Self-medication for Mood Disorders in San Diego

One of the reasons that people abuse alcohol and other drugs is to manage their emotional distress. This is known as the self-medication hypothesis. This hypothesis has been proposed as an explanation for the frequent co-occurence of anxiety and substance use disorders.

Recently, Bolton and his colleagues used data from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), a large (n=43,093, age 18 years and older) nationally representative survey of the U.S. population to test the self-medication hypothesis. They looked at the rates of self-medication among individuals with four types of mood disorder: dysthymia, a milder form of chronic depression; major depression; bipolar I, a mood disorder that includes bouts of mania and depression; and bipolar II, a mood disorder that includes bouts of hypomania, less severe than full-blown mania, as well as depression.

Overall, nearly one-quarter (24.1%) of individuals with any of the four mood disorders listed above used alcohol and drugs to manage their moods. Self-medication was even more prevalent among individuals with bipolar disorder. During depressive episodes, 41.0% of individuals with bipolar I disorder and 34.7% of those with bipolar II disorder engaged in self-medication with alcohol and other drugs of abuse.

Men were more than twice as likely as women and divorced and widowed individuals more likely than others to engage in self-medication. On the other hand, African-Americans, Asians, Hispanics and Pacific Islanders and individuals over the age of 44 years were less likely to self-medicate. Thus, younger, divorced, white males with mood disorders are the subgroup in the population most likely to engage in self-medication.

Bolton and his colleagues also found that individuals who self-medicated for mood disorders were more likely to experience co-occuring anxiety and personality disorders than those who did not self-medicate for mood disorders. Self-medicating men were more likely to suffer from panic attacks while self-medicating women were more likely to suffer from generalized anxiety disorder. Both genders of self-medicators were more likely to meet the diagnostic criteria for dependent personality disorder.

Lasting Recovery as a dual diagnosis enhanced substance abuse treatment program can help individuals who suffer from mood and other mental health problems associated with their substance abuse/dependence.

Reference: Bolton JM, Robinson J, Sareen J. Self-medication of mood disorders with alcohol and drugs in the National Epidemiologic Survey on Alcohol and Related Conditions. J Affect Disord. 2008, Nov 10.

Arthur J. Farkas, Ph.D.