Is it an Addiction Problem or A Mental Health Problem?

Is it addiction or is it a mental health problem, or is it just a phase? It can be really hard to pull apart the pieces because addiction and mental health just kind of go hand in hand. And there are also some phases in life where people tend to use more substances, like when they're in college. And it can be hard to tell. Are we really dealing with an addiction problem, like a for real addiction problem, or is it something else? That's what we're going to explore in today's video. And I'm going to give you some guidelines to help you think through that process and make some decisions, either for yourself, because you're wondering for yourself, or because you're wondering about a loved one or a friend or person that you care about. For those of you who are new here, welcome to Put the shuffle down. This YouTube channel is all about helping you understand the science and psychology of addiction so that you're always five steps ahead of it. Because our goal is to make sure that you live the life that you want to live. And this is the only channel out there that helps you understand addiction from every angle, from the individual angle, from the science angle, the psychology angle, and from the family perspective. And so today's topic is pretty much always relevant. This is a question that I get asked so often, like, directly I'll get asked this question, but I also get asked this question kind of indirectly. And sometimes people don't say it out loud, but they're wondering, hey, could it be this? And maybe not addiction? Like, maybe my loved one is just going through a really hard time and they're grieving because they just lost someone that's really important to them and they've been drinking a lot. How do I know if it's really addiction? So I think the place that we need to start as far as pulling apart all of these different pieces is to look at what is addiction. Right now. There is the clinical definition. In fact, there are 11 official criteria. And there's a way to actually diagnose. It's not officially called addiction. It's called substance use disorder. That's the official term. And there's a way to officially diagnose substance use disorder. And so I've put a link in the description so that you can download Those for real. 11 criteria and look at it from a real, like, step by step approach. Because basically what it does, it has. You count, you know, how many of the 11 do you have or the does the person have? And that's how you make the diagnosis. But in general, a Real more simplified version or way to look at what addiction is. It's like, am I using some sort of substance or engaging in some sort of behavior in a way that's causing a lot of problems in my life and I just keep doing it anyway. Now, obviously it can be a little bit more complicated than that, but I really wouldn't get caught up in what it is or how much it is. It's really about how much space is this problem occupying in your life and how much problems is it causing in your life? You know, is it impacting your relationships, your work, your physical health, your sense of self esteem, esteem, all of those things? Like I said, make sure you download the official criteria. But if you're doing something in a problematic way and you've tried to cut it back or you've tried to stop altogether, and maybe you have success sometimes, but this problem just keeps coming back and it's causing a lot of unwanted effects in your life, and it just can't seem to make it go away or can't make it go away completely, Then my guess is you're probably dealing with some level of addiction. And that's really the key there because people don't understand that addiction, just like anything else, comes in levels, right? People tend to think, well, I'm either addicted or I'm not, or I'm alcoholic or I'm not, you know, but it doesn't really work that way. It's all sort of on a continuum. And it's like, where am I at on the spectrum of the problem? If it's interfering in your life and you've tried to manage it, you've tried to cut it back, you've maybe even tried to stop it, and maybe you've had some success with that, but the problem keeps coming back, then you're probably dealing with some kind of level of addiction. I don't know how severe that is, but you've got some problem with addiction. Most people don't want to acknowledge that they're dealing with some kind of addiction until it's like what I call end stage terminal level addiction, which is crazy, right? Other illnesses we want to catch early, other illnesses we want to identify and say, oh my gosh, I got this problem, I need to intervene now so I can get it under control faster because I know my chances of beating it are better if I deal with it sooner. Same thing with addiction. There is absolutely no need to wait till you or your loved one is living up under a bridge to decide that it's addiction is it causing problems, and it just seems to be persistent and doesn't want to go away. Probably some kind of addiction, right? So once you've identified that addiction is part of your equation, the next step is to understand that once something has turned into an actual addiction, it doesn't really matter why it happened at that point. I mean, it does, but not as much as you think. What I'm trying to say is, like, a lot of people say, well, okay, like, I'm drinking too much, or I'm talking too much weed, or I'm doing too much of this drug. But it's because