Schizophrenia And Addiction

What’s The Link Between Schizophrenia And Addiction?

Schizophrenia and addiction, or substance use disorder (SUD), often co-occur, with an estimated 50% of individuals suffering from schizophrenia having a history of substance abuse.

One link between the two is genetics, which plays a major role in the development of both disorders. Three distinct genes, encoding brain-derived neurotrophic factor (BDNF), catechol-O-methyltransferase (COMT), and protein kinase B (AKT), are known to have a strong relationship with both schizophrenia and substance use.

Another link between schizophrenia and addiction is known as the diathesis stress model or two-hit model, meaning that the neurobiological component of schizophrenia (altered neurotransmitters and brain structure), combined with environmental stressors such as substance abuse, increases the risk for schizophrenia.

Researchers believe that people with schizophrenia have a dysfunction related to the brain reward circuit, meaning that this dopamine dysregulation makes pleasurable things less pleasurable, increases their lack of motivation, and contributes to negative symptoms of schizophrenia, such as:

• Flat affect (limited emotional expression)
• Alogia (reduced speech)
• Avolition (lack of motivation)
• Asociality (social withdrawal)
• Anhedonia (inability to feel pleasure)

When schizophrenia symptoms arise, people may use substances to self-medicate these unnerving symptoms, increasing their risk for developing a substance use disorder.

Certain substances, like marijuana, cocaine, and amphetamines, can also exacerbate schizophrenic symptoms and worsen their severity.

What Is Schizophrenia?

Schizophrenia is a brain disorder that affects about two million Americans and is caused by a complex combination of factors such as genetics, alterations in brain chemistry, and environmental factors. It affects how a person thinks, feels, and behaves, and people are usually diagnosed between 16 and 30 years of age after their first psychotic episode.

Individuals suffering from schizophrenia are often unable to distinguish the imaginary from reality. It is marked by symptoms of hallucinations, delusions, and negative symptoms such as the inability to feel pleasure.

People with schizophrenia may have difficulty responding to various social situations in an emotionally appropriate manner. This often results in issues with interpersonal relationships or in other major areas of their life, such as at work or school.

While the direct cause of the disorder is still unknown, researchers believe it is linked to the following factors:

Genetics

Schizophrenia tends to run in families. In fact, it occurs in 10% of people with a first-degree family member, such as a sibling or parent, who has the disorder. If both parents have schizophrenia, the risk jumps to approximately 50%.

If an identical twin has schizophrenia, the risk for the other twin is about 40% to 50%. Researchers believe certain genes inherited from one’s parents may increase the risk of developing schizophrenia.

Scientists have also found that people with schizophrenia often have rare genetic mutations that may disrupt brain development.

Brain Structure And Chemistry

Imbalances of certain chemicals in the brain, such as glutamate, serotonin, and dopamine, are linked to schizophrenia. These imbalances affect the way the brain reacts to stimuli and can lead to hypersensitivity and hallucinations—common symptoms of schizophrenia.

Additionally, scientists have found small differences in the brain structure of those with schizophrenia. These differences include decreased gray matter, enlarged ventricles (cavities in the center of the brain filled with fluid), and increased or decreased activity in some brain areas.

Environmental Factors

Some scientists believe a person’s environment, combined with genetics, may also play a role in the development of schizophrenia. Environmental factors may include health-related problems occurring during birth, such as exposure to infections, viruses, or malnutrition. But it can also include childhood trauma and substance abuse.

Schizophrenia Symptoms And Effects

Schizophrenia is characterized by a broad range of symptoms that make it hard for the affected person to function normally. Symptoms vary and may be cognitive, behavioral, or emotional.

Common schizophrenia symptoms include:

Delusional Thinking

An individual suffering from schizophrenia may have beliefs or thoughts that are not based in reality. These delusions can be about anything and are usually based on misinterpreted sensory experiences (e.g., seeing a light flicker and thinking it’s a signal of some sort). Delusions may include:

• Feeling harassed or threatened by someone, real or imaginary
• Believing one has an incredible fortune or a mystic power
• Feeling that a disaster is about to happen
• Thinking they are someone else, like a historical figure or celebrity

It can be very difficult to convince someone with schizophrenia that these delusions are false.

Hallucinations

Hallucinations are when an individual hears, sees, smells, or feels something that does not exist. Someone suffering from schizophrenia might be immersed in an experience that has no actual basis in reality. Hearing voices is one of the most common hallucinations among those with schizophrenia.

