Substance abuse, mimicking mental health disorders, and the importance of differential diagnosis

A way that substance abuse could mimic mental health disorders is that one could have been exposed to a trauma, which created – an undiagnosed – mental disorder (ex. depression, anxiety, PTSD etc.). Because of the mental anguish one may encounter related to their disorder, they turn to drugs and/ or alcohol to self-medicate.  Frequent and prolonged use of substances affects the neurological makeup of one’s brain and can exacerbate the effects associated with their mental disorder (Volkow, 2022; SAMHSH, 2020). 

Suppose there is a suspicion that two or more disorders are present, while conducting deliberate “screening and a thorough differential diagnosis” is highly encouraged (SAMHSH, 2020, p.119). Although sometimes tricky to diagnose one that is experiencing psychotic disorders and other conditions that may overlap, differential diagnosis is essential because it allows healthcare professionals to parse what could appear to be a singular disorder into several disorders that require separate treatment protocols. Illnesses identified through differential diagnosis require tailored approaches, and there must be seamless coordination between all healthcare providers (ex., eating disorder, drug disorder, mental disorder) involved to establish a complete treatment environment. Failure to provide collaborative, integrated, and balanced treatment could allow for gaps where one’s substance and/ or mental issues could worsen (Volkow, 2022; SAMHSH, 2020).  

References

Substance Abuse and Mental Health Services Administration (SAMHSH). (2020). Substance Use Disorder Treatment for People With Co-Occurring Disorders: Treatment Improvement Protocol (TIP) 42. https://store.samhsa.gov/sites/default/files/SAMHSA_Digital_Download/PEP20-02-01-004_Final_508.pdf

Volkow, N. (2022).  Addiction often goes hand-in-hand with other mental illnesses. Both must be addressed. National Institute on Drug Abuse (NIDA). https://nida.nih.gov/about-nida/noras-blog/2022/09/addiction-often-goes-hand-in-hand-other-mental-illnesses-both-must-be-addressed on 2023, May 30