An addiction can be classified as a mental illness in that it is the progressive psychological deterioration resulting from a dependence on a substance. Like other mental illnesses, substance abuse affects people from all ethnic, cultural and socioeconomic backgrounds. Genetics, environment, childhood experiences, peers and trauma play a significant role in the development of an addiction.
Addiction is defined as a physical and psychological dependence on a mind-altering substance or as the compulsive us and dependence on a psychoactive substance. The World Health Organization defines addiction as a dependence syndrome. The term dependence is used by the WHO in replacement of addiction, although they are both considered the same condition. This syndrome is a cluster of physiological, behavioral and cognitive phenomena that develops after repeated substance use.
The clinical definition of dependence syndrome, or addiction, includes the following elements:
* A strong desire or sense of compulsion to take the substance
* Difficulties in controlling substance-taking behavior in terms of its onset, termination or levels of use
* A physiological withdrawal state when substance use has ceased or have been reduced, as evidenced by the characteristic withdrawal syndrome for the substance, or use of the same (or closely related) substance with the intention of relieving or avoiding withdrawal symptoms
* Evidence of tolerance, such that increased doses of the psychoactive substance are required in order to achieve effects originally produced by lower doses (clear examples of this are found in alcohol- and opiate-dependent individuals who may take daily doses sufficient to incapacitate or kill non-tolerant users)
* Progressive neglect of alternative pleasures or interests because of psychoactive substance use, increased amount of time necessary to obtain or take the substance or to recover from its effects
* Persisting with substance use despite clear evidence of overtly harmful consequences, such as harm to the liver through excessive drinking, depressive mood states consequent to periods of heavy substance use, or drug-related impairment of cognitive functioning; efforts should be made to determine that the user was actually, or could be expected to be, aware of the nature and extent of the harm.
Addiction as a Mental Illness
One theory of addiction is that the dependence on a psychoactive substance is a mental illness. The definition of addiction by the World Health Organization supports this notion. Addictions are characterized by the neglect of important social, educational, familial and employment activities. Drug and alcohol abusers invest excessive amounts of time and energy into obtaining and using their drug of choice despite other obligations. They will continue to use the substance despite the mounting hazardous and dangerous situations, legal and financial issues and occupational health problems.
Some theorists suggest that an addiction is another form of obsessive compulsive disorder, in that an addict will repeatedly use a substance and find it impossible to break the bonds of the obsession. Drug or alcohol abuse is often characterized by a complete obsession or compulsion to seek out and consume the substance. Some drug users even mourn the loss of their drug addiction or crave the feeling and ritual associated with obtaining and using a substance.
Antisocial personality disorder is another condition that is related to drug and alcohol abuse. Some believe that drug taking is a symptom of this condition as the individual is seeking more harmful ways to harm themselves and others, do not have consideration for their bodies and do not consider the consequences of drug or alcohol abuse to apply to them. Research suggests that up to 90 percent of those who have antisocial personality disorder also have a co-occurring drug or alcohol addiction.
An addiction can be considered a mental illness in the way that a person with the condition is often unaware of the effect it is having on other people, especially family members. Families suffer significant stress when a family member is an addict. They will invest money, emotional support and substantial time into trying to get help for their addicted family member. They will cover-up problems, make excuses to other family members or employees, allow themselves to be used for the sake of the addict getting their drug or booze and feel disappointed, neglected, abused and anxious for the addict. While families go to great lengths to support, help and deal with an addict, the person with the actual addiction is often blind to what is going on. They will accuse family or close friends of lying to them and stealing from them. They will refuse help when it is offered and become violent towards family members. In this sense, an addiction can be characterized by severe delusions and a lack of empathy.
Addiction Occurs alongside Mental Illness
Addictions are often associated mental disorders include schizophrenia, bipolar, attention deficit disorder, anxiety, depression and post traumatic stress disorder. Many believe that the two are always intertwined, and statistics show that there are high rates of co-occurring disorders. There are some suggestions that an addiction occurs first and is the cause of other mental illnesses. However, many critics believe that self-medication is often the cause of an addiction.
Depression and anxiety are illnesses that are commonly associated with an addiction. Depression is self-medicated with drugs and alcohol by many people in the community who do not seek formal help. Additionally, some believe that depression is caused by the use of drugs. Some substances such as MDMA have been found to severely impact on the levels of serotonin in the brain which is known to be the chemical that makes people feel happy and positive. Chronic and repeated use of alcohol can also cause a person to suffer from depression as the alcohol itself is a depressant. Anxiety is characterized by physical and emotional reactions to events or situations that are believed to be stressful. In a person who suffers from clinical anxiety, these responses are extreme and irrational. Some will respond physically to a social situation, work, catching public transport or even leaving their home. Many people who have the condition abuse substances as a way to cope in the real world and to calm their intense fears and emotional responses.
People suffering from post traumatic stress disorder often have a co-occurring substance abuse problem. Post traumatic stress disorder is characterized by severe anxiety that is related to a physically or psychologically traumatic event. A person with this condition suffers from crippling distress, fear, depression, paranoia and anxiety. Many use drugs and alcohol to deal with these emotional responses. Some studies suggest that up to 50 percent of people who are in formal drug and alcohol treatment also suffer from post traumatic stress disorder. These people become dependent on substance to hide their feelings, hurt themselves, deal with social anxieties and to help them alleviate the crippling symptoms of their condition.
Treating Addictions as Mental Illnesses
Treating a drug or alcohol addiction is similar in the way that other mental illnesses are treated. Medication is often prescribed to treat the changes that have occurred in the brain which may be required as a long term treatment. Cognitive behavior therapy, psychotherapy, motivational enhancement and other commonly used psychiatric treatments are also used to help an addict work through the issues associated with the disorder. Trauma, childhood abuse, delusional thoughts, lack of coping skills and severe depression are all issues that need the support of a trained professional.