MONDAY, Aug. 2, 2004 (HealthDayNews) -- A new study finds that substance abuse and depression aren't as intertwined as conventional wisdom would have it, but are stand-alone illnesses that each affect roughly one in 10 Americans.
Although a substantial minority of people with one of these disorders have another, most people suffer from just one, says a report in the August issue of the Archives of General Psychiatry. But in those commingling cases, doctors shouldn't assume they can kill two birds with one stone and should instead treat the problems separately, the researchers said.
"About 20 percent of people with a substance abuse problem have a mood or anxiety disorder," said lead author Bridget F. Grant, chief of the Laboratory of Epidemiology and Biometry at the National Institute on Alcohol Abuse and Alcoholism. "And about 20 percent of the people with a mood or anxiety disorder have a substance abuse problem."
In the past, it was assumed that for most people who had substance abuse problems and mood or anxiety problems, the psychological problems would go away once they stopped drinking or using drugs, Grant explained.
"But we found that many people who were alcohol or drug abusers really had true mood or anxiety disorders that should be treated," she said.
In their study, Grant's team collected data on 43,093 adults who took part in the National Institute on Alcohol Abuse and Alcoholism's National Epidemiologic Survey on Alcohol and Related Conditions.
During this 2001-02 survey, the volunteers were asked about substance use and mood and anxiety disorders during the past 12 months.
Grant's group found that 9.21 percent of the U.S. population had mood disorders, 11.08 percent suffered from anxiety, and 9.35 percent had substance abuse problems.
"Although the clinical literature says that in 60 percent of the substance abusers, the symptoms of anxiety and mood disorders will go away once they stopped drinking or using drugs, this is not the case," Grant said, adding that the finding surprised the researchers. "These are disorders that will last."
Since substance abuse and psychological problems often occur together but are independent of each other, people who treat substance abuse problems should assess patients for mood and anxiety problems and vice versa, Grant advised.
"When substance abusers present with mood and anxiety disorders, most of the time these will be mood and anxiety disorders that are not due to substance abuse, but ones that are going to last if not treated," she stressed.
Grant believes the combined problems of substance abuse and mood and anxiety disorders are on the increase in the United States.
"Now that we have the data, people with combined substance abuse and mood and anxiety problems will get treatment for their mood and anxiety disorders right along with their substance abuse, and that's a good thing," Grant said.
Mark D. Litt, a professor of behavioral sciences at the University of Connecticut Health Center, said the findings are important because doctors often treat the two ailments as a package deal. Generally, they are treated as if one were causing the other, he explained.
According to Litt, the common mantra among treatment professionals is, "We don't want to treat your depression or anxiety disorder because we need to treat your substance abuse problem first. Or, we can't treat your substance abuse problem because it's being caused by your anxiety disorder -- you're self-medicating."
This study, however, may put an end to that line of thinking, Litt said. "The demonstration that both disorders can occur independently, even though they manifest at the same time, takes away those excuses, and provides a rational for treating the disorders simultaneously," he said.
More information
Learn about anxiety disorders and their treatment from the National Institute of Mental Health.
