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Tug of War on the Brain

The second I woke up, all I could feel and hear was my heart racing, heat coursing

through my body, yet, a sense of coldness and sweat around my face. I sat up in my bed and all I

can feel is vertigo; looking around the room, feeling like my head is heavily floating. This was

all a result of my anxiety. I have dealt with it affecting the way I live since the third grade, but

did not see it as debilitating as it was until this year. The way I went around it was by finally

speaking with a doctor and seeing what we could do about it. Thus, I have been taking Zoloft for

about three months now and have seen clear signs of it helping me calm down my anxiety. I was

aware of needing to talk to someone about it because both my parents have always been really

open about seeking any sort of help for it. Through my fathers generational mental health and

addiction history, and my mothers insight through being in the education field, they have always

given me extremely helpful advice and important information on these topics. But what happens

when people do not have this option?

Many turn to substance use, ultimately making you feel better from the start, but becomes

more and more negative as you continue to use. One major consequence of substance abuse is

the fact that the brain and body both become weak, not only physically but internally. This can

then lead to the continuous cycle that drugs or alcohol may cause. For some, experimenting with

substances is something fun they do as a way of letting loose, or just from pure curiosity, but if

their DNA could have other plans. One’s genetic makeup can have a huge impact on whether or

not someone can get addicted easily. Therefore, the wrong pairing between an addictive drug and

one’s addictive makeup will most likely cease to result in any kind of good effect. Sure, the

substance may feel really great to take, and you like how it changes reality, but pretty soon that

reality becomes insufferable, where you are chasing this high that you will never be able to find

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again. All of these consequences create this void that you soon can not escape from because it

has you hooked, and trying to stop just creates even worse of a feeling because now you have to

go through the absolute horror of withdrawal. This toll upon the users self esteem and their

families wellbeing. Struggling to find yourself because you have been taken over by some

substance. Nothing will ever be as important as that drug or drink. You can not get away from

how it changes you, which brings me to my question: How does the cycle of poor mental health

correspond with addiction in today’s society?

Struggling with mental health is not a new idea, but the way it is looked at today is very

different from that of just a few years ago. Just as common background, it is important to be able

to fully understand the term of mental illness, which can be easily defined as being, “a condition

that affects a person's thinking, feeling, behavior or mood. These conditions deeply impact

day-to-day living and may also affect the ability to relate to others” (“Mental Health

Conditions”). This sets up the view on mental illnesses in society as of right now, providing

crucial information for diagnosis. Because it is affecting many aspects of one's life, it becomes

hard for people to live their actual daily lives as it is. Paired with the common struggles of

reality, it inevitably becomes challenging to even live like a “normal” person who is not

struggling with the effects of mental illness. Now with the main focus of the conducted research,

the question of substances comes into play. In so many aspects of life, one may encounter

someone who struggles with some sort of mental illness, as well as using a specific vice of some

sort, would make one wonder if there is any sort of correlation. As more people have become

aware of this happening, an increase in research has started to occur, presenting the fact that,

“Since mental health problems are caused by a complex interplay of genetics, the environment,

and other factors, it’s difficult to say if abusing substances ever directly causes them. However, if

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you are at risk for a mental health issue, abusing alcohol or drugs may push you over the edge”

(“Dual Diagnosis: Substance Abuse…”). The indication of nature vs. nurture is clearly depicted

within this statement. This idea of one's livelihood being affected by their environment as well as

their genetic makeup from family both play a huge role in the development of a person's life. If

they are raised under negative circumstances and struggle, this can inevitably contribute to the

state of their mental health. Yet, It is hard to directly pin point if abusing a substance plays into

an increase in mental illness struggles and vice versa. Through the first interview I conducted

with my mentor, Leigh Gregory, she was able to present a lot of insight on the struggles that

people go through, through the lens of a school psychologist. When asked about her opinion on

mental illness and addiction, she responded with, “we know that if you have poor mental health,

you may self medicate using substances, right? We also know that substances can contribute to

poor mental health, right, because it’s not a positive coping strategy. So they definitely play upon

each other” (Gregory). Relating back to circumstances of life, she helped to confirm this idea

that people who may struggle with mental health issues may be under the risk of self medicating.

This is seen especially if these people have less resources than others that are able to afford

treatment for any sort of issue they are experiencing.

