Mental Health and Substance Abuse

Mental health is a person’s condition with regard to their psychological and emotional/ social well-being. Mental illness is a condition that affects a person’s thinking, feeling, mood, and behavior. It affects everything about someone, how they act, what they think, how they feel, and what they do. It also shows how people relate to each other, handle their stress, and how they go about decision making. Mental health problems in the United States are very common (CDC, 2018). An estimated 50% of Americans are diagnosed with a mental disorder or mental illness at some point throughout their lifetime. Mental illness is also the third most common cause of hospitalization in the United States for the age group of 18-44. 1 in 5 Americans will experience a mental illness.

Americans lives with a serious mental illness like schizophrenia, bipolar disorder, or depression. There is no single cause for mental illness. Instead, there are many factors that can contribute to someone developing a mental illness. These factors include life experiences like trauma or abuse, experiences that relate to having chronic medical conditions such as diabetes, biological factors such as genes or chemical imbalances in the brain, not having many friends, always feeling alone or isolated, and last but not least drug and alcohol use (CDC, 2018). Drugs change the way your brain and body works.

They change the balance of chemicals and the chemical messaging that helps your brain to think, feel, and make decisions. Most people who are drug addicts are diagnosed with some type of mental disorder, and most people who have been diagnosed with a mental disorder develop a substance abuse problem. Drug addicts are twice as likely to suffer from a mood or anxiety disorder compared to those who don't do drugs. Drug use can also make someone develop short-term and long-term mental health issues. Some short-term issues are anxiety, mood swings, mood disorders, depression, sleeping problems, and psychosis. A drug-induced anxiety disorder includes panic attacks, which are periods of severe anxiety, and your heart rate increases, you experience trembling, sweats, shortness of breath, and a fear of losing control.

Someone could also feel like their surroundings are strange or unreal, and that they’re losing their identity or sense of reality. A drug-induced mood disorder is basically a rollercoaster of emotions. Someone could feel extremely happy and full of energy then suddenly feel sad, tired, irritable, and a loss of pleasure. This could also include more serious effects, such as impulsive behaviors and racing thoughts. Drug-induced psychosis includes delusions, believing things that aren’t true, and hallucinations, seeing and hearing things that aren’t there. Some long-term issues are ongoing mental health problems, such as depression, schizophrenia, triggering a mental illness that someone didn’t know they had, and the drug changing the way chemicals affect your brain functions.

Certain drugs that cause hallucinations work by increasing your serotonin levels. Serotonin is a chemical our brains naturally produce that regulates our mood; it’s called the “happy hormone”. These drugs cause your brain to release a higher amount of serotonin than it usually does. Over time your brain's natural storage of serotonin could drop so much that you could never have the same levels that you once had before you started to use drugs. Once your serotonin levels drop permanently you produce a significantly reduced amount of this hormone that makes you feel happy. This lack of serotonin is what causes depression.

Other drugs can cause schizophrenia. Someone could be at risk of having schizophrenia and not even know it, whether it’s hereditary or not. For those, using certain drugs can trigger an episode of schizophrenia. For example, our brains produce a natural hormone called endocannabinoids. This hormone regulates other chemicals in our brains that control aspects of brain functions and behavior. Cannabis has a compound, called THC, which stands for tetrahydro cannabinoid; this compound is what gets someone high. Because THC is so similar to the chemical endocannabinoid it mimics the effects of the natural compounds and takes over those aspects of someone's brain function. This “take over” causes schizophrenia.

Another disorder that is connected to substance abuse is Post-traumatic stress disorder (PTSD). PTSD is a severe anxiety disorder that is caused by a traumatic experience in a person’s life. Some of these experiences are military combat, motor vehicle accidents (like cars, boats, and planes), industrial accidents, natural disasters, robberies, kidnappings, shootings, rape, child abuse, imprisonment, concentration camps, political torture, and refugees. Those who suffer from PTSD are 14 times more likely to be diagnosed with a substance abuse disorder than those who don’t suffer from PTSD. Substance abuse and PTSD are commonly connected. One of the highest risk groups for both PTSD and substance abuse are veterans. According to the U.S. Department of Veteran Affairs veterans who seek treatment for a substance abuse disorder are usually diagnosed with PTSD.

This is probably due to the emotional stress, physical demand, and mental strain of combat. In the United States, specifically, the most common cause of PTSD in men is military combat, and for women, it’s physical assault and rape. In military women, PTSD is linked to sexual assault and/or harassment during their military service or experience. Around 1 in 5 female veterans have been diagnosed with military sexual trauma by the Veteran Affairs.

Substance abuse disorders and mental illnesses are both caused by crossing factors like genetics vulnerabilities, epigenetic vulnerabilities, environmental influences like exposure to trauma or stress, and issues with certain brain regions. Approximately 40-60% of someone’s vulnerability to a substance abuse disorder is due to genetics. Usually, this vulnerability occurs from complex interactions between multiple genes and genetic interactions with environmental effects. Genes can act indirectly by changing how people respond to stress or by increasing the probability of risky behaviors. This could influence the starting of substance use as well as the development of substance use disorders and mental illnesses (NIDA, 2020).

Epigenetics is the study of changes that affect how genetic information is read and acted on by cells in the body. As stated previously environmental factors like trauma, stress, etc. could make changes in gene expression. This change could alter functioning in neural circuits and eventually change behavior. Environmental factors collaborate with genetic vulnerability during certain developmental stages and increase mental illnesses and addiction. In brain region involvement there are many areas of the brain that are affected by substance use disorders and mental illnesses. The circuits in the brain that mediate reward, decision making, impulse control, and emotions could be affected by addictive substances. These circuits could also be disrupted in substance use disorders and other psychiatric disorders (NIDA, 2020). 

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