of this other thing. It's because I have an anxiety disorder and I can't seem to get under control. It's because this bad thing happened to me in my childhood. It's because I'm really depressed. It's because I can't sleep at night. And there's this thinking that I think a lot of people have that's like, okay, if I know that this addiction or this problem is because of this other thing over here, then if I deal with this other thing over here, the addiction will go away. That's the flaw in the thinking. Once something has turned into an addiction level of a problem, regardless of whether or not it's occurring because of some other, like, underlying mental health problem or developmental stage, it is its own problem. And that's really important to acknowledge because a lot of people try to fix these problems, but they want to do it backwards. And they don't have any luck because they keep trying to treat their anxiety disorder. And they think once they treat their anxiety and their anxiety gets under control, that their addiction is going to get under control. It doesn't work like that. Once it's gotten to that level of problem. Now you. You need to understand that you have two problems, and you really can't get at the underlying problem until you address the addiction. You're never going to get your depression under control. You are never going to fix your anxiety disorder. You're never going to get your mood disorder to stabilize or any of those things until you stabilize the addiction issue. Because it's kind of like if there's an underlying issue and addiction is on top of it, you're just not going to get to that. Because as long as you're putting all those chemicals or behaviors or problems into your life, it's going to keep all the other things on fire, right? So the important thing to know here is you got to understand, do I have both of these problems? Right? And if I Do you need to kind of get it in your brain as far as like, how do I address them now? Simultaneously is probably the best bet. In most situations. If you've got to do one thing over the other, you definitely need to address the addiction. And then maybe, you know, five minutes later you need to address the other thing. But you can't address any kind of mental health problem, any kind of developmental problem, any kind of life transitions issue, and think that just because you address that, the addiction will go away because it just won't work like that. Most people that we see in our office have some level of what they call like a co occurring problem, or some places use the term dual diagnosis. But even if it's not another diagnosis, there's usually some other problems going on, right? So I like to call it a co occurring problem. You rarely see addiction just all by itself, and here's why. Because having mental health problems sets you up for developing addiction. So your chances of developing addiction when you have other issues are a lot higher. So you tend to see them together. And the other big reason for that is even if you don't have some kind of underlying mental health problem or something terrible bad in your childhood or anything like that, if you engage in an addictive behavior for long enough, you will develop other mental health problems. Does that make sense? So it's chicken or egg, you're gonna see both things together. Regardless. One of the things to try to figure out is, is the addiction causing the mental health problems or were the mental health problems there even before the addiction? Most people, by the time they get to our office, they've been diagnosed, everything under the sun, and it's so bad that usually when people come and they tell me that this diagnosis and that, I'm like pretty skeptical, which I probably shouldn't be, but I can't have, my first thought is, okay, we'll see, right? And the reason why is because over the years of watching so many people get clean and sober, they're just so different. And I feel like you have to take that addiction off the top to see what's left, right? People's personality is usually completely different. I'm like, oh, you're like totally different person than I even thought you were. Not even, not even thinking about like mental health problems. But if you've got co occurring issues going on and you get the addiction under control 99% of the time, whatever is left, even if it is underlying, is going to get infinitely better just from taking the addiction off. Because even if there was some kind of thing there before the addiction started. I guarantee you that the addiction is making it a thousand times worse. So most people feel like I'm using this because it's helping me manage this other problem. My mood disorder, my anxiety, my sleep issue, whatever. But it never is. That's the nature of addiction. It's always making it worse. There's no way around it. Because of the rebound effect from your brain's rebounding or response to addictive substance or behavior. It. It ultimately it gets you the opposite of what you want. And because of that, it makes those problems worse. So instead of getting yourself all wound up about where did this come from? Because people will literally, and families do this too, spend year, months, years, decades sometimes trying to answer this question of why is this happening? To the detriment of dealing with the fact that it's happening. Right? So it's kind of like, let me go to therapy and dig up every bad thing that ever happened. Let me. Let me