Substance abuse is a common form of self-medication that people with mental health conditions tend to rely on to cope with their emotional distress. The self-medication theory of addiction was proposed in 1985 by Edward J. Khantzian, M.D., a professor of psychiatry at Harvard Medical School, to describe the tendency for people to use alcohol and other drugs as a way to cope with disturbing emotional states as well as a range of mental illnesses, including anxiety and depression.
At first, self-medication may provide people with a sense of temporary relief from uncomfortable discomfort, pain and distress, but the use of alcohol or drugs is not an effective way to deal with problems in the long term. When people use “solutions” such as alcohol or drugs as a means to cope, they become less able to manage negative emotions and stressful situations on their own. Some people can get trapped in a self-destructive cycle in which they rely on alcohol or drugs to make them feel better, leading to dependence on the substance or behavior and contributing to worsening mental health symptoms.
Although drugs and alcohol are among the most common substances used to self-medicate, self-medication can come in many different forms:
1. Food: People who binge eat, use food for comfort or turn to food as a way to lift their mood, deal with stress or suppress uncomfortable emotions can end up getting trapped in a cycle of hopelessness and poor eating habits, which can end up making them feel worse. People with depressive disorders, for example, may crave carbohydrates or foods high in sugar, as these types of foods increase levels of serotonin (a brain chemical that elevates mood). Eating comfort foods like these can lead to weight gain and increase the risk for health conditions like heart disease and diabetes.
2. Alcohol may momentarily provide relief from anxiety or depressive symptoms, but used regularly, it can lead to alcohol dependence, chronic health problems and a range of negative consequences. Alcohol abuse is often a coping mechanism for people with many different types of mental health conditions — including depression, anxiety, post-traumatic stress disorder (PTSD) and trauma. Alcohol abuse is often one of the most dangerous coping mechanisms, as it increases the risk for suicide and contributes to worsening symptoms of mental illness.
3. Stimulants such as cocaine and amphetamines are often used by people with depression, hypomania and hyperactivity as a way to relieve the distress associated with these mental health conditions. The use of stimulants can lead to addiction, contribute to anxiety and depression, cause damage to the body’s cardiovascular system and can also increase the risk for sudden heart failure, stroke and death.
4. Cannabis is the most widely used substance among people with mental health conditions like depression. In small doses, cannabis has been found to be effective for treating people with depressive disorders, but too much can be harmful, contributing to worsening symptoms of depression and anxiety, and can even produce psychotic symptoms at high doses.
5. Opiates or prescription opioids such as codeine, oxycodone, fentanyl, heroin and methadone are often used as a way to self-medicate by people with affective and anxiety disorders — such as bipolar disorder, panic disorder and major depressive disorder. Opioid abuse can contribute to worsening symptoms of mental illness and can also increase the chance for developing a comorbid substance use disorder.
Who is more likely to self-medicate?
People may use alcohol and other drugs to help calm their nerves, relieve them of emotional pain, deal with anxiety or depression and help them manage mental health symptoms. One study found that 21.9 percent of people with anxiety disorders self-medicated with drugs and alcohol, while people with generalized anxiety disorder (GAD) had the highest self-medication rate (35.6 percent). In addition, patients with schizophrenia have higher rates of alcohol, tobacco and other drug abuse compared to the general population and about 90 percent of patients with schizophrenia smoke cigarettes.
A recent study found that people with chronic pain are also more likely to self-medicate with alcohol or drugs. The researchers at Boston University Medical Center found that 87 percent of the people who screened positive for illegal drug use, heavy alcohol use or prescription drug misuse were affected by chronic pain and more than half (51 percent) reported using one or more drugs to alleviate their physical pain, according to a press release earlier this month.
People with depressive disorders, post-traumatic stress disorder (PTSD) and childhood trauma are also at a greater risk for self-medicating with alcohol or drugs. Other studies have found that people with antisocial personality disorders (15.5 percent), bipolar disorder (14.5 percent) and anxiety disorders (4.3 percent) are likely to abuse substances or have a comorbid substance use disorder.
Why do people self-medicate?
Many people with mental health conditions use alcohol, marijuana, cocaine, opioids and other drugs to cope with their symptoms and emotional distress. One study found that 79 percent of high-risk drinkers used alcohol as a way to self-medicate, according to the National Council on Alcoholism and Drug Dependence (NCADD).
One explanation for the high rates of comorbid mental and substance use disorders is that psychoactive substances are a way for these individuals to deal with painful or disturbing symptoms of mental illness. People with undiagnosed mental illnesses such as depression, anxiety and paranoia may abuse substances as a way to treat their symptoms, while others who have been diagnosed may use alcohol or drugs to alleviate unpleasant side effects associated with medications they take to treat their symptoms.
The self-medication hypothesis suggests that alcohol and drugs are a way for people to deal with unresolved childhood trauma. Adolescents who use alcohol or drugs to deal with their problems can affect their brain’s normal development, which can increase their vulnerability for mental health problems like depression, anxiety and substance abuse later in life.
Dangers of self-medication
The problem with self-medication is that people who self-medicate typically do not seek professional help and may end up with more severe, worsening symptoms. Abused substances can have negative consequences on mental health and well-being, and increase the likelihood for developing substance dependence. People who do not seek professional help may try to cope with their symptoms on their own through self-medication.
Self-medicating with alcohol, drugs and certain behaviors (e.g., sex) can be dangerous and contribute to worsening symptoms of mental illness. Sovereign Health Rancho San Diego provides thorough assessments to all patients during admissions to determine whether there are any co-occurring disorders such as mental illness and substance abuse. Sovereign Health Rancho San Diego provides comprehensive behavioral health treatment services for adolescents with emotional and behavioral problems. For more information about the programs offered at our Rancho San Diego facility, please contact our 24/7 helpline.
About the author
Amanda Habermann is a writer for the Sovereign Health Group. A graduate of California Lutheran University, she received her M.S. in clinical psychology with an emphasis in psychiatric rehabilitation. She brings to the team her background in research, testing and assessment, diagnosis and recovery techniques. For more information and other inquiries about this article, contact the author at email@example.com.