Addiction and Schizophrenia

Schizophrenia is a serious mental health issue that is common in cases of addiction. Research has found that you’re more likely to abuse alcohol or drugs if you suffer from schizophrenia than those who don’t have this psychological disease. The combined case of schizophrenia and addiction is known as dual diagnosis or comorbidity.

If you or a loved one are struggling from schizophrenia and substance abuse, you will likely find it difficult seeking help, as psychological issues may become severe and deter you from undergoing treatment. However, you can fight schizophrenia and addiction through carefully planned treatment regimens and therapies handled by licensed healthcare experts.

These co-occurring disorders can be remedied through integrated treatment plans that typically involve substance abuse counselling, clinical psychotherapy, support groups and medication. Your schizophrenia and addiction issues will be handled simultaneously, as treating one without the other could cause the initial symptoms to return, leading you back to drug abuse.

Experts have found that schizophrenia is often the underlying cause of alcohol or drug abuse amongst people with a dual diagnosis. In some cases, schizophrenia will be triggered by the substance abuse. Symptoms of addiction also replicate those of schizophrenia, which makes it difficult to accurately spot the presence of a psychological disorder in cases of addiction.

If you had symptoms of schizophrenia before abusing drugs or alcohol, they will be exacerbated when you begin to use drugs or drink excessively.

What is schizophrenia?

Schizophrenia is a chronic and complex neurological disorder markedly known to cause an altered sense of reality in those suffering from it. The disorder induces hallucinations, delusional beliefs, strange personality traits, disorganised thoughts and paranoia. It also affects language (disorganised speech) and sense of self and causes impaired day to day functioning.

If you suffer from schizophrenia, your thinking, actions and feelings will be affected and you may see the world differently than it is in reality; your sense of perception will differ from that of people around you. Also, you may hear voices in your head and see things that aren’t there from time to time. You will likely find it difficult to express yourself in words. This mental illness also leads to a reduction in expressive thinking and social engagement, a lack of motivation, as well as other psychological problems such as depression, anxiety and substance use disorder.

The illness often results in alcoholism or chronic drug abuse. You may see drugs or alcohol as simple solutions when it comes to mitigating the symptoms with which you are afflicted. These substances can mask those symptoms and make you feel better, but only for a while – and at a cost. Substance abuse following signs of schizophrenia will ultimately lead to exacerbated symptoms of the disorder.

Schizophrenia usually begins to develop from a young age and fully develops later in life, beginning at the latter stages of adolescence or early adulthood. Causes of the mental illness include environmental factors and genetics.

While there is no known cure for the disorder, schizophrenia can be treated effectively via psychotherapy and medications. With the proper help, you can lead a healthy and productive life.

Spotting addiction and schizophrenia

Drug or alcohol addiction is common in cases of schizophrenia. If you have schizophrenia, the illness predisposes you to substance abuse. You will be tempted to use an addictive substance as an escape from your suffering, which can cause counterproductive complications in the long run.

The simultaneous occurrence of substance abuse and schizophrenia is called a dual diagnosis or comorbidity. Abuse of drugs and binge drinking do not directly cause schizophrenia, but they are powerful triggers for the disorder.

When schizophrenia and substance use disorder occur concurrently, it will be difficult to accurately diagnose comorbidity or identify a dual diagnosis. This is because the side effects of alcohol and drug addiction often resemble symptoms of schizophrenia.

If you’ve had symptoms consistent with schizophrenia which led you to abuse drugs or alcohol, then you will most likely suffer co-occurring disorders of addiction and schizophrenia. However, when alcoholism or drug abuse triggers inactive schizophrenic symptoms, this is where the difficulty of correctly spotting both cases comes to the fore.

Your addiction and schizophrenia can be accurately diagnosed with the help of well-trained addiction and mental health specialists. Standardised tests and face-to-face interviews will be carried out to determine your situation and the extent of your dual diagnosis.

