In this episode of The Codependent Doctor, I delve into the intricate relationship between addiction and mental health, emphasizing that addiction is often a coping mechanism for underlying issues such as anxiety, depression, PTSD, and more. As we wrap up the fifth and final episode of my miniseries on addictions, I explore various co-occurring mental health conditions that frequently accompany addiction and how they can exacerbate each other.
I discuss the importance of dual diagnosis treatment, which addresses both addiction and mental health simultaneously, providing individuals with the best chance for recovery. Throughout the episode, I highlight specific mental health disorders, including anxiety disorders, depression, PTSD, bipolar disorder, ADHD, borderline personality disorder, OCD, and eating disorders, explaining how each can fuel addiction and complicate recovery.
I share personal anecdotes and insights to illustrate the profound impact of trauma and emotional struggles on addiction. By recognizing the connections between these issues, I encourage listeners to seek help not just for addiction but also for the underlying mental health challenges that may be contributing to their struggles.
As we conclude this miniseries, I invite feedback and suggestions for future topics, reminding everyone that recovery is a journey that involves healing deeper emotional wounds. Join me next week as we return to our regular episodes, focusing on setting boundaries and building healthier relationships, particularly within the transgender and LGBTQ+ communities. Thank you for listening, and remember, we can do this together!
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:00):
Today, we're diving into how addiction and mental
health are deeply connected.
Addiction is rarely just aboutthe substance or the behavior
itself.
For many people, it's a way tocope with anxiety, depression,
trauma or other mental healthstruggles.
It can feel like a solution inthe moment, but over time it
often makes things worse.
Whether it's drinking to calmsocial anxiety, using stimulants
(00:24):
to cope with ADHD, or turningto substances to numb the pain
of PTSD, these patterns cancreate a cycle that's hard to
break.
In this episode, we're going toexplore some of the most common
co-occurring mental healthconditions that come with
addictions, like anxiety,depression, ptsd and more, and
how they can fuel addiction.
(00:45):
More importantly, we're goingto talk about why treating both
at the same time what's known asdual diagnosis treatment gives
people the best chance ofrecovery.
If you or someone you love hasstruggled with addiction,
today's episode will help youunderstand the deeper layers
behind it and why healing isn'tjust about quitting a substance,
but also about addressingwhat's underneath.
(01:06):
So let's get started.
Welcome to the CodependentDoctor, a weekly podcast
focusing on all thingscodependency.
Are you struggling to loveyourself, feeling burnt out or
having trouble forming lovingand meaningful relationships?
I can help you heal from thepast and move forward with
healthier selves, healthierrelationships and healthier,
more fulfilling lives.
(01:27):
Join me as we reclaim yourauthentic self.
I'm your host, a family doctorand fellow codependent, dr
Angela Downey.
We can do this together.
Here we go.
Hello to all my wonderfulpodcast listeners and welcome to
(01:52):
the 33rd episode of theCodependent Doctor.
I'm your host, dr Angela Downey, a family doctor and fellow
codependent.
Today's episode is going tofocus on the different
co-occurring disorders thatoften accompany addictions.
This is the fifth and finalepisode of my mini-series
Addictions.
I can't believe how fast thatwent.
If you have any suggestions forother mini-series or episode
(02:13):
topics you'd like me to address,I'd love to hear from you at
codependentdoctor at gmailcom.
When someone struggles withaddiction, whether to a
substance or a behavior, it'scommon to find other challenges
beneath the surface.
Many people come fromcodependent backgrounds, but
beyond that, addiction oftenexists alongside mental health
(02:34):
conditions.
People may turn to substancesor compulsive behaviors as a way
to cope with anxiety,depression, ptsd, bipolar
disorder, ocd, adhd, borderlinepersonality disorder or eating
disorders.
As I've emphasized throughoutthe series, addiction is complex
and shaped by biological,psychological and environmental
(02:57):
factors.
It can be difficult to untanglethe connections.
Does addiction fuelcodependency or does
codependency contribute to amental health condition that
then fuels addiction, or doescodependency directly feed into
addiction, making mental healthstruggles even worse?
The truth is, everyone'sjourney is different and it's
(03:17):
shaped by their upbringing,their genetics and personal
experiences.
If you've been following mypodcast, you know that I've
covered codependency and how tobreak free from patterns that no
longer serve you.
In this mini-series onaddictions, we've explored
different types of addictionsand paths to recovery.
Today, I'm going to focus on themental health conditions that
(03:38):
often go hand-in-hand withaddictions.
If you recognize yourself inany of these, I strongly
encourage you to speak with yourfamily doctor or a mental
health professional.
Addressing these co-occurringconditions can be a key part of
achieving lasting recovery.
The first mental healthcondition that I wanted to
discuss is anxiety disorders.
(03:59):
Approximately 50% of people witha substance use disorder also
experiences an anxiety disorder,and this can complicate
treatment.
It can often lead to higherrelapse rates and more severe
symptoms.
Many people turn to substancesor compulsive behaviors to
manage their anxiety, but thiscan quickly spiral into a cycle
of dependence, whether it'sdrinking to feel more confident,
(04:22):
using drugs to calm racingthoughts, or turning to
compulsive behaviors likegambling or binge eating to
distract from worry.
These short-term fixes oftenlead to lifelong problems.
Anxiety can feel overwhelming.
It's that constant worrying,the racing heart sensation or
that sense of panic that justwon't go away.
(04:44):
Racing heart sensation or thatsense of panic that just won't
go away.
Instead of facing thediscomfort, many people are
looking for ways to numb it.
If you have social anxiety,being in a room full of people
might make you nervous.
You overthink everyconversation and worry about
embarrassing yourself.
So you start drinking to loosenup a little.
At first it seems to help.
You feel more relaxed andtalkative, but over time you
(05:07):
might start depending on alcoholin social situations, making it
harder to feel comfortablewithout it.
Someone with generalizedanxiety disorder might feel
constantly on edge, so to cope,they start smoking or using
marijuana daily to take the edgeoff.
