Self-medication is when someone takes echinacea to fight off a cold or melatonin when they haven’t been sleeping well. Experts have defined the term as “the taking of drugs, herbs or home remedies on one’s own initiative, or on the advice of another person, without consulting a doctor.” In that sense, self-medication is something that most, if not all, people have practiced at one point or another, and it offers many benefits. However, the practice has a negative side when people use self-medication to treat mental health disorders.
Using substances, whether alcohol, prescription medications, or illegal drugs, to cope with the symptoms of a mental health problem can be dangerous. This is true whether the issue is depression, anxiety, trauma, or abuse. People even use food to self-medicate, leading to health problems associated with weight gain and issues with body image and self-esteem.
The Self-Medication Hypothesis
During the 1980s, clinicians began to hypothesize that some patients were using drugs to cope with the symptoms of their mental health issues. This theory, known as the self-medication hypothesis, was also used to explain why many people had both a problem with mental illness and addiction.
The hypothesis has been controversial, with one side believing it can help in a person’s therapeutic process and address the underlying issues behind the individual’s mental health disorder. Others feel that the theory doesn’t place enough personal responsibility on the individual for their addiction and that it can even legitimize illegal drug use.
Forms of Self-Medication
Self-medication can take several forms, from illegal drugs to prescription medications, from alcohol to food. Each form of self-medication has risks and problems associated with it. The person may feel a reprieve, but they risk long-term health problems from weight gain and severe issues with their self-esteem because of weight changes to their appearance. Some use food to cope with their emotions, known as bingeing or emotional eating.
Alcohol is often abused by those with anxiety, depression, and PTSD. Reliance on alcohol to cope with symptoms of these issues can quickly lead to dependence and addiction. Stimulants such as cocaine or amphetamines are abused because of the sense of euphoria they provide users. Because of the resulting crash, these drugs can make an individual’s depression worse, in addition to causing physical issues such as sudden heart failure and stroke.
Opioids in any form — heroin, codeine, or methadone — can worsen symptoms of depression and increase a person’s risk of overdose. It has been estimated that almost half, 45%, of individuals with a prescription opioid use disorder also have depression or anxiety.
Signs of Self-Medication
Research has provided insight into the extent of self-medication among people with different mental health issues. For instance, 22% of those with anxiety self-reported using substances to help in one study, while another found that 21% of those with post-traumatic stress disorder (PTSD), about 23% with major depression, and 41% with type 1 bipolar disorder did this to cope with symptoms of their illnesses.
Recognizing how common the practice is can help, as can knowing what signs to look for:
- Staying away from family, friends, social events, and other activities
- A sudden change in hobbies or who one spends time with
- Secrecy about how one spends time
- Neglecting physical care, such as showering or eating
- Having difficulties in work, school, or other areas
- New or unusual financial problems because of the cost of alcohol and drugs
- Changes in weight or appetite (increase or decrease)
- Mood swings, especially sudden fits of anger
- Insomnia and other sleep problems
Self-medicating may seem beneficial initially, but it can quickly cause the problems a person is experiencing to increase in dangerous and unhealthy ways.
Risks of Self-Medication
In the beginning, someone using drugs or alcohol to manage mental health disorder symptoms may find temporary help. However, over time, issues and dangers can develop. These problems can range from an incorrect self-diagnosis to a failure to recognize the potential risks of taking certain drugs. There can also be a range of rare but severe adverse side effects or interactions with other medications that can result in serious health problems. The risk of dependence and abuse is also a real concern.
Care for Mental Health and Substance Abuse
The 2018 National Survey on Drug Use and Health found that more than 9 million adults in America have a co-occurring disorder or dual diagnosis. This is a condition where the individual has both a substance abuse disorder and a mental health condition.
Today, the recommended treatment for a dual diagnosis is an integrated approach that aims to address both conditions. The process starts with detox, where the person stops using drugs or alcohol so that the body may clear all the substances from their body. Depending on the substance issue, this can be done at home with the input of a health care professional or within a facility under the care of medical supervision.
The next step is a form of rehab, either inpatient or outpatient. This allows the individual to learn new methods to manage their conditions and discover a community of peers for support. Therapy and medications are typically a part of this process. Known as medically assisted treatment or MAT, pairing behavioral therapy and medications to manage cravings and side effects can help an individual break old habits and practice new coping techniques.
Finally, the individual can engage with ongoing support through self-help and support groups after completing the more formal rehab process. These offer understanding and guidance from peers to keep a person on their path to recovery.
A licensed mental health and substance abuse intensive outpatient program (IOP) in Scottsdale, Arizona, Rising Phoenix was created to offer a safe, welcoming, and nurturing environment where clients are not judged but embraced, throughout their recovery process.