Some statistics worth knowing about schizophrenia

• According to the World Health Organisation, 21 million people are affected by schizophrenia worldwide.
• One in two people afflicted with schizophrenia have no access to (or don’t receive care for) their mental illness.
• The US Centre for Disease Control and prevention reported that between 0.6 and 1% of the global population are affected by schizophrenia.
• Schizophrenia is present in every society and all countries worldwide.
• In the UK, schizophrenia is a major mental health condition. About 220,000 of the population are undergoing treatment for this illness at any one time.
• There’s a 5-10% chance that those suffering from schizophrenia will die by their own hand without proper care within ten years after they’ve been diagnosed.
• The illness develops early in life, usually in late teenage years or early adulthood. It occurs slightly earlier in men than women. However, there have been reported cases of schizophrenia developing at 70 years of age.
• In 40% of males and 23% of females suffering from the condition, it began to develop at the age of 19.
• About 25% of those that suffer from schizophrenia will go on to completely recover without having any future problems from the illness.
• 30% of all adult mental health spending in the NHS is on issues related to schizophrenia.
• The majority of people suffering from schizophrenia (that are receiving treatment) lead healthy and productive lives.

Your doctors may choose a different approach when treating your condition. You could be diagnosed as suffering from a particular type of schizophrenia or receive more general treatment for this disorder, without being tagged to a specific subtype.

Regardless of the approach your doctor employs, you’ll be treated on an individual basis, according to your symptoms, how you experience them and the impact they have on your life. This is more vital than labelling your illness.

Here are some common schizophrenia subtypes in the UK:

Origins of schizophrenia and who is at risk

If you suffer from schizophrenia or know someone with this disorder, you may want to understand its causes, and perhaps know who else could be at risk of developing the illness.

In truth, researchers and scientists are still unsure about the direct causes and origins of schizophrenia. However, a number of factors and triggers have been identified as significant in the development of the illness. Genetic, environmental and biological factors have been marked as possible causes of schizophrenia. There’s also the risk of triggering a predisposition to the illness by abusing alcohol and other substances.

Getting to know these possible causal factors – and the elements that combine to increase the chances of this disorder occurring – can help you piece together your odds of developing schizophrenia.

Environmental factors

The development of schizophrenia can be triggered by environmental causes combined with genetic factors, scientists believe. These environmental factors can begin to lay the groundwork for schizophrenia, even before birth. Complications with pregnancy (as a result of environmental elements such as industrial chemicals and viral infections) could cause a tendency towards schizophrenia before you are even born.

Also, traumatic life experiences and chaotic living conditions can set you on the path towards developing this mental illness.

Biological factors

Biological factors that play key roles in the development of schizophrenia include brain chemistry and brain structure.

Chemistry

Scientists believe there’s an imbalance of chemicals in your brain if you are suffering from schizophrenia. These chemicals or neurotransmitters include dopamine, serotonin and glutamate. They make way for nerve cells present in the brain to send signals to each other.

Your response to stimuli will be affected if there’s an imbalance in these chemicals. This explains why sensory information like sound or light (that other people can handle) may overwhelm you if you have schizophrenia.

Hallucinations and hypersensitivity – common schizophrenia symptoms – may manifest due to the problem in processing different smells, tastes and sounds.

Structure

Some studies suggest that complications in the development of neural pathways and connections in the brain before you are born can play a role in the development of schizophrenia.

Through brain imaging, scientists have found a number of small differences in the brain structure of people living with schizophrenia. These brain structural differences include larger ventricles (spaces in the brain’s centre filled with fluid), decreased grey matter, smaller medial temporal lobes (parts of the brain that play memory roles) and decreased or increased activity in some brain areas.

Schizophrenia can feature a slow onset and development. Early signs of the illness can be difficult to detect, as they often manifest during adolescence. Initial symptoms such as changes in sleeping routines, as well as social withdrawal and unresponsiveness may be misconstrued as an adolescent ‘phase’.

You might not realise that you have schizophrenia until a doctor or psychologist diagnoses it. Even when the first signs develop, you may not take them seriously. Symptoms like inability to think clearly sometimes might be chalked up to tiredness or stress.

Symptoms of schizophrenia will vary from person to person. It will affect you differently from how it does other people. No one experiences every symptom simultaneously, as they often come and go.

Symptoms of schizophrenia are divided into two main categories: positive and negative. Some symptoms are also classed as cognitive and emotional.

Positive symptoms

Positive symptoms are changes in thoughts or behaviour that occur in addition to your present normal behaviours and thoughts. Doctors identify these symptoms as ‘positive’, but it doesn’t necessarily mean they are good. They include hallucinations, delusions and other symptoms.

Hallucinations

Hallucinations tend to suggest things that aren’t actually there. You may hear, smell, feel and see things that don’t exist in reality. You’ll be so immersed in these non-existent ‘realities’ that voices could influence your thought process by warning you that you’re in danger. Hearing voices is one of the most prevalent hallucinatory symptoms of schizophrenia. Sometimes, the voices even talk to each other.