This creates a tolerance,meaning that they need more and
more to feel the same relief,and that can lead to dependence.
(05:30):
Instead of substances, somepeople might turn to food
shopping or social mediascrolling to avoid their anxious
thoughts.
A person struggling with panicattacks, for example, might
binge watch TV or shop online toavoid their fears.
These behaviors can becomeaddictive, making it hard to
stop, even when they causefinancial, emotional or health
(05:51):
problems or health problems.
Codependency can fit into themix because people with
codependency often struggle withlow self-worth and fear of
rejection, and that can makeanxiety even worse.
If someone is constantly tryingto please others or manage
other people's emotions, theymight feel chronically anxious
about how they're perceived.
(06:12):
This can lead them to use asubstance or behavior as a way
to cope.
An example would be acodependent person in a
relationship with an addictmight feel anxious all the time.
They might be worried abouttheir partner's behavior, their
emotional state or whetherthey're going to relapse.
Instead of setting boundaries,they might drink to numb their
(06:33):
stress or engage in compulsivecaretaking behaviors to feel
some form of control.
Anxiety and addictions feed offof each other, making it
crucial to treat both at thesame time.
Therapy, mindfulness andlearning healthier coping
strategies like exercise,meditation or journaling can
really help with this.
(06:54):
Exercise, meditation orjournaling can really help with
this.
Recognizing the link betweenanxiety and addiction and
codependency is the first steptowards breaking free from
unhealthy patterns.
Depression is another disorderthat we often see with
addictions.
Depression and addiction oftengo hand in hand, feeding off of
each other in a way that canmake both conditions worse.
Many people turn to alcohol,drugs or other addictive
(07:18):
behaviors just to escape thatfeeling of sadness or feeling of
hopelessness or emotionalnumbness.
But what starts as a way tofeel better can quickly spiral
into dependence and it makesdepression even more severe.
When you're depressed,everything feels heavy, simple
tasks can feel overwhelming,motivation is low and negative
(07:41):
thoughts can take over.
Many people self-medicate withsubstances or compulsive
behaviors in an attempt to lifttheir mood or numb their pain.
A person struggling withdepression might have a drink
after work to take the edge off,but over time one drink turns
into several.
Alcohol is a depressant, whichmeans that while it might make
(08:01):
you feel better in the moment,it actually slows down your
brain function and it lowersyour mood.
Over time this can lead to aneven deeper depressive state,
making the person want to drinkmore just to escape it.
Some people turn to painkillersor sleeping pills to help them
relax or escape their thoughts.
But these substances they alteryour brain's chemistry and it
(08:23):
makes it harder for the brain toproduce natural feel-good
chemicals like serotonin anddopamine.
Over time, the person relies onthe drug to feel normal, which
can quickly lead to dependence.
Depression can cause low energy.
It causes fatigue, brain fogand some people might use
something like cocaine or methor even excessive caffeine to
(08:46):
give themselves a temporaryboost.
But after the high wears off,the crash makes depression even
worse and it leads to anexhausting cycle of highs and
lows.
The relationship betweendepression and addiction isn't
one-sided.
Addiction can also causedepression or make existing
depression worse.
Substance use can disrupt thebrain's natural balance of
(09:07):
chemicals like serotonin anddopamine, which regulate your
mood.
Over time, this can increaseyour feelings of sadness or
fatigue or hopelessness.
Many people struggling withaddiction feel ashamed or guilty
about their behavior,especially if it has caused
problems in the relationships orin your workplace.
These emotions can fuel moreself-worth and deeper depression
(09:29):
, making it harder to break thecycle when someone stops using
alcohol or drugs cycle.
When someone stops usingalcohol or drugs, withdrawal
symptoms like irritability,fatigue and sadness can feel
just like depression and itmakes it tempting to use again
just to feel better.
People with depression are twoto four times more likely to
(09:50):
develop a substance use disordercompared to those who do not
have depressive disorders, andthe combination of depression
and addiction significantlyincreases.
The combination of depressionand addiction significantly
increases the risk of suicidalthoughts and behaviors.
This highlights why treatingboth conditions together is so
important.
If depression is left untreated,even getting sober might not
feel like enough to bring relief.
(10:10):
People with codependency oftenstruggle with low self-worth,
guilt and the need to take careof others.
If you're in a relationshipwith someone who is struggling
with addiction and depression,you might feel responsible for
fixing them.
You might neglect your ownneeds while trying to save them,
believing that if you love themenough or do enough for them,
that they're going to get better.
(10:31):
A person in a codependentrelationship with an alcoholic
partner might feel like theycan't leave because they worry
that their partner is going toget better.
A person in a codependentrelationship with an alcoholic
partner might feel like theycan't leave because they worry
that their partner is going tofall apart.
They might make excuses fortheir drinking or take on extra
responsibilities to keep thingstogether.
Meanwhile, they may beexperiencing their own
depression.
They might feel trapped,exhausted and hopeless.
(10:53):
To truly heal, both depressionand addiction need to be treated
together.
Therapy and support groups,medication if needed and
lifestyle changes can make ahuge difference.
If you're struggling with both,it's important to seek help not
just for the addiction, but forthe underlying mental health
struggle as well, because thismental health struggle might
(11:14):
actually be fueling it.
Post-traumatic stress disorder.
For many people struggling withaddiction, trauma is at the
root of their pain.
Whether it's childhood abuse,neglect, a violent attack, maybe
an accident or combatexperience, trauma can leave
deep emotional scars.
When these wounds aren'tproperly healed leave deep
(11:37):
emotional scars.
When these wounds aren'tproperly healed, people might
turn to alcohol, drugs or otheraddictive behaviors to numb the
pain and avoid dealing withpainful memories.
Ptsd isn't just about havingbad memories.
It's about the body and thebrain getting stuck in survival
mode.
After trauma, the nervoussystem can become hypersensitive
and it can make people feellike they're constantly on edge.
(11:58):
They might be easily startledor emotionally numb.
Back in 2015, I rescued twopeople who were drowning.
We were at Rushing River inOntario and I was swimming with
my kids at the beach when I sawthem struggling in the water.