sort through my memories, let me get hypnotized and figure out what's underneath there. And I'm not saying that's not helpful or important. I'm just saying, like, that is not going to make an addiction go away once it's there. Once it's there, it's its own beast, it's its own life form. And you gotta deal with that and then go in if you want to, and deal with that other stuff. There are only a couple of exceptions to the rule. And by the rule, I mean what I'm telling you, which is deal with the addiction first and the other stuff very quickly afterward. Like, put it in order if you want to get anywhere. You're not going to get anywhere by dealing with the mental health stuff first with the grief first with anything else. You've got to deal with the addiction first. Only a couple of exceptions to that rule, and they're very few, but the ones that are there are pretty important. The only time that you want to deal with the mental health concern first is if it is really severe, like psychosis or schizophrenic in an acute stage, or like a bipolar disorder. That's acute as in someone is completely out of their mind and not in control and doesn't even have the awareness or capability to understand or think about or deal with an addiction. Does that make sense? Like if someone's psychotic and they're delusional and they're paranoid and they think they're aliens from another planet dressed up as FBI officers that are chasing them around, you can't get to the addiction because at that point the mental health problem really is so acute, that severe and maybe even dangerous that you can't get to the addiction. So in that kind of situation, and sometimes that's being caused by the addiction, like there's something called substance induced psychosis, which is, I use so many drugs I lost my mind. Most of the time that's temporary, right? And even if what you have to do is put someone in like a facility or something and make sure they're not taking the drugs like, like a drug that's real likely to cause that, something like a meth or a stimulant, you very quickly have to treat that psychosis. So that's really about the only time you want to reverse that order. It's quite natural for all of us to get into that why question. And it can be important and it can be helpful. It can be helpful in a lot of ways. It can be helpful because you're identifying what are the other things underneath there that I need to address. It can be helpful because it helps us to deal with our own shame or being mad at ourselves or having some empathy for ourself or for another people. It's not that it's not helpful, it's just that you can't get so focused on that that you don't deal with it. Because what I see a lot of is people will. Not only do they try to treat it in the wrong order, but they will use the mental health problem as an excuse or even a manipulation for not dealing with the addiction problem. So I call it like, it's like hiding behind the mental health problem. And people that have addictions do this all the time and they get really good at it. And in fact, it's. It's really like one of the best, most effective ways to get your family off of your case, right? Because you develop this storyline either because you know they believe it or because you believe it too, or whatever, that I can't help it because. And especially if, you know, there's severe trauma in the past, severe anxiety, then the family has so much empathy, they start to believe, well, you just can't help it, right? And they let you off the hook from dealing with this addictive behaviors. And they kind of. It's almost like they. They sort of give you permission. In fact, I've seen families outright give people permission to continue to drink or use drugs or whatever because they're completely convinced that the person can't help it. And without the substance, the mental health problem Just goes crazy or they feel so bad about some of the things that have happened in this person's life that they, they basically just kind of give them a free pass. Empathy is helpful. Empathy is important. Having empathy and understanding maybe why someone developed the problem they had and that maybe there are some reasons why that happened to them and some bad things have happened. That's, that's a good thing. But allowing it to be an excuse is not a good thing. Right? Because I'm promising you it is not helping the mental health problem. It only ever makes it worse. Like, that's. It only, only ever makes it worse. It may feel really like temporarily in the moment, like it's helping your anxiety or helps you go to sleep or whatever. But I promise you, on the back end and on in the long run, it's making the problem worse. So you're not helping someone else by allowing that to be the case. And I see a lot of family members that just, they have so much empathy for the person or sometimes guilt, like parent guilt or guilt over something else will allow you to give the other person a passion. And, and they usually know that, right? The person with substance abuse problems, they know that and they play that card because like the ace card, and they know that it's going to work on you, right? So they, they whip it out there every single time. But it's a bad play if there are other issues. You have to address all the issues. But a lot of times, if you take the substance abuse off the top, a lot of those issues go away. Most of the time they go away. And the ones that are left usually get pretty infinitely