Delusions

These are thoughts and beliefs that are too strange to make sense and have no realistic bases. You might believe or concoct incorrect conspiracy theories that people will find strange. These delusional thinking patterns commonly include believing that an imaginary person or entity is about to harm you, believing you’re a famous person or that you have a superpower and thinking that the world is about to end.

Disorganised thought or speech

If you suffer from schizophrenia, you may have a hard time trying to organise and maintain your thoughts. You may not comprehend when you’re being talked to, because your thought patterns are disorganised as a result of the illness. When you talk, you might make statements that aren’t logical, talk off topic in the middle of conversations and join words that are unrelated, which makes it hard for people to understand you.

Trouble concentrating

You’ll be unable to follow conversations and stay on track with what’s happening around you.

Catatonic behaviour or disordered motor control

Your movement may become childlike and very disorganised. You could exhibit strange postures, erratic motor behaviours, a lack of impulse control and repeated movement. You may also display what experts call catatonia – a motionless and unresponsive state where you can stay perfectly still for a long period of time.

Negative symptoms

This phase includes being withdrawn from social life and showing no concern for personal hygiene or appearance. These symptoms gradually develop and slowly worsen.

They are often mistakenly attributed to other disorders such as anxiety and depression. Negative symptoms of schizophrenia include:

• Loss of interest in formerly enjoyable activities such as relationships and sex
• Changes in sleeping patterns, lack of concentration and wanting to stay indoors
• Feeling uncomfortable around other people, not wanting to say anything, and unable to start a conversation

What are the early warning signs of schizophrenia?

Schizophrenic symptoms often appear during the early 20s or late teenage years. The illness is less common amongst females than males. Symptoms of the disease may begin to appear during key moments in your life, like after the loss of a loved one, a major traumatic event, or a major breakup within the family (especially the divorce of parents).

Some of the early signs of schizophrenia to look out for include:

Schizophrenia and addiction: Understanding the relationship

The relationship between schizophrenia and addiction is quite complex. The link between these disorders is strong and can be easily confused.

Normally, the side effects of substance abuse are consistent with those of schizophrenia. Whether there’s an underlying case of schizophrenia or not can be hard to detect. In most cases, schizophrenic symptoms may be inert, but can be triggered by abusing alcohol or other addictive substances.

Studies have shown that nearly 50% of people struggling with schizophrenia also have a substance abuse issue or have had one in the past. The true dilemma and puzzle faced by clinicians when it comes to treating the dual diagnosis of these disorders is figuring out which came first and which triggered which.

However, trained and qualified experts in addiction and mental healthcare have testing procedures in place to understand the relationship between your substance abuse and schizophrenia.

Why so many people with schizophrenia are addicted to substances

When people suffer from schizophrenia, they often see drugs or alcohol as a means to escape their debilitating symptoms and cope with stress, especially when they have not received treatment for their condition.

In truth, these drugs create an outlet for escaping reality when you take them. Their effects on the brain may temporarily augment what you have lost through schizophrenia. Nevertheless, taking addictive drugs as a means to self-medicate has its downsides.

The most common substance abused by people living with schizophrenia is nicotine. Other substances include alcohol, marijuana and cocaine. Stimulant drugs or other depressants may also be used to feel either hyper or calmer, respectively.

The effects of substance abuse on schizophrenia

Long-term substance use disorder will result in worsening and more frequent paranoid delusions and auditory hallucinations. There is also the risk of a psychotic relapse linked with marijuana and alcohol abuse. Substance abuse can also affect your treatment for schizophrenia.

Living with schizophrenia and addiction

Schizophrenia is an extremely challenging mental illness to live with. Its symptoms may disconnect you from the real world and render you incapable of caring for yourself. You may find it difficult socialising and connecting with others and there may be strains on your relationships with family and friends.

However, if you have schizophrenia, it doesn’t mean you have to live with these specific situations. While you may not find things as agreeable as the average human being, you can definitely lead a healthy and productive life. Effective treatment plans are available that can help you cope and live with the illness.

Please refrain from taking drugs or abusing other substances to cope with your condition. The best way to achieve a healthy, happy life is to seek professional help.

If you have taken drugs and have fallen foul of addiction, you can also get the required help to overcome your substance abuse and receive care for your mental condition.

