The two most commonly misused substances – alcohol and cannabis – leave the user with a range of mental health issues. These abate with time off from using them.
This is why you might think you have a serious mental illness but the symptoms will ease off by quitting. Let’s look at the thorny issue of dual diagnosis in this article.
Alcohol use causes changes in the brain and after a time of excessive use you can experience symptoms of:
These symptoms can remain with you for weeks after stopping, so you may worry that you have finally done it now and gone over the edge into madness.
Such symptoms are often the reason that people go to the doctor in the first place, but as we will discuss later it is important to be completely honest about your substance use as the doctor can get you the right help.
High-quality UK research published in 2020 looked at the psychiatric symptoms that people experience with cannabis use.
These symptoms, as with alcohol can be very worrying for the person experiencing them and can even scare them out of seeing the doctor for fear of being given a big-time diagnosis like paranoid schizophrenia or a personality disorder.
As we will see later, many of these symptoms do ease off as the brain recovers from the chemicals leaving your system.
Many self-medicate their psychiatric symptoms with their substance of choice. This is not a good idea.
Society accepts people drinking alcohol or smoking cannabis to self-medicate. The classic case is someone getting obliterated when their partner has left them or ‘saying farewell’ when someone in their life has died.
Being intoxicated often gives a brief sensation of happiness and softens the pain felt in a given moment. This isn’t always to be recommended when one is feeling generally depressed about life’s lot or when one is experiencing worrying mental health issues.
Bluntly, there are far better chemicals out there made by pharmaceutical companies for depression than alcohol, which is known to make you very depressed. Big Pharma wouldn’t be in business if Big Alcohol had all the solutions!
Looking at the constituents of cannabis, THC is known among the cannabis user world to cause anxiety thanks to the ‘energetic high’ it gives you. Yet cannabis consumers often want to get stoned to deal with anxiety.
This doesn’t quite sit well does it?
The research paper we looked at for this article also showed that CBD may not alleviate the symptoms of anxiety and psychosis brought about by THC, though admittedly balanced cannabis science has a long way to go before any hard and fast conclusions can be made.
What is plain for alcohol and cannabis users is that where you experience symptoms of serious psychiatric problems you should set about leaving your poison of choice alone.
As we indicated above, the reason most people who misuse substances go to the doctor is when they experience the feeling of ‘going mad’ in some way.
They may have been detained by the police for acting dangerously with the intent of self-harm or harming others (or actually succeeding in hurting themselves or others), or seek support when the symptoms of psychosis, depression or anxiety are getting too much.
Where you are a substance user it will help the doctor make a better decision as to your care and treatment if you are upfront about what and how much you are using.
The Diagnostic and Statistical Manual (DSM) used in the US for instance includes a category for instances where substances may be contributing to the mental health issues.
This often means a different care and treatment pathway to that of someone who has no significant pattern of substance use.
As the best research shows, ultimately time off your favourite substance can allow the brain to rewire and in many cases stop the symptoms you are experiencing.
This is not going to be quick. The thing about substance withdrawal is that chemical and nerve changes take place in the brain, so it is not dependent on whether the alcohol, cannabis or other drugs are in your body for those symptoms to occur.
Essentially after a week or so of abstinence from alcohol, you will have zero alcohol in your body but if your brain is still ‘wired’ to exist with it in your system.
For someone with substance misuse problems who experience mental health issues the first phase of treatment will be to take a significant time off that substance.
If you are experiencing things like psychosis, anxiety and depression then you will also likely be medicated for those symptoms with things like antipsychotics, anti-anxiety medication and antidepressants.
While someone with psychiatric symptoms who does not use substances may stay on those medications for life, the substance user is likely to be weaned off them after a time.
This is because the substance user’s nervous system is readjusting to a world where it doesn’t have those substances to deal with.
In a nutshell, if you are experiencing severe mental health issues while using or withdrawing from a substance you can recover. Those who do not use substances may continue in treatment.
Other research has shown that the problems caused during substance use can cause social, financial and housing problems.
In extreme cases, people can become homeless and without a family or social network. Successful treatment pathways often look not just at getting you clean, as without the safety net of a circle of friends, secure housing and a purpose in life such as a job you could well fall back into your old ways.
Where it comes to dual diagnosis, service users often value the support they get from AA or a peer support treatment programme as well as the nursing and psychiatric support they receive from professionals. Clean/dry friends can help just as much as a doctor, nurse or social worker.
People often seek help for substance misuse when they think they are ‘losing their mind’. The good news is that you could well recover quite quickly – in weeks or months – from those feelings and experiences.
Be honest with your doctor and treatment team from the outset about what and how much you use.
There is a range of things available out there from medication to support groups and even housing and help to get training or a job that will help you build a solid base from which to begin life anew. By taking advantage of these you could well leave that time of your life behind you and move on with your life.