. A severe mental health condition can become much worse with alcohol or drugs because both affect the brain, changing a personâs thinking and actions.
Both mental health problems and addiction need to be treated
Because mental health problems and using alcohol or drugs are so connected, treating and managing them are also connected. For example: your friend is in terrible grief after losing his spouse. His alcoholism has returned as he drinks to cope with the loss. Any grief counseling would need to talk about the drinking, and any addiction treatment would need to confront his grief and what has changed in his life.
