Drugs and Mental Health

What is the relationship between drugs and mental health?

There are several ways in which substance use and mental health issues might affect each other. Here are a few examples of how drugs and mental health can interact.

The presence or absence of a drug can create psychiatric symptoms.

Alcohol is a depressant and over time, heavy use reduces the level of GABA (a chemical messenger) in the brain. When GABA levels are low, people feel more anxious and depressed.
On the other hand, if you are dependent on a drug and you reduce your use, you may develop psychiatric symptoms. This is because if you are dependant on a substance, your body adapts to the presence of that drug by changing the chemicals in your brain. When you reduce or remove that drug your body needs to reverse these chemical changes. During this change you may experience withdrawal symptoms that can include anxiety, depression or in rare cases even psychosis.

In some cases drug use can trigger mental health issues (the risk of this happening increases if the user has a close relative with a history of poor mental health).

If you have a parent with a history of depression, but you have never experienced symptoms of depression and anxiety yourself, you may find if you start using cannabis regularly it triggers feelings of anxiety, depression or paranoia.

Drug use may exacerbate symptoms of mental illness.

Research has shown that for people living with psychosis, the problematic use of alcohol is connected to an increased risk of hallucinations and delusions.

The effects of certain drugs can mimic the symptoms of a psychiatric disorder.

A person with no history of psychiatric symptoms can develop paranoid delusions after heavy methamphetamine use but after they stop using the drug the symptoms go away.

Symptoms of mental illness may be masked by drug and alcohol use.

A young person with attention-deficit/hyperactivity disorder may feel calmer and less distracted when they use amphetamines. Their symptoms may not emerge until they have stopped using the substance.

Drug use and poor mental health may also be independent of each other.

In some cases a person’s mental illness or symptoms of poor mental health may not be related to their drug use. However there may be a common risk factor that underlies them both. The risk factor could be biological, psychological or social.

Drugs, the mind and the environment we live in.

While the brain is a highly complex physical system when we refer to the ‘mind’ we are include our thinking, reasoning, emotions and memories. The mind is a broader concept and while it arises from brain activity many people believe it also includes our whole sense of our bodies and our unique spirit or identity. Our minds are built as much from our relationships with our environment, including other people, as they are from chemical interactions in the brain.

In fact many scientists believe that environments (social, physical and economic) can change the physical makeup of our brains, for better or worse. In other words the brain and the environment both influence each other and it is often difficult to separate cause and effect.

In this sense alcohol and drug use can not only affect the chemical workings of our brain but if consumed to excess, can start to affect our sense of self, our social interactions and our capacity to think and act in clear and independent ways. Once this happens there can be a negative feedback loop. For example excessive drinking can lead to anti-social behaviour, which leads friends to keeping their distance, which in turn might lead to drinking in private. This can increase social isolation and lead to depression.

On the other hand people who have experienced significant trauma in their lives may find that alcohol or drugs offer some relief from psychological distress. This is entirely understandable even though in the long term substance use is unlikely to offer any real solutions.

Most good substance misuse or mental health treatment approaches look at the problem holistically. This means they take into account a person’s individual makeup, circumstances and history. Addressing chemical dependence may be one part of the picture but also addressing social, economic and psychological factors will be just as important.

Mental health and mental illness are two different things.

Mental health is a broad umbrella term but it might be characterised as something that facilitates a range of positive behaviours and states.

Mental health:

• Helps us to value ourselves and others
• Enables us to meet life’s challenges and responsibilities without becoming overwhelmed
• Allows us to think clearly and realistically about ourselves, others and situations we find ourselves in
• Supports good quality relationships
• Helps us find meaning in life
• Lets us set our own direction rather than feeling pushed and pulled by circumstances.

Mental illness refers to a range of conditions that have a serious impact on quality of life over a longer period of time. Different mental illnesses can create problems for thinking, mood or behaviour. Mental illnesses must be diagnosed by a qualified clinician such as a doctor or a psychologist.

To give one example of the difference between the two, if something sad or difficult happens to a mentally healthy person their response would be to feel sad but also to understand that the sadness will pass and even really terrible events don’t have to be overwhelming, or if they are then the feeling of being overwhelmed will pass. In other words, mentally healthy people can keep things in perspective. An unhealthy response might be to feel completely overwhelmed by the event, sinking to a very low mood and for that to last for a long period such as several weeks.

Dual diagnosis is a term that is used if a person has been given a diagnosis by a clinician of more than one mental illness or a combination of a mental illness and problematic drug or alcohol use.