Four things you should know about schizophrenia and addiction

Risks associated with long-term addiction and schizophrenia

Long-term addiction can result in serious complications when you have a co-occurring disorder such as schizophrenia. Your functioning may deteriorate more quickly than it would have without the addition of drugs or alcohol, your treatment outcome could take a turn for the worse and you may end up harming yourself due to more severe hallucinations.

Schizophrenia and alcohol addiction

Research has shown that one in three people living with schizophrenia will have a case of alcoholism. Substance abuse is common in people with schizophrenia and alcoholism is no different. Due to its legality and accessibility, alcohol is an easy alternative to turn to if you’re seeking to dull or alleviate your schizophrenic symptoms.

There’s a certain link between alcohol and schizophrenia despite scientists refusing to blame alcohol as the direct cause of this disorder. The general consensus is that alcohol can trigger an onset of schizophrenia if there is an underlying genetic predisposition to it.

Risks of using alcohol to cope with schizophrenia

Using alcohol as a means to cope with schizophrenia is never advised. You may be doing yourself more harm than good. While alcohol may provide a relief for what you’ve been going through, it will eventually amplify the symptoms of schizophrenia you were trying to quell in the first place.

Using alcohol puts you at risk of abusing the substance and inducing more severe schizophrenic episodes. You will often relapse to psychotic episodes and experience poor functioning, impaired cognitive function and impaired motor behaviours. There’s also the risk of neglecting to receive treatment and failed attempts at recovery, from both your addiction and the mental disorder.

Treating schizophrenia and alcohol addiction

There are treatment plans targeted at helping people with co-occurring alcoholism and schizophrenia fight their conditions. You can get help through an integrated recovery plan that treats both conditions concurrently.

Treatment will include a medically assisted alcohol detox and withdrawal phase, whereby the substance will be flushed out of your system under medical supervision. Drugs like benzodiazepines may be used to help reduce withdrawal symptoms.

A rehab programme that gets to the root of your schizophrenia and alcohol abuse will be carried out to help you achieve balance and defeat your addiction.

Detox is generally the first stage of the whole dual diagnosis treatment plan. This is where the abused substance will be eliminated from your body under medical care, so you can start your rehabilitation phase in a sober state, free of drugs.

Once you’re rid of the drug, the professionals handling your treatment will evaluate your condition and determine the best course of treatment to follow. Your treatment plan will be 100% individualised to tackle your addiction and schizophrenia, as you have uniquely experienced them.

Antipsychotic medications will be administered to help alleviate the severity of delusional beliefs and hallucinatory experiences in order to keep you focused on treatment and your rehabilitation.

The rehabilitation stage involves various forms of psychotherapy, aimed at getting to the roots of the underlying causes of both disorders. Therapies involved include Cognitive Behavioural Therapy (CBT), which is aimed at identifying and fixing behavioural problems that led to addiction, training you on how to cope with schizophrenia and family therapies that are also commonly employed in treating both disorders through the help of relatives.

With the right course of treatment, your struggles with addiction and schizophrenia can be old news. All you need to do is seek help from competent professionals. If you have a loved one struggling with this issue, please get them help immediately.

Choosing the best dual diagnosis treatment centres for schizophrenia and addiction

The facility you choose for addressing your dual diagnosis will determine how successful your treatment will be. Dual diagnosis – especially one that involves schizophrenia – is not a regular case of standalone substance abuse. As such, it’s important to consult experts that can honestly guide you towards choosing the best centre for treatment that meets your personal needs.

FAQs

Sources

• https://www.webmd.com/schizophrenia/what-causes-schizophrenia
• https://www.medicalnewstoday.com/articles/36942.php
• https://www.medicalnewstoday.com/articles/192770.php
• https://www.rethink.org/diagnosis-treatment/conditions/schizophrenia/types
• https://www.dualdiagnosis.org/schizoaffective-disorder-addiction-treatment/signs-of-schizophrenia/
• https://en.m.wikipedia.org/wiki/Schizophrenia
• https://www.rcpsych.ac.uk/healthadvice/problemsanddisorders/schizophreniakeyfacts.aspx?theme=mobile
• https://www.ncbi.nlm.nih.gov/pubmed/10881208
• https://www.nhs.uk/conditions/schizophrenia/symptoms/
• https://www.webmd.com/schizophrenia/schizophrenia-symptoms
• https://www.livingwithschizophreniauk.org/facts-and-figures/