Substance Use Disorders

Many mental illnesses also overlap with substance abuse problems. This is known as comorbidity (when two disorders occur in the same person at the same time). Many people with mental illness eventually have a wake-up call to unhealthy habits (like having their stomach pumped or spending all their money on coke). A wake-up call is very important because substance abuse only makes mental illness worse or sometimes disguises it from being diagnosed in the first place.

· 60% of adolescents who meet the criteria for a substance abuse disorder also meet standards for another mental illness (https://nida.nih.gov/publications/research-reports/common-comorbidities-substance-use-disorders/part-1-connection-between-substance-use-disorders-mental-illness)

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· Around one in four individuals with a mental illness such as schizophrenia, bipolar disorder and major depression also have a problem with substance use (https://nida.nih.gov/publications/research-reports/common-comorbidities-substance-use-disorders/part-1-connection-between-substance-use-disorders-mental-illness)

· Bipolar disorder that begins in adolescence indicates a greater risk of substance use than bipolar disorder that begins in adulthood (https://nida.nih.gov/publications/research-reports/common-comorbidities-substance-use-disorders/part-1-connection-between-substance-use-disorders-mental-illness)

· People with mood/ anxiety disorders are twice as likely to suffer from a substance use problem than those who don’t (https://www.turnbridge.com/news-events/latest-articles/comorbid-substance-abuse/#)

· One problem is that some drugs (particularly for anxiety) can be addicting especially benzodiazepines such as Xanax (which Hope is prescribed), Klonopin (which she is also prescribed), and Valium.

Hope has a problem with alcohol at the beginning of the book but she gives it up after it adversely affects her health. So far, she has been sober for six and a half years.

Note: Something very unpopular to mention is the link between psychosis and cannabis use among those who have schizophrenia or bipolar disorder. Hope (who has problems with psychosis) smokes a bit of pot in the book and she dates several dealers (there is drug use throughout the book). It is dangerous for someone with psychotic tendencies to smoke pot; it can contribute to a psychotic break. “Duration of cannabis use in people with bipolar disorder is associated with the duration of mania” (https://www.emcdda.europa.eu/topics/pods/comorbidity-substance-use-mental-disorders-europe_en). Don't mean to dampen your high; just telling it like it is.