To understand why mental ill health and addictions arise, we first need to understand that stress is nature’s way of telling us that key emotional needs are unmet.
Addictions arise as a short-cut to managing stress and meeting these needs, when we are unable to do so in healthy ways. If we find ourselves troubled by feelings of stress and anxiety in response to an unmet need, we may fall into the trap of using depressant substances – including alcohol, cannabis and opioids like heroine – which relax the mind and body to meet the need to get control over how we feel.
For example, if a person feels anxious at the prospect of large social gatherings they may avoid social situations – but this reaction will prevent them from meeting emotional needs for connecting to other people. If they learn that drinking alcohol lowers anxiety, they may fall into the habit of using alcohol to manage stressful feelings in anticipation of social events. This situation is not uncommon and can be helped by practicing relaxation skills ahead of an event and learning to socialise confidently without alcohol.
Addictions can often arise in response to serious anxiety disorders. Andy* had returned to the UK after a period of travelling abroad and came to get help from Suffolk Mind’s Healthy Minds Counselling service, suffering with both addictions and post-traumatic stress disorder. While travelling overseas, he had witnessed distressing scenes of dead bodies at a cemetery for people living in extreme poverty and been the victim of violent attacks and muggings.
As a result, Andy found that he was constantly on edge and had been experiencing intrusive memories, thoughts and flashbacks of these events. The part of Andy’s brain that is concerned with meeting the need to feel safe – the amygdala, or ‘security officer’ – was on red alert, looking out for signs of danger and sending Andy constant reminders.
Andy had become addicted to using alcohol to try and calm down and block out these symptoms. To try and get over the alcohol addiction, Andy had begun using prescription drugs instead, but soon became addicted to these too. Working with a psychotherapist to treat the post-traumatic stress disorder, who used relaxation techniques and a technique called Rewind, Andy was able to get relief from the intrusive thoughts and memories; better meet the need for security; and then reduce the amount of prescription medication he was using.
This case study shows how addictions can arise in response to mental ill health, but can drug use cause mental ill health? Some people experimenting with cannabis report experiencing feelings of anxiety or paranoid thoughts. Many studies have demonstrated that cannabis use increases the risk of psychotic illnesses like schizophrenia – symptoms of which include hallucinations, seeing and hearing things which others do not, including voices, and delusions & strongly held beliefs. However, there are other factors which significantly increase the risk of psychotic illness, including traumatic experiences during childhood and adolescence and stress acting on a genetic predisposition.
Paradoxically, studies have also shown that people experiencing psychotic illness like schizophrenia may try to manage the symptoms of their illness with cannabis. Why would this be? One reason is that cannabis is a compound of many substances, including THC (Delta-9 tetrahydrocannabinol) which triggers the release of dopamine, a neurotransmitter associated with causing psychotic symptoms; but also cannabidiol, which suppresses dopamine release and provides some temporary relief from stress and psychotic symptoms.
In surveys, some schizophrenia sufferers say that they feel fewer of the side effects of anti-psychotic medication compared to cannabis, and have more control over the dosage of cannabis than they do over prescribed medication – even though the long-term effects of using cannabis can make the symptoms of psychotic illnesses even worse.
Other drugs associated with psychotic illness include hallucinogens like mushrooms and LSD, and stimulant drugs like cocaine and amphetamines. Hallucinogens mimic the hallucinatory symptoms – hearing and seeing things – of psychotic illnesses.
Stimulant drugs speed up our nervous system and can affect the quality and amount of sleep people using them have. Because cocaine and amphetamines trigger the release of dopamine, which is associated with seeking rewards and the feelings which come with satisfying emotional needs, taking them may temporarily improve people’s mood and give them relief from feelings of dissatisfaction of low mood.
The answer to overcoming addictions and the symptoms of mental ill health is always having a life that works to meet emotional needs in healthy ways. As Andy’s experiences demonstrate, seeking help with mental ill health that may be maintaining the addiction is a necessary first step towards relief from mental ill health and addiction too.
*Anonymised case study
You can also seek advice from your GP, the Suffolk Wellbeing Service or by calling Suffolk Mind on 0300 111 6000 or visiting their website suffolkmind.org.uk.