We hear a lot in the recovery space today about dual diagnosis and co-occurring mental health issues when substance use disorder is brought up, 45% of people fall into this category. While true that many who suffer from substance use struggle with another mental health disorder, it does not always take a secondary diagnosis to explain the struggle that those affected by addiction have with emotional regulation. A large number of those who suffer from substance use often struggle to regulate even the most basic of negative emotions, and lacking appropriate coping skills to deal with life’s daily ups and downs is a reason many self-medicate. It’s important to know and understand if a secondary mental health diagnosis is present, however, equally important is an understanding of what regular daily life events create conditions to abuse substances.

How Can Anything That Leads to Addiction be Considered Basic?

To quote the basic text of Alcoholics Anonymous, a prominent 12step recovery program, “We were having trouble with our personal relationships, we couldn’t control our emotional natures, we were prey to misery and depression, we couldn’t make a living, we had a feeling of uselessness, we were full of fear, we were unhappy, we couldn’t be of help to other people–”. While basic may seem like a general and dismissive term, for alcoholics, this identifying paragraph is telling of how general the issue can be among that population.

• Anxiety – The anxieties of everyday life are difficult for many in this group to deal with. How bills will get paid, being overcommitted, or even the pressure to simply perform in their daily tasks can create anxiety. This often perpetuates a cycle that includes more substance use as it becomes a tool to manage this anxiety, and the action of using often makes these problems worse.
• Frustration – Those with substance use disorder often experience what can be seen as extreme frustration when things don’t go as planned. This frustration often quickly turns into anger that can end up directed inwardly as a form of self-loathing or outwardly at circumstances and other people.
• Insecurity – People with substance use disorder often feel inadequate, be it as a result of their substance use or, more commonly, due to an established pattern of negative self-image and low self-worth. This can lead to a number of other negative emotions that can be difficult to navigate, such as jealousy, anger, hurt, and self-pity.
• Sadness – Those with substance use disorder can often co-occurring struggle with depression, both situational and chronic. Symptoms and feelings that may worsen depressive episodes, such as loneliness, isolation, shame, and guilt, are often experienced by people who struggle with substance use. 
• Fear – At the root of many negative emotional responses for people with substance use disorder is fear, of the unknown, of rejection, of losing something they place high importance on. Whether the fear is founded or unfounded, it is often the motivator for many to act out in order to keep themselves protected from it.

On the opposite side of this scale, many that suffer from the disease of addiction are also prone to excessive positive emotions. An excessive need to celebrate a positive outcome can lead to an excuse to continue to drink or use or excitement and motivation can often mirror a manic state.

This inability to regulate their most basic emotions is a struggle many speak to having suffered from since they were children. Being unable to emotionally navigate life circumstances was often a reason to feel separate from others and in that isolation learn to bottle up the intensity of what they were feeling. This may have contributed to using and drinking behaviors for some as they moved into adolescence and early adulthood as they wanted to fit in with their peers who were able to manage things like rejection, sadness, or victory. Once substance use was aided in not only soothing whatever emotional upheaval they were experiencing but also allowed them to more comfortably connect with their peers, it gained the spot as a coping mechanism that worked. Even as consequences began to result from drinking and using, it was such a useful and needed tool it became impossible to let go.

This is where treatment and 12step or SMART recovery play such an important role. First, the identification that many others suffer from this ability to manage their emotional landscape. Secondly, that there are tools and coping methods outside of the substances they have relied upon. It can be essential to cure the isolation that exists when you believe no one struggles in the same way that you do, and connecting with people is the key that leads to healing. 

Ashley Addiction Treatment is an innovative treatment program located on Maryland’s Chesapeake Bay. Ashley provides support for professionals seeking help with addiction. We are able to help people with co-occurring disorders and offer confidential treatment programs to meet your needs. Please reach out to us today at 800-799-4673.