The adrenaline hit me likenever before.
I felt like I could lift a carif I had to.
(12:20):
It was a father and a daughterand they were both fighting to
stay above water.
I was terrified that the father, who was much bigger than me,
might pull me under.
When he lost consciousness, Ifelt a little bit of relief, I'm
almost embarrassed to saybecause I knew that he couldn't
drag me down with him and that Iwould be able to swim back to
(12:40):
shore with any kind ofresistance.
Somehow I got them both back tosafety and, miraculously, we
all survived.
It was a life changingexperience for me and it was one
that should have been a victory, but I could never have
predicted how it would haveaffected me long term.
Even now, when I think aboutthat moment, my heart races and
(13:01):
I start to panic.
It's completely involuntary.
Once I was driving when thememory surfaced and before I
knew it, I was speeding.
I was going like 120 kilometersan hour in an 80 kilometer an
hour zone.
My heart was racing and my bodyreacts as if I'm back in that
moment sweating, trembling andcompletely on edge.
(13:23):
I've always been a strongswimmer, but now I have panic
attacks in lakes and I oftenneed to wear a life jacket just
in case I ever have to savesomeone again.
Even playing with my kids atthe beach is difficult because
I'm constantly scanning thewater looking for signs of
danger.
And this is happening with anevent that had a positive
(13:44):
outcome and everyone survivedand everyone was good.
Now imagine if the outcomehadn't been positive?
Imagine spending years runningthrough fields full of landmines
never knowing if today is theday that you're going to get
shot or have to carry a friendto safety.
War veterans face years oflife-threatening situations that
(14:04):
flood their bodies withadrenaline over and over again.
Or think about a child whonever knows what kind of mood
their parent will be in whenthey get home.
They're walking on eggshellsand bracing for the next
explosion.
What if you grew up wonderingif tonight would be the night
that someone would come intoyour room and take advantage of
you?
You never knew when they weregoing to come.
(14:25):
These experiences don't justdisappear.
The fear and the hypervigilancethey stay with you even when
the danger is gone.
Your body keeps the score andit reacts as if the trauma is
happening all over again.
Even though you danger is gone,your body keeps the score and
it reacts as if the trauma ishappening all over again, even
though you're now safe.
That's the cruel reality oftrauma.
It rewires your brain and itmakes it incredibly hard to
(14:48):
relax, to trust or to let yourguard down.
People with PTSD mightexperience flashbacks and
nightmares, reliving thetraumatic event over and over
emotional numbness, where theyfeel disconnected from life and
from other loved ones.
Hypervigilance, constantlyfeeling unsafe even in normal
situations.
(15:09):
Avoidance, trying to push awayanything that reminds them of
the trauma.
To cope, many peopleself-medicate with substances or
compulsive behaviors.
Someone with PTSD might drinkheavily before bed to avoid
nightmares or to temporarilyescape from intrusive thoughts.
Over time, their body builds atolerance leading to heavier
(15:30):
drinking independence.
Some people turn to opioids orother sedatives or stimulants to
block out emotional pain.
Turn to opioids or othersedatives or stimulants to block
out emotional pain.
However, these substances theycan disrupt brain chemistry,
making PTSD symptoms even worsewhen the effects wear off.
Instead of using substances,some people develop workaholism
or excessive gaming, bingeeating or gambling habits to
(15:53):
keep themselves distracted frompainful emotions, themselves
distracted from painful emotions.
44% of people with PTSD alsomeet the criteria for a
substance use disorder.
Veterans with PTSD are twice aslikely to develop alcohol use
disorder and three times morelikely to develop drug use
disorders compared to veteranswho do not have PTSD.
(16:14):
This shows how closely traumaand addictions are linked.
Many people are usingsubstances not because they want
to, but because they feel likethey have no other way to cope.
Since trauma plays such a bigrole in addiction recovery needs
to address the underlying pain.
Programs like refuge recoveryor trauma-informed therapy, and
(16:37):
EDMR, which is eye movement,desensitization and reprocessing
, help people work throughtrauma in healthy ways.
If you or someone that you loveis struggling with both PTSD
and addiction, it's important toseek help that treats both
conditions together.
Simply quitting the substanceis not going to heal the trauma,
but working through the pain ina safe and supportive
(16:59):
environment can lead to realhealing.
Bipolar disorder is a conditionthat causes extreme mood swings
and it shifts betweenhigh-energy mania and deep
depression.
During manic episodes, peopleoften feel unstoppable.
They are full of energy, makingimpulsive decisions and
sometimes engaging in riskybehaviors like spending sprees,
(17:20):
reckless driving or excesssubstance use.
Then the crash comes.
The depressive phase can bringoverwhelming sadness and
exhaustion, and even thoughts ofsuicide.
This rollercoaster of emotionsmakes it easy to see why
substances like alcohol or drugscan become a way to cope,
either to calm down, drain maniaor escape the pain of
(17:42):
depression.
Unfortunately, self-medicatingthis way only makes things worse
and it intensifies the moodswings and increases the risk of
addiction.
Imagine someone with bipolardisorder who, during a manic
phase, feels invincible anddrinks heavily while partying
because they believe nothing cantouch them.
Then depression hits.
(18:02):
They use alcohol again, thistime to numb the pain and
withdraw from the world.
The cycle repeats, making itharder to stabilize their moods
and function day to day.
Treatments usually involvetherapy, mood stabilizers and a
structured recovery plan thatteaches healthy ways to manage
emotions.
Support groups and professionalhelp can make a huge difference
in breaking the addiction cycle, while it also addresses the
(18:26):
challenges of bipolar disorder.
People with ADHD attentiondeficit disorder often struggle
with impulsivity or difficultyfocusing and emotional
regulation, which can make themmore prone to addiction.
The brain's reward system worksdifferently in people with ADHD
, and it leads them to seek outstimulation, sometimes in the
(18:47):
form of a drug or alcohol, tofeel more control or focused
Stimulants like cocaine, meth oreven misused ADHD medications
can provide a temporary sense ofclarity and energy, but they
also increase the risk ofdependency.
