Self‐Medication with Alcohol or Drugs for Mood and Anxiety Disorders

Substance use is one way that people deal with the difficult symptoms present in mood and anxiety disorders. As people become more reliant on the effects of the substances to relieve distress the use can develop into dependence. Self‐medication has been proposed as a reason for the high rates of comorbidity between mood and anxiety disorders and substance use disorders.

A recent review, published in the Journal of Depression and Anxiety, has examined the current literature on the prevalence of substance use as self-medication, the comorbidity between mood and anxiety disorders and substance use disorder and the clinical implications.

Results from their search show that the prevalence of substance misuse among those with mood or anxiety disorder ranged from 21.9% to 24.1%. 

Characteristics that are particularly associated with substance use as a means of coping are being male, younger age, being separated, divorced or widowed, and being Caucasian.

The authors of the review also found evidence from longitudinal studies that linked self-medication for mood and anxiety disorders as a predictor of incidence and persistence of substance use disorder.

The presence of mood and anxiety disorders has been associated with increased relapse and poorer treatment outcomes among those also being treated for substance use disorders. The current “gold standard” model of care is the joint treatment of mood/ anxiety disorder and substance use disorder. The researchers suggest the development of skills, such as enhancing motivation, creating a positive supportive environment, learning to tolerate distress, and preparing for possible relapse may be useful when treating people with both mood or anxiety disorder and substance use disorder.