When I was a young kid, my teachers would ask, “Which came first: the chicken or the egg?” I hated that question because I never really understood what it meant. Once I started working in the field of addictions and mental health, though, the logic behind the question became clearer. The question can be applied this way: Does the mental health issue (e.g., depression, anxiety, bipolar, PTSD) cause the addiction? Or, does the addiction cause the mental health issue? Which comes first: the chicken or the egg?
Comorbidity and Concurrent Disorders
When two issues appear together they are said to be comorbid. Typically, addiction issues are often comorbid with mental health issues. When someone has been diagnosed with a mental health and addiction issue, they are said to have concurrent disorders. For example, a lot of people who develop an addictive behaviour (like gambling, alcohol use, Internet gaming, pornography) are concurrently dealing with some sort of personal mental health issue as well (like depression, trauma, or anxiety).
So, the question then becomes: did the addiction cause the mental health problem, or did the mental health problem cause the addiction?
With comorbid illnesses, it’s often difficult to know what causes what. The reason for this is because the symptoms of one illness often overlap with the symptoms of another illness.
For example, worrying excessively about things for a few months in a row (when there is no evidence to be worried about those things), is a common symptom of Generalized Anxiety Disorder. But, worrying excessively about things is also a common side affect of alcohol or drug intoxication. Over time, you can develop abnormal levels of anxiety that are being caused by the addictive substance.
In the end, if you are wondering whether your mood is being caused by your addiction, or vice versa, the best thing to do is to just start somewhere. It’s important that you at least start addressing the feelings, thoughts, and behaviours associated with one of these conditions – the emotional problem or the addiction. Since the two are connected, often times lessening the symptoms of one condition will lessen the symptoms of the other.
What matters is that you find a therapist with whom you feel comfortable with. Finding a therapist with whom you can build a healthy working relationship will allow you to make significant change in one – or both – of these areas at the same time.
To use the same metaphor as I started with: if you work with the egg, you’ll also be working with the chicken. And if you heal the chicken, you’ll also be healing the egg.
Hope this bit of psychology helps with your knowledge and understanding of comorbid conditions…
Links related to this post:
- Click here for a .pdf published by the American Psychological Association on comorbidity
- Click here for a good explanation on concurrent disorders by the Centre for Addiction and Mental Health.