We Need to Talk About the Link Between Addiction and Schizophrenia

Addiction and substance abuse are severe and complex issues that affect a large majority of the population; however, there is a link between addiction and schizophrenia in particular that we need to discuss.

There is so much stigma surrounding addiction and substance abuse, but the reality of these conditions is they are often born from an individual’s attempt to self-medicate due to other mental health issues. With schizophrenia, addiction and substance abuse may develop as an individual’s attempt to manage symptoms linked to the illness, such as depression, anxiety, as well as the presence of the effects of past trauma. Oftentimes substance use is even used as a self-medicating way to and deal with the hallucinations that are frequently a large part of the illness.

Addiction and substance abuse can include both legal and illegal substances, and as many as 50 percent of individuals with schizophrenia have a history of substance use. While addiction and substance abuse may be used as self-medication, they can also trigger symptoms of schizophrenia in individuals who are susceptible due to genetic risk factors. This often is a double-edged sword, because while substances may be used to self-medicate symptoms of depression, anxiety and trauma, they can worsen symptoms of schizophrenia — particularly hallucinations and delusions. Both addiction and schizophrenia also present similar symptoms, which can make diagnosis of schizophrenia difficult. The symptoms of schizophrenia, when substance abuse is present, are often missed or assumed to be the product of addiction or substance abuse.

When in the process of diagnosing addiction or substance abuse, an individual should also be screened for other mental illnesses — such as schizophrenia — to determine if there are co-occurring conditions. The truth is that most of the time addiction and substance abuse occur as a way to manage the symptoms of underlying mental illnesses. It is important to determine if an individual is at risk of developing schizophrenia due to genetic risk factors, and to consider this diagnosis if symptoms are present — despite the use of substances.

In so many cases, addiction and substance abuse occur as a solitary way for individuals to manage the symptoms of mental illness on their own if they are unable to see help, or are unwilling. And while it is important to address and manage the substance abuse, it is important to determine if further mental illnesses or mental health issues are present so they may be co-managed along with addiction or substance abuse. In most cases, therapeutic pharmaceutical care is an excellent way to manage schizophrenia, and when the correct medications and therapy are available, the substance abuse will often decrease.

In my experience, my past substance abuse was an attempt to manage my anxiety and depression, as well as the symptoms of PTSD I was experiencing; however, upon experiencing psychosis and severe suicidal ideation I was admitted as an inpatient to the psychiatric unit at a behavioral health hospital, which started my healing journey. I still struggle with using substances occasionally, but my further outpatient work with a therapist and psychiatrist has helped me to develop coping mechanisms that I can use when I have urges to use. And finding the right medication for my schizoaffective disorder has helped my psychotic symptoms.  I am a big advocate for psychiatric medications because they have drastically improved my quality of life daily, and when they are paired with psychotherapy, their healing effects are ever grander.

If you are concerned about addiction or substance abuse in yourself or a loved one, it is important that you are able to seek help from professionals. Crisis centers are excellent resources to share your concerns and find resources in your area. Treatment and diagnostic evaluation may seem daunting, but you or your loved one deserve to live a life free from the pain of undiagnosed mental illnesses and addiction or substance abuse. There shouldn’t be shame around substance abuse, because many times using substances is the best option that individuals feel they have access to when seeking relief from depression, anxiety, trauma or hallucinations and delusions.

Everyone deserves care and compassion, and the more we empathize with others and understand that we are all doing the best we can in the moment, the more we can improve the lives of ourselves and those we love.  There is a significant link between addiction and/or substance abuse and schizophrenia, and early detection is key for finding recovery and healing.