Others might turn to substanceslike alcohol or marijuana to
calm their racing thoughts, butthese can worsen focus and
(19:09):
emotional control in the longrun.
Someone with ADHD mightstruggle with completing tasks
at work and feel frustrated thatthey can't focus.
One day they try a friend'sprescription stimulant and
suddenly feel productive andnormal again.
This quick fix can become adangerous habit leading to
misuse and addiction.
The good news is that ADHD canbe managed with structured
(19:30):
recovery programs, therapy andnon-addictive medications that
help regulate focus and emotions.
Cognitive behavioral therapy,or CBT, is especially helpful in
teaching strategies to manageimpulsivity and build healthy
coping skills without turning tosubstances.
Borderline personality disorder,or BPD, is a condition marked
(19:51):
by intense emotions, fear ofabandonment and impulsive
behaviors, which can makeaddiction more likely.
People with BPD often feelemotions more deeply than others
and might struggle with moodswings, unstable relationships
and self-destructive behaviors.
To cope with overwhelmingemotions like anger, sadness or
anxiety, they might turn tosubstances like alcohol, drugs
(20:14):
or even addictive behaviors likegambling or binge eating.
Unfortunately, while these canprovide a temporary relief, they
often make emotions harder tomanage in the long run and lead
to a cycle of dependency.
For example, someone with BPDmight feel intense anxiety after
a fight with a loved one, so tonumb the pain, they drink
heavily, feeling momentaryrelief, but the next day the
(20:37):
guilt and the shame will set in,making them feel even worse,
which leads to drinking again.
This self-destructive cycle canbe difficult to break without
proper treatment.
One of the most effectivetherapies for BPD and addiction
is dialectical behavior therapyDBT, which helps people manage
emotions, build healthy copingskills and improve relationships
(20:58):
without relying on substances.
Learning to regulate emotionsin healthier ways can make a
huge difference in recovery.
Obsessive-compulsive disorderOCD is a condition where
unwanted intrusive thoughtsobsessions, lead to repetitive
behaviors, called compulsions,in an attempt to reduce anxiety.
For example, someone might feelan overwhelming fear of germs
(21:22):
and wash their hands excessivelyto feel safe.
These compulsions provide atemporary relief, but the
anxiety always returns and itcreates a cycle that can take
over a person's life.
To escape the constant stressand racing thoughts, some people
with OCD turn to substanceslike alcohol or drugs to help
them feel more in control.
However, this can quickly leadto dependency, as they start
(21:45):
relying on substances instead ofhealthier coping mechanisms.
Someone with OCD might drinkalcohol to quiet obsessive
thoughts at night, thinking thatit's going to help them relax,
but over time they need more andmore alcohol to achieve the
same effect, leading toaddiction.
The problem is that substanceuse can actually make OCD
symptoms worse.
(22:05):
It increases anxiety,compulsions and then the feeling
of being out of control.
So, instead of easing obsessivethoughts, addiction can create
a new obsessive behavior likeconstantly chasing the next
drink or drug to avoiddiscomfort.
The most effective treatment forOCD and addiction is cognitive
behavioral therapy CBT,particularly exposure and
(22:26):
response prevention ERP Exposureand Response Prevention ERP.
This therapy helps peoplegradually face their fears
without resorting to compulsionor substances.
Medications like SSRIs alsohelp balance brain chemistry and
reduce obsessive thoughts.
Building healthy routines,mindfulness practices and
learning emotional regulationtechniques are key steps in
(22:48):
breaking the cycle of OCD andaddiction.
Eating disorders and addictionsoften go hand in hand because
both involve using externalthings like food, alcohol or
drugs to cope with emotions,stress or feelings of low
self-worth.
People with eating disordersmight develop rigid rules around
food, they might have intensefears of gaining weight, or
(23:09):
cycles of binging and purging,all of which can create
overwhelming anxiety.
To manage this distress, someturn to substances like
stimulants to suppress theirappetite, alcohol to numb
emotions or drugs to escape bodyimage concerns.
Some people struggling withbulimia might binge eat as a way
to soothe their emotions, thenpurge out of guilt or fear of
(23:32):
weight gain.
If they drink alcoholafterwards to relax or avoid
feelings of shame, they mightstart relying on alcohol as part
of their routine.
Over time, this can turn intoan addiction, making both
conditions worse.
Similarly, a person withanorexia might use stimulant
drugs like Adderall or cocaineto control their appetite,
thinking that it's going to helpthem stay thin.
(23:53):
While it might seem like asolution at first, substance use
can quickly spiral out ofcontrol, leading to worse mental
and physical health issues.
Both eating disorders andaddictions require specialized
treatment that focuses onhealing self-worth, emotional
regulation and healthier copingmechanisms.
Therapies like CognitiveBehavioral Therapy CBT and
(24:16):
Dialectical Behavioral TherapyDBT can help individuals learn
how to manage distress withoutturning to food or substances.
Treatment often involvesnutritional support, therapy and
medical care to rebuild bothphysical and emotional
well-being.
Self-compassion, bodyacceptance and breaking the
cycle of self-punishment are thekey steps in recovery process.
(24:38):
Addiction isn't just about thesubstance or the behavior.
It's often rooted in deeperemotional struggles, past trauma
and untreated mental healthconditions.
Many people might turn toaddictions as a way to cope pain
, numb difficult emotions orfeel a sense of control when
life is overwhelming.
That's why recovery isn't justabout quitting a substance or
(25:02):
behavior.
It's about healing theunderlying wounds that fuel that
addiction in the first place.
When we address both addictionand mental health together, the
chances of long-term recoveryare much higher.
This wraps up my mini-series onaddiction.
I hope these episodes have beenhelpful to shed some light on
why addiction happens, how itconnects to codependency and
(25:24):
what steps can be taken towardsrecovery.
If you found any of thishelpful, I'd love to hear from
you.
Whether you have any comments,questions or ideas for future
episodes, feel free to reach outat codependentdoctor at
gmailcom.