better just by taking the substance abuse off the top of it. Right? And then what you have left is a lot more manageable. Now, the mental health problems probably will get a little worse at first because you're in withdrawal and your brain chemicals are stabilizing, so your anxiety is going to go crazy. You're probably going to feel depressed, you're not going to be able to sleep. I mean, there is a period of time where things may feel a little worse, but then they start to feel better and better and better and you get back on board. I have occasionally seen people who got sober whose depression did get worse, but with treatment, they were able to sort of get that, get that back on board. I'm just telling you there's no way the underlying thing is going to get better until you treat the addiction. And that. And that goes with the same thing as far as, like, when we try to tell ourselves It's. It's. It's a phase, right? It's just a time someone's going through in their life or, you know, they're just being a teenager, or they're just, you know, they're just partying in college. Everybody parties in college. And that's where you gotta do a little differentiating between what is normal. Teenager experimentation, rebellion, what is normal partying it up in college versus addiction. And if you want to know the difference, look at those 11 criteria, the ones I told you in the description. You can find the link to download that. So you can really see what makes something addiction versus something else. How do you know the difference? Because it is. It is different a lot of times. It's just when you've been dealing with it for a long time, families will come in and they'll tell me about something that's going on with their kid and that sometimes, I don't know. It's always hard to put my finger on sometimes. But, like, I can know immediately. I'm like, oh, this family's in trouble because it's about the context of the situation. Not, like, one thing. Like, I caught my kids smoking weed. That doesn't make me think that your kid has an addiction problem. Like, okay, what else. What else was. There's a lot of other factors in there. So if you're worried, you don't know whether it's just a phase of life issue or something else, then look at those criteria. Once you've decided addiction is part of that, even if it is during a phase of life, you must deal with the addiction. Let's see who's here with us. I want to hear what you guys have to say on it because you guys are my expert witnesses. We'll take a look. We'll answer your questions and your comments. Make sure you post those if you're watching live in the comment box. And I will try to get to it. If you're watching on the replay, put it in the comments. And I always come back. I read all of the comments, and I try to respond to as many of them as I possibly can. All right, let's see who's hanging out with us today. Hey, Megan and Jennifer and Jay. Let's see. Jay's got something to say. It looks like Jay says, I'm so glad you're covering this. I've been wondering about lately, about my partner. He says he's not on drugs, but he's been acting abnormal. He has ADHD and he's all over the place. So I Don't know. That can be difficult. I mean, someone with ADHD can be impulsive or hyperetic, but there's usually kind of a difference in ADHD and drug behavior. So if you know what the person's like before they had a drug problem, that's an easy way to tell. If they're just coming off of drugs, their behavior may be somewhat erratic or impulsive or moody or something like that. And that can be because of the withdrawal. So it sounds like what Jay's trying to figure out is, are they really off the drugs now or are the drugs still in play? But there are some behaviors that are just addiction related. And you. And you can, you know, the lying, the scheming, the manipulation, the stories that don't line up, the inability to accept no or limits. There are just some things that pretty closely related to addiction. So if you're seeing those, you can. You can start to sort of pull apart the pieces there. Hi, Sarah. Sue and. Hi. It's like, hello, Soleil. Hey, Amber. Managed. He managed to hide me his cross addiction for 10 years. Isolated me and put the guilt on me. Gaslighted me. Could he be npd? And npd, for those of you don't know, stands for narcissistic personality disorders. Why so many addictions? Is this due to mother neglect? Great question. There are. So. There's so much crossover between addiction behavior and narcissistic personality behavior that it can be hard to pull apart those pieces. And I actually, I have a video specifically on that. How to tell if it's addiction or narcissistic personality or both. Because it can definitely be both. Right? So. So you can check that out if you want the detailed answer to that. But one question I would ask you is if you know this person before the addiction took place, if it's a personality disorder, it will have always been there. Those same behaviors will have always been there. If they weren't really like that before, but they act like that now, and they're in an addicted state. It's probably more related to the addiction because all people that are addiction behave selfishly. All people that have addiction gaslight and manipulate and can't tolerate limits and all of those things which can look like narcissistic personality. I feel like that currently, the narcissistic thing is one of those buzzwords. And I feel like that happens