Is Addiction Really a Mental Health Issue?
September 11th, 2023
By P. Casey Arrillaga, LCSW, LCDC
For
most of modern medical history, addiction and other mental health issues have
been classified and treated as two separate problems. More recently, it’s
become increasingly clear that this is a false distinction that can interfere
with someone getting all the help they need. In this post, we’ll look at how
this separated view came to be, why it’s time to let it go, and how to get
appropriate treatment that takes a more holistic view of the issues at hand.
How
They Came to be Separated
The
simplest reason that addiction (officially known as Substance Use Disorder) and
other mental health disorders have been treated separately is that for most of
our history, neither one was well-understood but both needed some kind of help.
For a few hundred years, mental health help often looked like
institutionalizing patients without much hope that they would get better. Many
treatments were tried, but getting better was more a matter of luck than
science.
Medicine
had even less to offer those plagued with addiction, which was most often seen
as a lack of willpower. People were advised to moderate alcohol intake even
when it was clear that this was not working. Sober houses and treatment centers
were founded in the 19th Century and some people undoubtedly walked
out free, but the science behind this was a mystery to all involved.
This
is largely because until the 20th Century, the functions of the
human brain were almost completely unknown, at least in any way that would help
addiction or any other mental health issue. Psychology was also a primitive art
that focused on dream interpretation and letting people talk with as little
input as possible from the psychiatrist.
Thus,
the institutions that were put into place to address addiction offered moral and
religious instruction, while other mental illness were treated with anything
from ice water baths to a lifetime of being warehoused in a psychiatric
hospital. If the two worlds met each other, it was when the person with the
addiction was so far gone that they were put into a mental ward with no
intention of ever letting them go.
Why
They Do Better Treated as One Problem
All
this started to change in the mid to late 20th Century, as
psychiatric medications became more effective and brought with them hope of
many mental illnesses finding stabilization to the point that those who had
them could rejoin society. No “magic pill” appeared to address addiction, but
some success came from more modern treatment centers that focused on addiction
alone. These mostly used the 12 Step model combined with group therapy and
education. For people who clearly fit both into mental health and addiction
treatment centers, there was professional debate about “which one should be
treated first.” People might be sent away from an addiction treatment center to
“get their mental illness in order” and then return for addiction treatment or
vice-versa.
As
the 21st Century dawned, the thinking started to shift toward the
idea of “co-occurring disorders,” which encompassed treating both that which
was categorized as mental illness and the addiction at the same time. There was
precious little talk about thinking of them as one big family, though. “Treat
both together” became the prevailing wisdom. The worlds of treatment for
addiction and other mental conditions were like siblings that had grown up in
different families. The approaches felt very different even if an objective
view could see similarities in the underlying conditions.
Addiction
and any other mental condition center in the brain, both rely on the workings
of chemical messengers known as neurotransmitters, and each can be treated
using many of the same methods as the other. The main reason to think of them
separately now is tradition, not any scientific finding.
Experiential
evidence for this includes how much addiction treatment has relied on some of
the techniques used to help other mental health disorders, such as medication
management, therapeutic techniques including CBT and deeper trauma processing
methods, and a recognition that healing involves seeing the client as a whole
person worthy of compassion, not a moral failing who needs to be browbeaten
into better behavior. Similarly, other mental health disorders have benefitted
greatly from some of the discoveries of addiction treatment, such as harnessing
the power of community through mutual self-help fellowships and having those
who are in recovery from a given mental illness help others who are new to
treatment for it.
The
most powerful evidence is how often addiction and other mental health disorders
appear together. In fact, it is now recognized that it is vanishingly rare to
find someone who has an addiction and no other mental health issues. Similarly,
a very high percentage of those with another mental health problem become
addicted as they use alcohol and/or other drugs in an attempt to control their symptoms.
How
to Find Effective Treatment for the Whole Picture
If
you or a loved one are looking for treatment for addiction and any other mental
health disorder, it is not enough to find place that advertises itself as
giving “co-occurring treatment,” because almost every treatment center says
this today. Instead, look at the depth of experience of the staff, check to see
if the center take clients who are primarily focused on other mental issues or
do they say “co-occurring” but really shoehorn everyone into an addiction
treatment model, see how well they deal with trauma, and ask about what kind of
treatment outcomes they commonly see.
At
Windmill Wellness Ranch, we are proud to offer treatment that takes the whole
person into account. We have some of the best staff in the nation, as verified
through both outside observers and our clients, and we have been rated as
having the best outcomes in the United States by Trac9 assessment systems. Most
importantly, we have the testimony of the many people who have recovered from
addiction and other mental health conditions together at our facility.
The
Bottom Line
Addiction belongs in
the same category as other mental health condition rather than being treated as
a separate class of disorder. Recognizing this allows the most effective
treatment to be found and implemented. When seeking help for yourself or a
loved one, insist on treatment that takes the whole person into account and addresses
everything at the same time to get the best outcomes possible.
About The Author
P. Casey Arrillaga is the Team Leader for Education at
Windmill Wellness Ranch, and he is the author of books including “Realistic
Hope: The Family Survival Guide for Facing Alcoholism and Other Addictions”.
His books, podcast, videos, etc. can be found at CaseyAuthor.com