Your feedback helps me createcontent that truly resonates and
supports you on your journey.
Next week, we're going to bereturning to our regular
(25:45):
episodes of the CodependentDoctor, diving back into the
topics that help you setboundaries, prioritize yourself
and build healthierrelationships.
I wish you all a great week asyou learn to foster a better
relationship with the mostimportant person in your life
yourself.
I'm going to meet you here nextweek for another episode of the
Codependent Doctor, when I'mgoing to be talking about
(26:06):
challenges faced by thetransgender community and LGBTQ
plus communities.
Take care for now.
Thank you for joining me and Ihope today's podcast resonated
with you.
Click, like and subscribe soyou don't miss any future
episodes and to help others whomight benefit.
This podcast is not meant toprovide medical advice and
should not replace seeing yourdoctor for mental health
(26:28):
concerns.
If you're having a mentalhealth crisis, please present to
a hospital, call 911 or yourlocal crisis helpline.
I'll talk to you next week foranother episode of the
Codependent Doctor.
We can do this together.
Today, we're diving into how addiction and mental
health are deeply connected.
Addiction is rarely just aboutthe substance or the behavior
itself.
For many people, it's a way tocope with anxiety, depression,
trauma or other mental healthstruggles.
It can feel like a solution inthe moment, but over time it
often makes things worse.
Whether it's drinking to calmsocial anxiety, using stimulants
(00:24):
to cope with ADHD, or turningto substances to numb the pain
of PTSD, these patterns cancreate a cycle that's hard to
break.
In this episode, we're going toexplore some of the most common
co-occurring mental healthconditions that come with
addictions, like anxiety,depression, ptsd and more, and
how they can fuel addiction.
(00:45):
More importantly, we're goingto talk about why treating both
at the same time what's known asdual diagnosis treatment gives
people the best chance ofrecovery.
If you or someone you love hasstruggled with addiction,
today's episode will help youunderstand the deeper layers
behind it and why healing isn'tjust about quitting a substance,
but also about addressingwhat's underneath.
(01:06):
So let's get started.
Welcome to the CodependentDoctor, a weekly podcast
focusing on all thingscodependency.
Are you struggling to loveyourself, feeling burnt out or
having trouble forming lovingand meaningful relationships?
I can help you heal from thepast and move forward with
healthier selves, healthierrelationships and healthier,
more fulfilling lives.
(01:27):
Join me as we reclaim yourauthentic self.
I'm your host, a family doctorand fellow codependent, dr
Angela Downey.
We can do this together.
Here we go.
Hello to all my wonderfulpodcast listeners and welcome to
(01:52):
the 33rd episode of theCodependent Doctor.
I'm your host, dr Angela Downey, a family doctor and fellow
codependent.
Today's episode is going tofocus on the different
co-occurring disorders thatoften accompany addictions.
This is the fifth and finalepisode of my mini-series
Addictions.
I can't believe how fast thatwent.
If you have any suggestions forother mini-series or episode
(02:13):
topics you'd like me to address,I'd love to hear from you at
codependentdoctor at gmailcom.
When someone struggles withaddiction, whether to a
substance or a behavior, it'scommon to find other challenges
beneath the surface.
Many people come fromcodependent backgrounds, but
beyond that, addiction oftenexists alongside mental health
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conditions.
People may turn to substancesor compulsive behaviors as a way
to cope with anxiety,depression, ptsd, bipolar
disorder, ocd, adhd, borderlinepersonality disorder or eating
disorders.
As I've emphasized throughoutthe series, addiction is complex
and shaped by biological,psychological and environmental
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factors.
It can be difficult to untanglethe connections.
Does addiction fuelcodependency or does
codependency contribute to amental health condition that
then fuels addiction, or doescodependency directly feed into
addiction, making mental healthstruggles even worse?
The truth is, everyone'sjourney is different and it's
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shaped by their upbringing,their genetics and personal
experiences.
If you've been following mypodcast, you know that I've
covered codependency and how tobreak free from patterns that no
longer serve you.
In this mini-series onaddictions, we've explored
different types of addictionsand paths to recovery.
Today, I'm going to focus on themental health conditions that
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often go hand-in-hand withaddictions.
If you recognize yourself inany of these, I strongly
encourage you to speak with yourfamily doctor or a mental
health professional.
Addressing these co-occurringconditions can be a key part of
achieving lasting recovery.
The first mental healthcondition that I wanted to
discuss is anxiety disorders.
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Approximately 50% of people witha substance use disorder also
experiences an anxiety disorder,and this can complicate
treatment.
It can often lead to higherrelapse rates and more severe
symptoms.
Many people turn to substancesor compulsive behaviors to
manage their anxiety, but thiscan quickly spiral into a cycle
of dependence, whether it'sdrinking to feel more confident,
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using drugs to calm racingthoughts, or turning to
compulsive behaviors likegambling or binge eating to
distract from worry.
These short-term fixes oftenlead to lifelong problems.
Anxiety can feel overwhelming.
It's that constant worrying,the racing heart sensation or
that sense of panic that justwon't go away.
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Racing heart sensation or thatsense of panic that just won't
go away.
Instead of facing thediscomfort, many people are
looking for ways to numb it.
If you have social anxiety,being in a room full of people
might make you nervous.
You overthink everyconversation and worry about
embarrassing yourself.
So you start drinking to loosenup a little.
At first it seems to help.
You feel more relaxed andtalkative, but over time you
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might start depending on alcoholin social situations, making it
harder to feel comfortablewithout it.
Someone with generalizedanxiety disorder might feel
constantly on edge, so to cope,they start smoking or using
marijuana daily to take the edgeoff.
This creates a tolerance,meaning that they need more and
more to feel the same relief,and that can lead to dependence.
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Instead of substances, somepeople might turn to food
shopping or social mediascrolling to avoid their anxious
thoughts.
A person struggling with panicattacks, for example, might
binge watch TV or shop online toavoid their fears.
These behaviors can becomeaddictive, making it hard to
stop, even when they causefinancial, emotional or health
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problems or health problems.