There is no denying that substance use biologically shifts one's brain, but recognizing

how this happens is an extremely large factor to its idea today. It is honestly scary to understand

just how different using a substance can make a person. How everything else in their life may no

longer matter because it is deemed less important than whatever substances they are using: “As a

substance use disorder deepens in intensity, substance use is the only thing that produces relief

from the bad feelings associated with withdrawal. And like a vicious cycle, relief is purchased at

the cost of a deepening disorder and increased distress when not using. The person no longer

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takes the substance to “get high” but instead to avoid feeling low” (“The Neurobiology of

Substance Use, Misuse, and Addiction”). The use of the word disorder helps to contribute to this

idea that addiction is part of something that affects one's mental health. It can even be seen as an

actual mental illness. People use substances to get away from that of an illness or it could be the

early signs of the development of one, in the long term effects of using. The negative effects of

drugs may be enough to make someone want to stop using, but what happens if they have

become reliant on the drug and their addiction makes it seem impossible to do so? Terms for

these issues help to make people understand that these disorders and issues are a big time life

changer, helping to describe the term of substance dependence, defined as “the medical term

used to describe use of drugs or alcohol that continues even when significant problems related to

their use have developed” (“Substance Use Disorder”). As a result of commonly used

substances, many people know that too much of anything can cause more harm than good. The

fact that it creates such immense damage in a person's life, yet it has affected the way they

function on a day to day basis goes to show how destructive, both addiction and mental illness

can be for a person. They cannot just stop using because the substance has completely taken over

their body; it becomes hard for them to live any sort of “normal” life they may have lived in the

past, because that substance is still in the back of their mind. It may go away from time to time,

but in specific times of sadness or anxiety, many people turn back to their substance of choice

because it has created a comfort for them. Adding on to another reason users are subjected to risk

include age: “Early drug use is a strong risk factor for later development of substance use

disorders, and it may also be a risk factor for the later occurrence of other mental illnesses.

However, this link is not necessarily causative and may reflect shared risk factors” (NIDA).

Therefore, for one experimenting with drugs at a young age, the consequences are strong because

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they are still developing. Those chemical differences affect how one will grow up, their attitude,

behavior, and treatment of the world around them. As it states shared risk factors, experiences

between people who struggle with addiction and are commonly the same with those who struggle

with mental illness. These may not cause either end of these issues but a lot of research goes to

show that people struggling with either tend to go through the same cycle of behavior.

While both mental illness and addiction can stem from the makeup of one's brain, there

are other predominant elements that can contribute to these diagnoses. This term of

dual-diagnosis really puts into perspective how linked both a mental illness and addiction cycle

relate. They usually spin off from each other, formulating more and more negative ramifications:

“When a mental health problem goes untreated, the substance abuse problem usually gets worse.

And when alcohol or drug abuse increases, mental health problems usually increase too” (“Dual

Diagnosis: Substance Abuse…”). The correspondence is clear with this statement. For ones

struggling with mental health problems, substance use makes it worse in the long run, as well as

the other way around. Awareness needs to be spread about this topic. It is hard treating one

debilitating issue as it is, let alone two. Although mental illness or addiction may not cause the

other, there sure is a lot of research that shows how people cope with their issues. An

increasingly frightening statistics explains that, “37 percent of alcohol abusers and 53 percent of

drug abusers also have at least one serious mental illness” (“Dual Diagnosis: Substance

Abuse…”). This line seriously exemplifies the connection between addiction and poor mental

health and how they can play on one another. 53 percent of drug users have an additional mental

illness, revealing how a lot of the times these are not separate issues and can usually stem from

the same experiences. Through more conversation with Leigh Gregory, she was also able to

explain instances where she had seen, “situations where a student was depressed or anxious. And

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then they started using and then we saw suicide ideation or more extreme manifestations of their

mental health issues” (Gregory). Not only can substance abuse cause an increase in possible

mental illnesses, it can directly make a person's pre-existing illnesses worse. Yet, there are still

other things that can cause such issues. Through the eyes of Marriage Family Therapist and

school counselor, Denise Uhl, the second professional in the conducted interviews for this

project, she explains that, “even if you're not predisposed to anything, that would be of concern.

You can still go down very dangerous rabbit holes in your mind if you let it in if you don't have

good coping skills” (Uhl). Therefore, even when something is not genetic, or has not occurred in

one's environment, their personality can connect to the beginnings of addiction or poor mental

health. In the long run, since coping skills were unhealthy to begin with, if their issues or

disorders go untreated, there will be a new shift in the balance of their brain, making their

behavior no longer their norm; but recovery is hard, and many people cannot get through it.

