Comorbidity: causes and control

According to the 2014 National Survey on Drug Use and Health (NSDUH) of Substance Abuse and Mental Health Services Administration (SAMHSA), approximately 43.6 million Americans aged 18 and older experienced some form of mental illness. As many as 20.2 million adults had a substance use disorder in 2013, of which 7.9 million people had both a mental illness and a substance use disorder. “To help explain this comorbidity, we need to first recognize that drug addiction is a mental illness. It is a complex brain disease characterized by compulsive, at times uncontrollable drug craving, seeking, and use despite devastating consequences- behaviors that stem from drug-induced changes in brain structure and function,” says NIDA Director Nora D. Volkow, M.D.

Risk factors associated with dual diagnosis

According to NIDA, six out of 10 people who abuse drugs also have a mental illness. Having both conditions increases the intensity of mood swings, depression, violence and suicide, with each condition worsening the severity of the other. Researchers have found that alcohol use may stimulate the same neurotransmitters in the brain which are also involved in bipolar illness, thereby suggesting that alcohol use may “initiate” bipolar disorder symptoms. Of late, role of genetic factors in the development of comorbid conditions has received much attention, with positive family history being considered a major risk factor for children.

Path to recovery

According to NIAAA, alcoholism can make the symptoms of bipolar disorder treatment resistant. There are many instances wherein only one disorder is treated while the other remains untouched. While a combination of counseling and medication plays an important role, supportive services such as case or care management can also lead to recovery.