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I need the pills to function. I have to have them to go through my day, Pauline* (not her real name), says as she scratches her arm to satisfy a withdrawal itch. It has been a day since she used the subject medication.
Her hands are shaking as she tries to explain how she came to depend on the medication prescribed for her Major Depressive Disorder.
It has been a year since she began taking the medication.
“They gave me Artane to control the side effects from other medication. I think I misused it and now I can’t go for a day without it,” she said.
“They said use when necessary but it gave me so much relief I started popping it daily even when the primary medication did not have severe side effects.”
On his part, John* narrates how he was diagnosed with psychotic disorder after a long-term use of marijuana.
“I would hallucinate of things that I can’t yet understand. I was going mental and would even talk to people others could not see or hear,” he said.
Upon noticing a change in his behaviour, John’s parents sought help from a psychologist specifying Substance Use Disorder (SUD).
He is still in rehabilitation therapy.
IntraPersonal Health Psychologist Evans Oloo says the relationship between substance abuse and mental disorders is multi-pronged.
“For starters, Substance use disorder (SUD) is a direct cause of certain mental health conditions. For example long-term use of marijuana in some individuals, especially those predisposed can cause schizophrenia and psychotic disorders,” he says.
Oloo notes that SUD is also a trigger for underlying mental health conditions.
“An individual may have latent mental health conditions, that only manifest once they start using drugs,” he says.
“Substance use either as a result of severe intoxication or withdrawal can induce psychiatric conditions. For example, severe alcohol withdrawal can mimic symptoms of anxiety or depressive disorders.”
Oloo adds that mental health is a risk factor for addiction because persons with the conditions, for example, depression may seek drugs to alleviate the negative feelings and low mood that are associated with the illness.
“Another person may seek sedatives to calm them down especially if they suffer from bouts of anxiety," he adds.
Oloo states that it is not uncommon for individuals who have suffered trauma either through sexual or physical assault, or even those who have had a terrible accident to use alcohol or other forms of prescription medication to dull the emotional pain and other symptoms of trauma-related conditions.
“It is also true that substance use is also a risk factor in the development of mental illness. The long-term use of alcohol or marijuana will affect the brain circuits and alter the brain's neurochemistry. The same circuits associated with the development of mental illness,” he says.
He states that people who seek psychiatric treatment need to also seek SUD treatment, as they correlate.
“The best approach to treat individuals with both conditions, what we refer to as concurring, is to ensure that as a matter of standard procedure, anyone who presents with a mental health symptom, they should be screened and assessed for SUD,” he says.
“Because these two conditions tend to present with very similar symptoms.”
Oloo says it is important to ensure that people suffering from both mental health disorders and SUD, need to get treatments for both under the same roof.
He says it is important to ensure that people suffering from both mental health disorders and SUD, need to get treatments for both under the same roof.
PREVENTIVE MEASURES
Oloo said the best prevention measure is to reduce the risk factors. One of the risks for both conditions is difficulties in living under negative family or early childhood experiences.
He proposes minimising traumatic incidents that take place when people are young.
“If we can treat SUD and mental health disorders early, then we reduce the chances of that escalating to full-blown concurring condition,” he says.
Oloo says there is also a need to put access to measures that reduce access to substances. Early involvement in substance use is a major risk factor for creating mental health disorders in the future years.
He says another preventive measure is to train and create awareness for individuals to say “no” to substance use.
There is also a need to constantly monitor individuals as early as possible to see whether they have any symptoms of mental illness.
“The earlier it is detected and treated the better because it saves them from both conditions; SUD and mental health disorder. An example I will give is with ADHD. This condition manifests early in childhood and unfortunately, it is not treated early yet it is one of the risk factors for SUD,” he says.
“People tend to seek out drugs to counter it, leading to SUD.”
Oloo says parents, community health workers and caretakers need to learn how to detect the issues earlier on.
He adds that the stigma behind the disorders needs to stop so that it can be easier to seek treatment.
“A stable home, effective parenting, good guidance and supervision, proper policies within schools and at home that reduce access to drugs are very effective preventing measures that would reduce SUD,” Oloo concludes.