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Circumstantial Addiction: Why Do People Self-Medicate?

Millions of people in the U.S. use drugs and alcohol at some point in their lives. Many of them overindulge in these substances to the point where they lose themselves and see their troubles float far away.  

“At the very least, drugs, booze, gambling and so forth take you out of yourself.  They focus your attention elsewhere,” Marc Lewis, Ph.D., writes in his Psychology Today piece titled, “Addiction as Self-Medication.

“They may rev up your excitement and anticipation of reward (in the case of speed, coke, or gambling) or they may quell anxiety directly by lowering amygdala activation (in the case of downers, opiates, booze, and maybe food),” he continues. “The mechanisms by which this happens are various and complex. But addicts and ex-addicts (like me) know what it feels like. If we find something that relieves the gnawing sense of wrongness, we take it, we do it, and then we do it again.”

This sense of relief Lewis talks about is familiar to many people. This desire to alleviate discomfort drives many people to continue to pick up and use addictive substances, even when it’s unwise to do so. 

Using substances to complete a specific task or achieve a desired effect is known as circumstantial or situational substance, as explained in Schaeffer’s model. A person who uses to cope with mental or emotional instability may use regularly, and such use can lead to chronic substance use or abuse.

Frequently using substances can pave the way to a dependence that becomes a hard-to-break addiction. 

It may appear that people who drink or do drugs excessively may enjoy what they’re doing. It may even seem like they don’t want to stop. However, if this is you or your loved one displaying such behavior, look a little closer. What actually may be happening is you or the person you are concerned about is self-medicating. 

Further, you (or your loved one) may be self-medicating to manage a mental health disorder that you may or may not know about. This compulsion to use substances in this manner, even when it is clearly risky to do so, is a sign of something deeper that needs to be addressed immediately.

What Is Self-Medicating?

Healthline publishes that the concept of substance abuse being a form of self-medication is officially recognized as the self-medication hypothesis. It was first introduced in 1985, according to the site. 

“The hypothesis claims that people use substances as a response to mental illness. It states that alcohol and drug abuse is often a coping mechanism for people with a variety of mental health conditions, including depression,” it writes. “It also suggests that people gravitate toward the substance that alleviates their symptoms most effectively.”

The substances used can be just about anything, from widely accessible alcohol and tobacco products to street drugs, designer drugs, prescription drugs, or everyday chemicals found around the house. People may also abuse herbal supplements and other legally sold over-the-counter drugs. Nothing is off-limits to a person who wants to use and feels that they need to.

Mental health disorders one can struggle with that could lead to self-medication include:

  • Anxiety disorders
  • Depression
  • Bipolar Disorder
  • Obsessive-Compulsive Disorder (OCD)
  • Panic Disorder
  • Personality disorders
  • Post-Traumatic Stress Disorder (PTSD)
  • Schizophrenia

It is not uncommon for people who have mental health disorders to self-medicate with mind- and mood-altering substances. MentalHealth.gov writes that more than one in four adults who manage serious mental health disorders also has an issue with substance use. It also says that substance use problems happen more frequently when certain mental health disorders are present.

Why Do People Self-Medicate With Addictive Substances?

People who use substances do so to change their mood for the short-term. They may do this to feel like they have a better grip on trying situations. Or, they may do it to numb themselves to overwhelming emotional pain.

 If someone who is depressed wants to feel “up,” they may take a psychostimulant drug, such as cocaine, amphetamine, or nicotine. An anxious person who wants to relax and quiet their mind may turn to alcohol, a benzodiazepine such as Xanax, or an opiate drug, such as the illicit drug heroin or prescription medication that they may or may not have been prescribed. 

Many people use more than one drug at the same time for whatever desired effect they’re going for. The common thread is users are seeking relief at any cost. They may find that such drugs or alcohol may help them better cope with disturbing symptoms that they can’t explain or aren’t even aware of.

Trauma is often at the root of self-medicating behaviors, writes Lewis. He says: 

“Trauma includes abuse, neglect, medical emergencies, and other familiar categories, but it also includes emotional abuse, and above all, loss.”

“Take-home message: the relationship between trauma and addiction is unquestionable,” Lewis writes, after highlighting research that examined Adverse Childhood Experiences as they relate to physical and mental problems that occur later in life after those experiences.

People who are battling severe mental illness are more likely to use or abuse substances. Alcohol, marijuana, and cocaine are among the substances that are abused frequently in the population of people who have mental disorders and substance use disorders.