Disorganized Speech

Disorganized speech results from disorganized thinking. Those with schizophrenia often have difficulty organizing and maintaining their thoughts. This can lead to sudden, mid-sentence topic changes or to meaningless words or gibberish that is difficult to understand. The person may also repeat words and phrases, use rhyming words, or make random, illogical statements.

Disorganized Motor Or Catatonic Behavior

Individuals suffering from schizophrenia might exhibit disorganized, almost childlike motor behavior. This behavior can include excessive movements, strange postures, and a lack of impulse control. The person may also go in and out of a catatonic state, in which they will not speak, move, or respond to communication.

Negative Symptoms

Negative symptoms of schizophrenia are the absence of normal emotional and motivational behaviors. These symptoms often present years before a person has their first schizophrenic episode—when psychotic symptoms, like hallucinations and delusions, set in. Negative symptoms are often mistaken for other mental health issues, such as depression or anxiety disorders.

Common negative symptoms of schizophrenia include:

• Lack of interest or motivation
• Diminished emotional expression
• Changes in sleep patterns
• Becoming socially withdrawn
• Not caring about their appearance or hygiene

Can Substance Abuse Cause Schizophrenia?

The causes of schizophrenia are believed to be multifactorial, meaning that many different factors play a role in increasing the risk of schizophrenia. Substance abuse is not a direct cause of schizophrenia.

However, substance abuse is a known environmental factor that increases the risk of developing schizophrenia. Individuals with addiction may have an increased risk of developing schizophrenia if they also have the genetic and neurobiological risk factors associated with schizophrenia.

Why Do People With Schizophrenia Abuse Drugs And Alcohol?

It is believed that people with schizophrenia abuse drugs to help cope with their symptoms as a way to feel relief. Sadly, people with schizophrenia are at higher risk of poverty and homelessness since psychotic symptoms can ​​disrupt education and employment. They may use drugs and alcohol to deal with the social shame associated with poverty.

Schizophrenia is associated with a dysfunction in the brain’s reward system, and people may use dopamine-filled drugs and alcohol to increase the pleasure sensations they are lacking.

How Is Schizophrenia And Addiction Treated?

When treated independently, treatment for schizophrenia and addiction both typically involve a combination of treatment medications, therapy, rehabilitation education, and support groups.

Dual diagnosis or co-occurring disorder programs work by treating both schizophrenia and drug addiction simultaneously, instead of as two separate conditions.

Generally, detox—the process of removing drugs from the user’s system—is the first step in dual diagnosis treatment. Once the user’s body is free of the substance, a clinical team can better assess the patient’s schizophrenia symptoms and determine the next steps of addiction treatment.

Antipsychotic medications are usually prescribed to help alleviate symptoms of schizophrenia caused by chemical imbalances in the brain. Sometimes, several prescriptions may be tested before finding the right medication to treat a patient’s specific chemical imbalance.

One of the most common forms of therapy used in dual diagnosis is family therapy. Many individuals suffering from schizophrenia are part of high-stress families. Family therapy can help to reduce the amount and severity of stressors that can act as a trigger for both schizophrenia and substance abuse.

Cognitive behavioral therapy (CBT) is another common type of therapy used to treat co-occurring schizophrenia and addiction. CBT helps the patient identify specific behaviors or ways of thinking that contribute to their addiction, as well as their schizophrenia. It can also help patients learn to manage symptoms of schizophrenia, such as auditory hallucinations, that may persist even when taking antipsychotic medications.

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Can People With Schizophrenia And Addiction Fully Recover?

While there is no cure for schizophrenia or addiction, full recovery in terms of symptom relief is possible for both disorders.

Medication and psychotherapy approaches for schizophrenia have shown remarkable progress in symptom control, and studies show that approximately 60% of people with schizophrenia show drastically improved outcomes with appropriate treatments, with up to half of this number achieving a full recovery, meaning they return to their previous level of functioning.

People with addiction can fully recover, living a drug and alcohol-free life. To achieve this, most people need to enter a treatment where they receive medication management and therapy tools needed to be successful in their recovery. People may need to be on medication and attend therapy as a lifelong treatment protocol to keep symptoms at bay.

Find A Treatment Center Today

Recovery from schizophrenia and addiction is possible. If you or a loved one is suffering from co-occurring disorders, there are treatment options available. Contact a treatment provider or visit our rehab directory today to learn more.