Codependency can fit into themix because people with
codependency often struggle withlow self-worth and fear of
rejection, and that can makeanxiety even worse.
If someone is constantly tryingto please others or manage
other people's emotions, theymight feel chronically anxious
about how they're perceived.
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This can lead them to use asubstance or behavior as a way
to cope.
An example would be acodependent person in a
relationship with an addictmight feel anxious all the time.
They might be worried abouttheir partner's behavior, their
emotional state or whetherthey're going to relapse.
Instead of setting boundaries,they might drink to numb their
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stress or engage in compulsivecaretaking behaviors to feel
some form of control.
Anxiety and addictions feed offof each other, making it
crucial to treat both at thesame time.
Therapy, mindfulness andlearning healthier coping
strategies like exercise,meditation or journaling can
really help with this.
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Exercise, meditation orjournaling can really help with
this.
Recognizing the link betweenanxiety and addiction and
codependency is the first steptowards breaking free from
unhealthy patterns.
Depression is another disorderthat we often see with
addictions.
Depression and addiction oftengo hand in hand, feeding off of
each other in a way that canmake both conditions worse.
Many people turn to alcohol,drugs or other addictive
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behaviors just to escape thatfeeling of sadness or feeling of
hopelessness or emotionalnumbness.
But what starts as a way tofeel better can quickly spiral
into dependence and it makesdepression even more severe.
When you're depressed,everything feels heavy, simple
tasks can feel overwhelming,motivation is low and negative
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thoughts can take over.
Many people self-medicate withsubstances or compulsive
behaviors in an attempt to lifttheir mood or numb their pain.
A person struggling withdepression might have a drink
after work to take the edge off,but over time one drink turns
into several.
Alcohol is a depressant, whichmeans that while it might make
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you feel better in the moment,it actually slows down your
brain function and it lowersyour mood.
Over time this can lead to aneven deeper depressive state,
making the person want to drinkmore just to escape it.
Some people turn to painkillersor sleeping pills to help them
relax or escape their thoughts.
But these substances they alteryour brain's chemistry and it
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makes it harder for the brain toproduce natural feel-good
chemicals like serotonin anddopamine.
Over time, the person relies onthe drug to feel normal, which
can quickly lead to dependence.
Depression can cause low energy.
It causes fatigue, brain fogand some people might use
something like cocaine or methor even excessive caffeine to
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give themselves a temporaryboost.
But after the high wears off,the crash makes depression even
worse and it leads to anexhausting cycle of highs and
lows.
The relationship betweendepression and addiction isn't
one-sided.
Addiction can also causedepression or make existing
depression worse.
Substance use can disrupt thebrain's natural balance of
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chemicals like serotonin anddopamine, which regulate your
mood.
Over time, this can increaseyour feelings of sadness or
fatigue or hopelessness.
Many people struggling withaddiction feel ashamed or guilty
about their behavior,especially if it has caused
problems in the relationships orin your workplace.
These emotions can fuel moreself-worth and deeper depression
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, making it harder to break thecycle when someone stops using
alcohol or drugs cycle.
When someone stops usingalcohol or drugs, withdrawal
symptoms like irritability,fatigue and sadness can feel
just like depression and itmakes it tempting to use again
just to feel better.
People with depression are twoto four times more likely to
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develop a substance use disordercompared to those who do not
have depressive disorders, andthe combination of depression
and addiction significantlyincreases.
The combination of depressionand addiction significantly
increases the risk of suicidalthoughts and behaviors.
This highlights why treatingboth conditions together is so
important.
If depression is left untreated,even getting sober might not
feel like enough to bring relief.
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People with codependency oftenstruggle with low self-worth,
guilt and the need to take careof others.
If you're in a relationshipwith someone who is struggling
with addiction and depression,you might feel responsible for
fixing them.
You might neglect your ownneeds while trying to save them,
believing that if you love themenough or do enough for them,
that they're going to get better.
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A person in a codependentrelationship with an alcoholic
partner might feel like theycan't leave because they worry
that their partner is going toget better.
A person in a codependentrelationship with an alcoholic
partner might feel like theycan't leave because they worry
that their partner is going tofall apart.
They might make excuses fortheir drinking or take on extra
responsibilities to keep thingstogether.
Meanwhile, they may beexperiencing their own
depression.
They might feel trapped,exhausted and hopeless.
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To truly heal, both depressionand addiction need to be treated
together.
Therapy and support groups,medication if needed and
lifestyle changes can make ahuge difference.
If you're struggling with both,it's important to seek help not
just for the addiction, but forthe underlying mental health
struggle as well, because thismental health struggle might
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actually be fueling it.
Post-traumatic stress disorder.
For many people struggling withaddiction, trauma is at the
root of their pain.
Whether it's childhood abuse,neglect, a violent attack, maybe
an accident or combatexperience, trauma can leave
deep emotional scars.
When these wounds aren'tproperly healed leave deep
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emotional scars.
When these wounds aren'tproperly healed, people might
turn to alcohol, drugs or otheraddictive behaviors to numb the
pain and avoid dealing withpainful memories.
Ptsd isn't just about havingbad memories.
It's about the body and thebrain getting stuck in survival
mode.
After trauma, the nervoussystem can become hypersensitive
and it can make people feellike they're constantly on edge.
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They might be easily startledor emotionally numb.
Back in 2015, I rescued twopeople who were drowning.
We were at Rushing River inOntario and I was swimming with
my kids at the beach when I sawthem struggling in the water.
The adrenaline hit me likenever before.
I felt like I could lift a carif I had to.
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It was a father and a daughterand they were both fighting to
stay above water.
I was terrified that the father, who was much bigger than me,
might pull me under.
When he lost consciousness, Ifelt a little bit of relief, I'm
almost embarrassed to saybecause I knew that he couldn't
drag me down with him and that Iwould be able to swim back to
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shore with any kind ofresistance.
Somehow I got them both back tosafety and, miraculously, we
all survived.
