1.5 The Relationship between substance use and mental health problems

Youth & Drugs and Mental Health: A Resource For Professionals

1.5 The relationship between substance use and mental health problems

A young person’s substance use and mental health problems are interrelated and they may affect each other in a number of different ways. For example, mental health problems may precede substance use and a young person may be using substances to cope with or “self-medicate” mental health symptoms. Alternatively, he or she may have developed mental health symptoms as a result of substance use (Ballon, in press; CAMH, 2002a).

The following information can be helpful in thinking about how the two disorders might be related.

Relationship Between Substance Use and Mental Health Disorders

“There are several ways in which substance use and mental health problems affect each other:

Create - Substance use can create psychiatric symptoms. Example: Alcohol is a depressant - if any youth uses alcohol long enough, the youth could develop depressive symptoms and eventually meet criteria for major depression.

Trigger - Substance use can trigger the emergence of some mental health disorders if a youth is predisposed to mental illness. Example: A youth whose mother has bipolar disorder may have never experienced symptoms of mania until the youth uses PCP.

Exacerbate - Symptoms of mental illness may get worse when a youth uses alcohol and drugs. Example: A youth with suicidal ideation may make an actual suicide attempt after drinking alcohol because the youth becomes more depressed and less inhibited.

Mimic - Substance use can look like symptoms of a psychiatric disorder. Example: A youth with no history of psychiatric symptoms can develop paranoid delusions after heavy methamphetamine use.

Mask - Symptoms of mental illness may be hidden by drug and alcohol use. Example: A youth with attention-deficit/hyperactivity disorder may be less distractible when using cocaine. Psychiatric symptoms may not emerge until the youth stops using substances for a significant period of time.

Independence - A mental health disorder and substance abuse disorder may not be related to each other, but a common factor may underlie them both. Example: A youth’s genetic makeup may make the youth vulnerable and more likely to develop mental illness and/or substance abuse." (Trupin & Boesky, 2001).

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