Mental Illness and Substance Abuse
Mental health problems are frequently complicated by substance abuse, putting patients in need of special care.
Rep. Patrick Kennedy's release from drug rehab puts a spotlight on people
who suffer from a trying combination of health problems: substance abuse and a mental health disorder.
Kennedy -- the son of Sen. Edward Kennedy -- checked into a rehab clinic in
May 2006 after a car accident near the U.S. Capitol. The younger Kennedy says
he has no memory of the incident; he admits he had taken medications usually prescribed for sleep problems and
to control nausea.
After his release from rehab, Kennedy told reporters he suffers from
addiction and bipolar disorder.
Doctors say they are increasingly seeing patients from all walks of life who
suffer from a combination of substance abuse and mental health problems.
Experts estimate that at least 60% of people battling one of these conditions
are battling both.
"Mental health problems and substance abuse are often seen
together because one makes you more vulnerable to the other," says Alan
Manevitz, MD, a psychiatrist with New York-Presbyterian Hospital, Cornell
University campus, in New York.
Mental health problems are common in the U.S. An estimated 1 in
5 adults in the U.S. suffers from a diagnosable mental disorder, according to
the National Institute of Metal Health.
When there is a biological or genetic vulnerability to any type
of mental health problem, regardless of how big or small, Manevitz says,
substance use often triggers the onset of that problem.
"The substance is not really causing the mental health
problem, but it can be a precipitating factor that causes the condition to
manifest," Manevitz tells WebMD.
"In this respect, the mental health condition is already
actively present when the substance abuse begins, but the patient just doesn't
know it -- the problem is driving the addiction, it just hasn't yet been
recognized or diagnosed," Manevitz tells WebMD.
It is, in fact, the increasing awareness of this dual diagnosis
that has opened the door to a whole new line of thinking about both substance
abuse and mental health problems. Indeed, some researchers contend that certain
forms of mental illness and some addictions may, in fact, be a single
Among the areas where this research is most prominent is a
condition known as bipolar disorder -- a disease characterized by cycles of
extreme mood swings between deep depression and high elation, or
mania. During periods of mania, patients show extreme irritability, racing
thoughts, little need for sleep, poor judgment, distractibility, abuse of
drugs, and denial that anything is wrong. Depressive periods are associated
with feelings of hopelessness, guilt, too much sleep, and thoughts of death or
"What we have found is that people with bipolar disorder,
particularly women, have an enormously high rate of alcoholism -- up to seven times
that of the general population," says Mark Frye, MD, director of the UCLA
Bipolar Disorder Research Program in Los Angeles.