in mental health. Like, they're just these phases that we go through just as a culture of, like, what everybody's thinking about, like, bipolar for a long time was like, the buzzword and everyone was bipolar, and then everyone's add and now I feel like the thing is narcissistic personality disorder. In my entire career of dealing with people that have addictions, I have probably met a handful of people five or less that I thought truly had narcissistic personality, sort of. So the chances that someone has an addiction versus that, it's a lot higher that it could be addiction related, which is actually really good news, because addiction is pretty fixable, to be honest. Narcissistic personality disorder is not so much. If you don't know the person before, then find someone who does know the person from before, like a family member, friend, and kind of get a feel for their behaviors before the addiction took place. And that. That's the biggest thing that can help you separate. Is it this or is it that, or is it both? Let's see. Facebook user says. Is that why a dual diagnosis rehab is more likely to help with recovery? Yes, dual diagnosis. From the strict definition of it, dual just means more than one, right? So it could mean I have depression and anxiety. I mean, from a technical standpoint, but usually clinically, when people use the term dual diagnosis, it means addiction and something else, right? It means addiction and anxiety, addiction and PTSD, addiction, addiction and bipolar. So if you're in a dual diagnosis facility, chances are they're going to focus heavily, maybe even mainly on the addiction for those reasons that we just talked about before. The interesting thing is that most addiction facilities, unless it's just like a sober living facility where they don't, like, have like, clinically trained people, also deal with mental health stuff, because almost everybody that has addiction has mental health stuff, right? So people that deal with addiction, counselors that deal with addiction, deal with all the other stuff, because you have to. Sometimes people that only deal with mental health stuff, though, don't necessarily feel comfortable with addiction. Honestly, it's not all that different. And mostly it's just in people's heads, but it freaks people out. It's like, oh, I don't deal with addictions. I don't know what to do with that, you know, and they. They will shy from it. So if someone is just in a mental health facility, they may not get help for the addiction. If they're in an addiction facility or treatment center, then it's more likely that you can get dual diagnosis help. But that's a really good question. Christine says, does addiction cause people to be a narcissist? Yes, it does. Really good question. Yes, it does. And the reason it does is because now it doesn't make people have narcissistic personality disorders because that clinical definition means it's like it's ingrained, it's hardwired into the person. Right. It will make people behave narcissistically which is different than making them have a personality. So does that make sense? It does because it puts you in such a desperation state all the time, in such a state of survival that you have to put your needs first all the time. Right. That's one of the things pieces. And then it gets a little bit more complicated psychologically. Right. The other pieces of it is that a lot of the ways you deal with the shame and guilt of the choices that you're making that you really know inside your heart are wrong. Is to make other people the villain. To not have empathy for other situations because it's almost like you close that part of your heart off as a way of protecting yourself from your own shame and guilt. So there are some psychological reasons and biological reasons why that happens. But the answer to the question is yes, people with addictions will behave narcissistically, but it doesn't mean they have that personality disorder necessarily. Great question. Almost impossible to know which came first. It can be difficult to pull apart. But honestly, the thing that you really need to know is. Or the thing that's really important is dealing with the addiction. Because if you take the addiction off and you see what's left, that's going to answer your question for you ultimately. And like I said, people can get tied up too much in trying to find the answer to that question and totally miss the boat. And Antonia says, I am so sad. My 28 year old son is utterly unreachable, in denial. He's abusive and angry with me, me and I just have to stay away. But he's really needy too. It's the push pull you, he won't comply with any help at all. That is really tough, that push pull thing. Right. Like it's like they're angry and they treat you crappy and they probably blame you for everything. But then it's like they also have this victim thing going on as well. It, it's this alternation between the victim role and the persecutor role. And the, the, the thing about that is, and I actually have a video coming out about that pretty soon is when we feel like we're the victim, when we feel sorry for ourselves, we use that self pity as a justification for being hurtful to other people. Right. Because we feel like, you heard me, I'm Hurt you back. Whether that's reality or not, that's kind of how we get into that persecuted role, is we justify it by being like, they had it coming for some reason, reason. Or they deserve it, or they need it somehow. Let's