Which Came First: The Chicken or The Egg? Mental Illness and Addiction

Often, drug rehab patients have more than an addiction problem. Many patients have a co-occurring mental illness that their particular drug rehab must address. Substance abuse treatment centers generally have psychiatrists and psychologists on staff to address this need for mental health issues. The question many patients and doctors alike have regarding what’s known as "dual diagnosis" is whether or not the substance abuse is a result of the mental illness or the mental illness is a result of the substance abuse. This question becomes a "which came first: the chicken or the egg?" dilemma.

While scientists have attempted to figure out the answer to this question, there is no definitive answer. Some researchers at substance abuse treatment centers and universities across the world believe that substance abuse triggers mental illness in those with a genetic vulnerability for such diseases as schizophrenia, bipolar disorder, or major depressive disorder. Other researchers believe that substance abuse simply worsens symptoms of a pre-existing mental illness. The latter school of thought believes addicts and alcoholics are simply self -medicating their mental disorder.

Doctors at substance abuse treatment centers who treat dual diagnosis symptoms on a daily basis quickly point out that both addiction and other mental illnesses are brain diseases sharing the same biology. These illnesses involve the same chemicals, pathways and molecules in the human brain. For example, drug rehab patients with addiction and schizophrenia may be surprised to know that increased dopamine levels are characteristic of schizophrenia and cocaine abuse. The transportation of serotonin in the brain is characteristic of alcoholism and mood disorders, such as bipolar.

While the answer to "chicken or the egg question" remains a mystery, recognizing a dual diagnosis situation in drug rehab patients is not mysterious for substance abuse treatment center psychiatrists. Most psychiatrists can point to various character traits in individuals that diagnose them as having both addiction and a co-occurring mental illness, especially when the patient has enough time abstinent from mood altering chemicals. At first, however, it is probably best to let a patient in a drug rehab detoxify completely from drugs and/or alcohol before making a dual diagnosis.