A cup full of pills

The Problem With Self-Medicating 

It is human nature for people to want to handle their problems on their own. In cases such as these, they may not be interested in seeking professional medical help. However, using drugs and alcohol to cope with a mental illness is not advised for several reasons.

First, substance use for conditions this serious will not work out over the long-term. Users are at risk of making their condition worse, especially if they have a mental health disorder. If they are on medications for a mental disorder, using alcohol and drugs can interact with medications and cause a toxic, life-threatening reaction. 

HelpGuide.org notes that if a person is taking medications, such as antidepressants, mood stabilizers, or anti-anxiety medication, drugs and alcohol can make them less effective.

Another reason self-medicating with substances is risky is because it can bring on symptoms of mental illness.

“Certain illegal drugs can cause people with an addiction to experience one or more symptoms of a mental health problem,” MentalHealth.gov writes.

It can also increase one’s risk of developing a mental disorder.

HelpGuide.org sheds light on this, writing. “Mental disorders are caused by a complex interplay of genetics, the environment, and other outside factors. If you are at risk for a mental disorder, abusing alcohol or illegal or prescription drugs may push you over the edge. There is some evidence, for example, that certain abusers of marijuana have an increased risk of psychosis while those who abuse opioid painkillers are at greater risk for depression.”

All of these underscore how dangerous a circumstantial addiction is, especially where circumstantial or situational addiction is concerned.

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Dual Diagnosis Treatment

As MentalHealth.gov reminds, there are various reasons why mental health disorders and substance use disorders intersect. If you have observed in either yourself or a loved one that there’s a struggle with both types of disorders, it is critical that you seek help now. Having both disorders together is called comorbidity or dual diagnosis. It is also referred to as having co-occurring disorders.

You are advised to look for a professional treatment program at an accredited facility that treats both disorders at the same time. Treating one or the other will not help. Both must be treated at the same time to see improvement.

It is not always easy to tell if co-occurring disorders are the cause of self-medication. If any of the following experienced, it may be time to seek professional help:

Signs of a mental disorder are:

  • Anxiety
  • Excessive fears, worries
  • Confused or muddled thinking
  • Flashbacks, intrusive memories of traumatic events
  • Hallucinations
  • Paranoia
  • Depression (feelings of hopelessness, sadness, irritability)
  • Self-harm
  • Severe changes in mood
  • Suicidal thoughts

Signs of Substance Use Are:

  • Changes in appearance (dilated pupils, weight loss, weight gain, needle marks)
  • Changes in behavior
  • Changes in one’s schedule, friends or associates
  • Drug paraphernalia found
  • Financial woes, job loss

Before a person can begin dual diagnosis treatment, they must meet the standard criteria for a mental health illness as defined by the most current version of the Diagnostic and Statistical Manual of Mental Disorders. A medical professional, such as a psychiatrist, physician, psychologist, or therapist is the best person to determine if co-occurring disorders are present. They also can advise on the next steps to take once a diagnosis has been made.

An integrated approach to co-occurring disorders is one that involves treatment for the mental disorder and treatment for the substance use disorder. HelpGuide.org advises that treatment for the mental health issue may involve medication, individual or group counseling, peer support, and lifestyle changes. 

Before that can begin, you have to undergo medical detox to address any drug or alcohol withdrawal symptoms. During that time, you’ll also receive an assessment of your physical health and mental health needs. Addiction care specialists and medical professionals monitor the detox process and medications given. This ensures patients receive help in controlling the behavioral effects of substance abuse and mental illness. 

When you begin treatment at a professional facility, keep in mind that medical detox is only the first step of a successful recovery. Participating in a treatment program that is  created with your input is key. Also, make sure the program offers healthy coping strategies and a relapse prevention plan that helps you live the life you’ve always wanted.

Sources

“Schaeffer's Model.” Department of Health | Schaeffer's Model. Retrieved from https://www1.health.gov.au/internet/publications/publishing.nsf/Content/drugtreat-pubs-front8-oh-toc~drugtreat-pubs-front8-oh-2~drugtreat-pubs-front8-oh-2-2

“Mental Health and Substance Use Disorders.” Mental Health and Substance Use Disorders | MentalHealth.gov. Retrieved from https://www.mentalhealth.gov/what-to-look-for/mental-health-substance-use-disorders

Recognizing Forms of Self-Medication – Healthline. Retrieved from https://www.healthline.com/health/depression/forms-self-medication

“Adverse Childhood Experiences (ACEs).” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention. Retrieved from https://www.cdc.gov/violenceprevention/childabuseandneglect/acestudy/index.html?CDC_AA_refVal=https://www.cdc.gov/violenceprevention/acestudy/index.html

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