Treating both addiction and mental illness is one of the most important steps regarding

recovery. However, recovery is a very long and challenging process with various bumps along

the way, but it can always lead into something very rewarding. But since it can be challenging, it

is understood that, “Recovery is an ongoing process and relapse is common” (“Dual Diagnosis:

Substance Abuse…”). With both addiction and mental illness disorders, people should seek

treatment and recovery if possible. They manifest in different ways yet both require a learning

process that will hopefully lead to a full recovery. With addiction it can be a relapse and with

mental illness, maybe it is an episode or a few. Although, there are still occurring problems for

those unable to access treatments for recovery; resulting in a never ending cycle of actually

getting “better.” Through this question of how many people actually get the help they need,

specific statistics show that, “In fact, nearly 9 million people have a co-occurring disorder

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according to the Substance Abuse and Mental Health Services Administration. Yet, only 7

percent of these individuals get treatment for both conditions. And nearly 60 percent receive no

treatment at all” (Gordon). The “today’s society” is touched upon in this piece of information;

because in the grand scheme of things, barely anyone struggling with these experiences are

actually getting their much needed support. Raising questions related to accessibility, money, and

opportunity. Many people do not have the income to help themselves feel better in a safe and

medical way so they seek the easier option of self medicating. In search of a personal experience,

reading the book, Tweak: Growing up on Methamphetamines, by Nic Sheff, was the perfect

thing. His struggles with addiction and his family, beautifully captured in this memoir, is

strikingly important for this topic. Related to this idea of recovery, Sheff writes, “They keep

having to wake me up so I'll take my meds…but I only ask to be left alone. I have this feeling,

like I just wish I didn't have to exist. I wish it would all just go away. It's not as though I'd want

to do anything proactive, like actually dying. No, I just want to disappear…I don't know who I

am and my body feels beyond repair. It is sunken down to nothing” (Sheff N, 277). Through this

event, readers can see that not only do drugs take a toll on one's body, but it takes a toll on how

one thinks. Nic is miserable with himself, wanting to escape from his problems, yet, lucky he is

in rehab where he can resolve the issues he has been facing, instead of pushing them down with

the numbing drug of choice. Recovery is hard but not impossible. As long as there is some sort

of strength that is helping someone recover, there should always be optimistic hope.

While the effects of mental illness and addiction obviously impact the person struggling,

it can also create a large amount of distress upon the people around them. Because both of the

main issues occurring cause many differences in a person's life, they begin to change behavior,

possibly leading to, “substance-related legal problems, or continued substance use that interferes

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with friendships, family relationships, or both” (“Substance Use Disorder”). These changes

definitely alter relationships these individuals have. Negative energy spreads, so it is the same

with how others will react when presented with negative attitudes such as sadness and anger

caused by poor mental health or substance abuse. Especially if parents are raising a struggling

teen; the stress factor can be up the roof. If they have never dealt with something like this they

could become prone to guilt or sadness, then affecting their mental state, all relating back to a

cycle: “Mental health conditions often has a ‘ripple effect’ on families, creating tension,

uncertainty, stress and sometimes significant changes in how people live their lives” (“Mental

Health Conditions”). This theory can be directed towards the idea of cause and effect. One

person's behavior can change another person's behavior in negative and positive ways, but most

addictions and mental illnesses are expressed through negative side effects, causing an increase

in negative emotions for the people around the ones struggling. As a result of finding even more

personal experiences with this, reading David Sheff's memoir, Beautiful Boy: A Father's Journey

Through His Son's Addiction, gave even more insight on how life changing it is to have a loved

one struggling: “Nic has used meth… I increase my pleas for him to go into rehab, but he will

not yield. I learn that now that he is over eighteen, I cannot commit him. If he were a threat to

himself or someone else, there's a complicated process by which I could commit him for a brief

evaluation at a mental hospital, but a parent concerned about a child's drug use doesn't qualify”

(Sheff D, 116). Through a fathers perspective, this pent up guilt and inability to help his son,

because he will not take it, causes mass desperation. He feels as though he has failed because his

son is struggling, causing his struggle to feel content with all other aspects in his life. David has

tried everything in order to get his son the help he needs, but nothing else is able to help him but

himself. He has no other options, which contribute to the decrease of his own mental health.

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There is no other struggle like the feeling of living with mental illness or the effects of

addiction. Both kinds of disorders, as known, cause changes in one's physical and mental health,

both important for overall health in general. Therefore, living with a mental illness, such as

depression, can increase, “the risk for many types of physical health problems, particularly

long-lasting conditions like diabetes, heart disease, and stroke” (“About Mental Health”). Not

only do mental health problems create issues with emotions and behavior, it can change the state

of someone's physical health as well. Many people experience times in depression where they

have no motivation whatsoever, causing them to even be incapable of doing activities such as

showering or brushing their teeth. And through the trials of everyday life, everyone knows that

this will create many unhealthy and dangerous problems in the long run. Through changes in the

body caused by these issues, the brain is obviously one that is largely impacted. The physical