see. Hey, Jana. Do they have big shame? Why do they prefer to die than being discovered? Why do they need a woman to appear in their life? Is normal to the eyes of others? Are they dependent of women, too? Okay, hold on. Let. That's a few questions there. Let me. Let me dissect that down a little bit. Do they have big shame? Yeah, for the most part, they do. And it's kind of hard because, like, somebody else earlier asked the question is, does it make them narcissistic? They. They'll come across as narcissistic, but sometimes the narcissistic behavior is a reaction to the shame. So it looks like they don't care. It looks like they don't have empathy. But deep down inside, on, like, on the real heart level, they do. They know their behaviors are wrong, and they use the other stuff as a way to distract themselves from the shame. Why do they prefer to die than be discovered? That's a really good question. And the answer to that is, is because they feel like life without drugs or the substance or the addictive behavior isn't worth living. Because in their experience, when you're in activation, anytime you go without life is just hell, right? Like, you're physically sick, you're psychologically a mess. You. You don't have the capacity to experience joy or happiness. So in your mind, when you think. When you're an active addiction, you think about sobriety. It's just like, screw that, because you. You associate it with absolute misery. So it's not really why do they prefer to die than be discovered, it's why do they sometimes prefer to die than give it up? The being discovered is really. They don't be discovered because they don't want to give it up. Right. And it's because they don't. They can't imagine life without it. And they can't understand that actually life will get better eventually because they just associate it with such misery. Good question. Megan says, I had a manic episode when I was 23, but I was drinking and smoking and eating a lot of weed. I was diagnosed bipolar, but haven't had an episode since. That's interesting, Megan. And we see that actually with a lot of young people especially, and particularly from smoking a lot of marijuana will trigger, like, a psychotic break or an underlying mental health condition to come through, particularly with the drug marijuana. And it's like it activates it sometimes and if you stay off of the marijuana it usually, a lot of times it will go away and not come back. If you go back to using it, it usually comes back though once you've sort of activated that, it keeps re triggering the problem. Let's see here. Sammy Jo says all of the above with far and few between bouts of clarity. How do I keep him from making me mentally ill? That's a good question Sammy Joe. Right. And I have a lot of videos. In fact my video I released last week was about, you know, is someone else's addiction making you crazy basically and how to, how to find your sanity back. But you're right, if you're around it and you're, you're really close to it, it's going to suck you in. It's going to pull you into the vortex. Somebody put a comment on one of the, on the video that I was talking about that released last week. This is something like of course it controls your emotions. Like it's like watching your two year old run out in front of traffic and then other people saying why are you upset about it? Like, like you could concentrate on something else. Right. It's a very natural process. Tony says, I believe addiction comes from a dysfunctional family even if they can't see it. Well sometimes it can come from a dysfunctional family but not always. In fact most of the people we see in our office come from like really nice, really good, pretty functional families. Here's what I do think addiction will make a family dysfunctional. So maybe that's why it seems like it. Because if there's an addiction family there's usually dysfunction but sometimes it's the addiction bringing the dysfunction because is definitely you put addiction in a family it's going to make it dysfunctional every time. It's going to, it's gonna, it's just gonna be like a toxicity that's gonna totally just regulate everything. Let's see here. Jenny says, My 29 year old son is kind to me but doesn't take care of himself. Mental health wise. He seems not to be drinking and using but also sabotages any recovery he's in. He got kicked out of sober for not working. That's interesting. So he's not getting kicked out Jenny for like a relapse or something but he's getting kicked out for not working. So maybe what's happening is the addiction is being addressed and stabilized but the mental health problem isn't isn't being addressed or stabilized somehow, or the person's purposefully keeping themselves stuck somehow. I've seen that happen. And usually that will result in resuming the addiction at some point point, like get kicked out. Sometimes it's purposeful, sometimes it's not. But usually if it's left unchecked, we'll kind of come full circle. Thank you so much for everyone who joined us. I want you to watch next Andrew's Story, which is a video I did a while back. The reason I want you to watch that next is because it is the perfect example of dealing with the combination of mental health and addiction and the importance of recognizing both things and how do you treat both things and how do you get it under under wr? So I'm going to put it up here for you so you can check it out next. I think you're going to find it super interesting.