It was a life changingexperience for me and it was one
that should have been a victory, but I could never have
predicted how it would haveaffected me long term.
Even now, when I think aboutthat moment, my heart races and
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I start to panic.
It's completely involuntary.
Once I was driving when thememory surfaced and before I
knew it, I was speeding.
I was going like 120 kilometersan hour in an 80 kilometer an
hour zone.
My heart was racing and my bodyreacts as if I'm back in that
moment sweating, trembling andcompletely on edge.
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I've always been a strongswimmer, but now I have panic
attacks in lakes and I oftenneed to wear a life jacket just
in case I ever have to savesomeone again.
Even playing with my kids atthe beach is difficult because
I'm constantly scanning thewater looking for signs of
danger.
And this is happening with anevent that had a positive
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outcome and everyone survivedand everyone was good.
Now imagine if the outcomehadn't been positive?
Imagine spending years runningthrough fields full of landmines
never knowing if today is theday that you're going to get
shot or have to carry a friendto safety.
War veterans face years oflife-threatening situations that
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flood their bodies withadrenaline over and over again.
Or think about a child whonever knows what kind of mood
their parent will be in whenthey get home.
They're walking on eggshellsand bracing for the next
explosion.
What if you grew up wonderingif tonight would be the night
that someone would come intoyour room and take advantage of
you?
You never knew when they weregoing to come.
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These experiences don't justdisappear.
The fear and the hypervigilancethey stay with you even when
the danger is gone.
Your body keeps the score andit reacts as if the trauma is
happening all over again.
Even though you danger is gone,your body keeps the score and
it reacts as if the trauma ishappening all over again, even
though you're now safe.
That's the cruel reality oftrauma.
It rewires your brain and itmakes it incredibly hard to
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relax, to trust or to let yourguard down.
People with PTSD mightexperience flashbacks and
nightmares, reliving thetraumatic event over and over
emotional numbness, where theyfeel disconnected from life and
from other loved ones.
Hypervigilance, constantlyfeeling unsafe even in normal
situations.
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Avoidance, trying to push awayanything that reminds them of
the trauma.
To cope, many peopleself-medicate with substances or
compulsive behaviors.
Someone with PTSD might drinkheavily before bed to avoid
nightmares or to temporarilyescape from intrusive thoughts.
Over time, their body builds atolerance leading to heavier
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drinking independence.
Some people turn to opioids orother sedatives or stimulants to
block out emotional pain.
Turn to opioids or othersedatives or stimulants to block
out emotional pain.
However, these substances theycan disrupt brain chemistry,
making PTSD symptoms even worsewhen the effects wear off.
Instead of using substances,some people develop workaholism
or excessive gaming, bingeeating or gambling habits to
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keep themselves distracted frompainful emotions, themselves
distracted from painful emotions.
44% of people with PTSD alsomeet the criteria for a
substance use disorder.
Veterans with PTSD are twice aslikely to develop alcohol use
disorder and three times morelikely to develop drug use
disorders compared to veteranswho do not have PTSD.
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This shows how closely traumaand addictions are linked.
Many people are usingsubstances not because they want
to, but because they feel likethey have no other way to cope.
Since trauma plays such a bigrole in addiction recovery needs
to address the underlying pain.
Programs like refuge recoveryor trauma-informed therapy, and
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EDMR, which is eye movement,desensitization and reprocessing
, help people work throughtrauma in healthy ways.
If you or someone that you loveis struggling with both PTSD
and addiction, it's important toseek help that treats both
conditions together.
Simply quitting the substanceis not going to heal the trauma,
but working through the pain ina safe and supportive
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environment can lead to realhealing.
Bipolar disorder is a conditionthat causes extreme mood swings
and it shifts betweenhigh-energy mania and deep
depression.
During manic episodes, peopleoften feel unstoppable.
They are full of energy, makingimpulsive decisions and
sometimes engaging in riskybehaviors like spending sprees,
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reckless driving or excesssubstance use.
Then the crash comes.
The depressive phase can bringoverwhelming sadness and
exhaustion, and even thoughts ofsuicide.
This rollercoaster of emotionsmakes it easy to see why
substances like alcohol or drugscan become a way to cope,
either to calm down, drain maniaor escape the pain of
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depression.
Unfortunately, self-medicatingthis way only makes things worse
and it intensifies the moodswings and increases the risk of
addiction.
Imagine someone with bipolardisorder who, during a manic
phase, feels invincible anddrinks heavily while partying
because they believe nothing cantouch them.
Then depression hits.
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They use alcohol again, thistime to numb the pain and
withdraw from the world.
The cycle repeats, making itharder to stabilize their moods
and function day to day.
Treatments usually involvetherapy, mood stabilizers and a
structured recovery plan thatteaches healthy ways to manage
emotions.
Support groups and professionalhelp can make a huge difference
in breaking the addiction cycle, while it also addresses the
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challenges of bipolar disorder.
People with ADHD attentiondeficit disorder often struggle
with impulsivity or difficultyfocusing and emotional
regulation, which can make themmore prone to addiction.
The brain's reward system worksdifferently in people with ADHD
, and it leads them to seek outstimulation, sometimes in the
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form of a drug or alcohol, tofeel more control or focused
Stimulants like cocaine, meth oreven misused ADHD medications
can provide a temporary sense ofclarity and energy, but they
also increase the risk ofdependency.
Others might turn to substanceslike alcohol or marijuana to
calm their racing thoughts, butthese can worsen focus and
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emotional control in the longrun.
Someone with ADHD mightstruggle with completing tasks
at work and feel frustrated thatthey can't focus.
One day they try a friend'sprescription stimulant and
suddenly feel productive andnormal again.
This quick fix can become adangerous habit leading to
misuse and addiction.
The good news is that ADHD canbe managed with structured
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recovery programs, therapy andnon-addictive medications that
help regulate focus and emotions.
Cognitive behavioral therapy,or CBT, is especially helpful in
teaching strategies to manageimpulsivity and build healthy
coping skills without turning tosubstances.