hardwiring of the brain itself is changed through the, “circuits involved in reward, stress, and

self-control. Those changes may last a long time after a person has stopped taking

drugs…Addiction is a lot like other diseases… Both disrupt the normal, healthy functioning of

an organ in the body, both have serious harmful effects, and both are, in many cases, preventable

and treatable” (“Drugs, Brains, and Behavior: The Science of Addiction”). It is like living with a

chronic illness. A lot of the time it can be prevented, but once it has happened, it becomes a

slight nightmare to get out of. Habits formulated while abusing substances are proven to last

even after one has become sober, creating a scary reality because, even though they are

technically back to their old self, their brain has changed, and old tendencies can come back,

which can also then effect how they feel about themselves, furthering to affect their mental

health. Once again, through the eyes of Nic Sheff, he explains, “I was ashamed of my behavior,

but still I kept going forward. It was like being in a car with the gas pedal slammed down to the

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floor and nothing to do but hold on and pretend to have some semblance of control. But control

was something I'd lost a long time ago” (Sheff N, 2). His analogy really opens up the perspective

of how struggling with addiction may feel. No matter how badly someone wants to stop they

have lost control in those aspects of their lives; it becomes obsessive and compulsive. These

traits cause a sense of demolition in the way a person is living, consequently making them feel

even worse about themselves due to the way their brain is now operating. It is not as easy as just

saying, “yeah, I can stop” . It is a real, long term battle that people have to put up with and

experience on a day to day basis. They have to go through the struggles of recovery, sobriety, and

compulsive behavior for the rest of their life.

Throughout the process of answering the big question, it was learned that many people

struggle with both mental illness and addiction at the same time, referring to the term of

dual-diagnosis, as well as how people close to the ones struggling also struggle with their lives

because of it, and how the ones struggling are impacted. As a result of plenty of research, the

main question can be answered through the idea that poor mental health and addiction do not

directly correspond, but they are linked with many of the same experiences, causing people to be

more prone to both. It is an important topic to be educated on, because even if it is not seen out

in the world, a great deal of people struggle with these issues everyday. Friends or family

members may be experiencing it, random people seen on the street; an extremely sad case is

when homeless people who are clearly struggling with addiction and mental illness can not get

help. As a community, everyone sees addiction and mental illness, therefore being more aware of

the issues and how it can possibly be helped is just one great step people can take. Awareness

needs to be spread in order for people to understand what is going on and how they can support

themselves and others from the struggling tug of war on the brain.

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Works Cited

“Drug Misuse and Addiction.” National Institutes of Health, U.S. Department of Health and

Human Services, 13 July 2020,

https://nida.nih.gov/publications/drugs-brains-behavior-science-addiction/drug-misuse-ad

diction.

“Dual Diagnosis: Substance Abuse and Mental Health.” HelpGuide.org,

https://www.helpguide.org/articles/addictions/substance-abuse-and-mental-health.htm.

Gordon, Sherri. “Co-Occurring Disorders: Mental Health Issues & Addiction.” Verywell Mind,

Verywell Mind, 16 July 2021,

https://www.verywellmind.com/co-occurring-disorders-mental-health-and-addiction-415

8280.

Gregory, Leigh. Personal Interview. 2 March 2023.

“Mental Health Conditions.” NAMI, National Alliance On Mental Illness,

https://www.nami.org/about-mental-illness/mental-health-conditions.

NIDA. "The Connection Between Substance Use Disorders and Mental Illness." National

Institute on Drug Abuse, 27 Sep. 2022,

https://nida.nih.gov/publications/research-reports/common-comorbidities-substance-use-d

isorders/part-1-connection-between-substance-use-disorders-mental-illness Accessed 31

Jan. 2023.

Sheff, David. Beautiful Boy: A Father's Journey Through His Son's Addiction. Houghton Mifflin,

2008.

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Sheff, Nic. Tweak Growing up on Methamphetamines. Simon & Schuster, 2007.

“Substance Use Disorder.” Substance Use Disorder | Johns Hopkins Medicine, John Hopkins, 31

Jan. 2023,

https://www.hopkinsmedicine.org/health/conditions-and-diseases/substance-abuse-chemi

cal-dependency.

“The Neurobiology of Substance Use, Misuse, and Addiction.” The Neurobiology of Substance

Use, Misuse, and Addiction | Surgeon General's Report on Alcohol, Drugs, and Health,

U.S. Department of Health & Human Services, 2016,

https://addiction.surgeongeneral.gov/executive-summary/report/neurobiology-substance-

use-misuse-and-addiction.

Uhl, Denise. Personal Interview. 17 March 2023.

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