Borderline personality disorder,or BPD, is a condition marked
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by intense emotions, fear ofabandonment and impulsive
behaviors, which can makeaddiction more likely.
People with BPD often feelemotions more deeply than others
and might struggle with moodswings, unstable relationships
and self-destructive behaviors.
To cope with overwhelmingemotions like anger, sadness or
anxiety, they might turn tosubstances like alcohol, drugs
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or even addictive behaviors likegambling or binge eating.
Unfortunately, while these canprovide a temporary relief, they
often make emotions harder tomanage in the long run and lead
to a cycle of dependency.
For example, someone with BPDmight feel intense anxiety after
a fight with a loved one, so tonumb the pain, they drink
heavily, feeling momentaryrelief, but the next day the
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guilt and the shame will set in,making them feel even worse,
which leads to drinking again.
This self-destructive cycle canbe difficult to break without
proper treatment.
One of the most effectivetherapies for BPD and addiction
is dialectical behavior therapyDBT, which helps people manage
emotions, build healthy copingskills and improve relationships
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without relying on substances.
Learning to regulate emotionsin healthier ways can make a
huge difference in recovery.
Obsessive-compulsive disorderOCD is a condition where
unwanted intrusive thoughtsobsessions, lead to repetitive
behaviors, called compulsions,in an attempt to reduce anxiety.
For example, someone might feelan overwhelming fear of germs
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and wash their hands excessivelyto feel safe.
These compulsions provide atemporary relief, but the
anxiety always returns and itcreates a cycle that can take
over a person's life.
To escape the constant stressand racing thoughts, some people
with OCD turn to substanceslike alcohol or drugs to help
them feel more in control.
However, this can quickly leadto dependency, as they start
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relying on substances instead ofhealthier coping mechanisms.
Someone with OCD might drinkalcohol to quiet obsessive
thoughts at night, thinking thatit's going to help them relax,
but over time they need more andmore alcohol to achieve the
same effect, leading toaddiction.
The problem is that substanceuse can actually make OCD
symptoms worse.
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It increases anxiety,compulsions and then the feeling
of being out of control.
So, instead of easing obsessivethoughts, addiction can create
a new obsessive behavior likeconstantly chasing the next
drink or drug to avoiddiscomfort.
The most effective treatment forOCD and addiction is cognitive
behavioral therapy CBT,particularly exposure and
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response prevention ERP Exposureand Response Prevention ERP.
This therapy helps peoplegradually face their fears
without resorting to compulsionor substances.
Medications like SSRIs alsohelp balance brain chemistry and
reduce obsessive thoughts.
Building healthy routines,mindfulness practices and
learning emotional regulationtechniques are key steps in
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breaking the cycle of OCD andaddiction.
Eating disorders and addictionsoften go hand in hand because
both involve using externalthings like food, alcohol or
drugs to cope with emotions,stress or feelings of low
self-worth.
People with eating disordersmight develop rigid rules around
food, they might have intensefears of gaining weight, or
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cycles of binging and purging,all of which can create
overwhelming anxiety.
To manage this distress, someturn to substances like
stimulants to suppress theirappetite, alcohol to numb
emotions or drugs to escape bodyimage concerns.
Some people struggling withbulimia might binge eat as a way
to soothe their emotions, thenpurge out of guilt or fear of
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weight gain.
If they drink alcoholafterwards to relax or avoid
feelings of shame, they mightstart relying on alcohol as part
of their routine.
Over time, this can turn intoan addiction, making both
conditions worse.
Similarly, a person withanorexia might use stimulant
drugs like Adderall or cocaineto control their appetite,
thinking that it's going to helpthem stay thin.
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While it might seem like asolution at first, substance use
can quickly spiral out ofcontrol, leading to worse mental
and physical health issues.
Both eating disorders andaddictions require specialized
treatment that focuses onhealing self-worth, emotional
regulation and healthier copingmechanisms.
Therapies like CognitiveBehavioral Therapy CBT and
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Dialectical Behavioral TherapyDBT can help individuals learn
how to manage distress withoutturning to food or substances.
Treatment often involvesnutritional support, therapy and
medical care to rebuild bothphysical and emotional
well-being.
Self-compassion, bodyacceptance and breaking the
cycle of self-punishment are thekey steps in recovery process.
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Addiction isn't just about thesubstance or the behavior.
It's often rooted in deeperemotional struggles, past trauma
and untreated mental healthconditions.
Many people might turn toaddictions as a way to cope pain
, numb difficult emotions orfeel a sense of control when
life is overwhelming.
That's why recovery isn't justabout quitting a substance or
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behavior.
It's about healing theunderlying wounds that fuel that
addiction in the first place.
When we address both addictionand mental health together, the
chances of long-term recoveryare much higher.
This wraps up my mini-series onaddiction.
I hope these episodes have beenhelpful to shed some light on
why addiction happens, how itconnects to codependency and
(25:24):
what steps can be taken towardsrecovery.
If you found any of thishelpful, I'd love to hear from
you.
Whether you have any comments,questions or ideas for future
episodes, feel free to reach outat codependentdoctor at
gmailcom.
Your feedback helps me createcontent that truly resonates and
supports you on your journey.
Next week, we're going to bereturning to our regular
(25:45):
episodes of the CodependentDoctor, diving back into the
topics that help you setboundaries, prioritize yourself
and build healthierrelationships.
I wish you all a great week asyou learn to foster a better
relationship with the mostimportant person in your life
yourself.
I'm going to meet you here nextweek for another episode of the
Codependent Doctor, when I'mgoing to be talking about
(26:06):
challenges faced by thetransgender community and LGBTQ
plus communities.
Take care for now.
Thank you for joining me and Ihope today's podcast resonated
with you.
Click, like and subscribe soyou don't miss any future
episodes and to help others whomight benefit.
This podcast is not meant toprovide medical advice and
should not replace seeing yourdoctor for mental health
(26:28):
concerns.
If you're having a mentalhealth crisis, please present to
a hospital, call 911 or yourlocal crisis helpline.
I'll talk to you next week foranother episode of the
Codependent Doctor.
We can do this together.
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