Mental Illness and Smoking

[Dr_Hurt]

The percentage of people who smoke is significantly more among those who have been diagnosed with a mental illness compared with those who do not have any mental health problem.  While there may be many reasons for this, one factor is that many people who care for those with mental health problems have not considered it a priority.  For a long time the thinking seems to have been…”people with mental illness have enough to worry about without trying to stop smoking, plus it’s almost impossible for them to quit.”

While it is important to manage serious mental health symptoms, stopping smoking should be kept on the list of goals, and attempts to stop smoking should be encouraged during times that the psychiatric symptoms are stable.  Each time a person makes an attempt to stop smoking, the likelihood of success increases.  So even if a quit attempt doesn’t “stick”, it is better than not making a quit attempt at all.  People with a mental illness diagnosis CAN be successful at stopping smoking, and their chances of success increases with proper support, encouragement, and use of proven effective techniques. It is important to keep in mind that smoking is the single most likely cause of death among people with mental illness.  They deserve help for stopping smoking just as much, if not more, than everyone else. To learn more about EX and our free quit-plan where you or a loved one can re-learn life without smoking, visit www.BecomeAnEX.org.

Dr. Richard D. Hurt is an internationally recognized expert on tobacco dependence. A native of Murray, Kentucky, he joined Mayo Clinic in 1976 and is now a Professor of Medicine at its College of Medicine. In 1988, he founded the Mayo Clinic Nicotine Dependence Center and since then its staff has treated over 33,000 patients for tobacco dependence. Send your questions directly to Dr. Hurt at AskTheExpert@becomeanex.org

[JoAnne5-14-2008]

HAVE YOU LOST YOUR MIND!!.  I disagree with this non-sense.  Are you saying that the majority of smokers are mentally ill.  I've never agreed with any of your statements and I do believe you should keep them to yourself.  I don't think you are helping anyone who is trying to succeed in quitting.  Statements like these are truly unfounded and are the opinion of one person. I don't care if you do have the DR in front of your name.  We are here to help people in their journey to being smoke friend, not to diagnose anyone as being mentally ill.

[interstate_anna]

Did you even read his post?

[interstate_anna]

...because if you did, you would have obviously read that he is not diagnosing anyone with a mental illness.

In your very poignant words: "Statements like these are truly unfounded and are the opinion of one person."

Thanks Dr. Hurt for the helpful and informative post.

[firefall]

wutsa smoke friend?

[JoAnne5-14-2008]

typo - "smoke free"

[nan]

Sorry JoAnne but I do agree with the Doctor. I don't think he's saying that smokers have mental illness, but that mental illness, such as clinical depression, can be a contributing factor to continue smoking. Also I've seen several posts from people who've been concerned about depressive symptoms early on in their quits. Is the entire notion of mental health a stigma issue for you? Because addiction in itself is often, not only physical, but a psychological dis-ease. Maybe next time if you just don't read the doctor's blogs, it'll save you some aggravation; or, maybe next time if you don't agree with someone's post, you don't comment. We are here to help people in their journey of being smoke free, not to bite people's heads off if we don't agree with their blogs. The doctor's blogs may be of help to others. 

"Statements like these are truly unfounded and are the opinion of one person."

[mlynne]

I interpreted Dr. Hurt's message to say that among those with a mental illness, there is a higher percentage who smoke (not that the majority of those who smoke have a mental illness). Whether or not it is true in general, I have experienced moderate depression since I quit smoking six months ago. I've also had episodes of depression off and on throughout my life, so it came as no surprise.

It would stand to reason that if a medication such as bupropion (Zyban, Welbutrin) which is prescribed as an antidepressant, can also help curb the desire to smoke, that the two are strongly linked. However, as many of us EXes can testify, depression can and often does occur in current smokers as well as those who have quit and those who have never smoked.

[annie20]

I think that's very good information.   For folks with those kinds of challenges, no matter how small or fleeting they may be,  mastering a quit could mean quite a lot in more ways than one.  To all of us for that matter.   It's insane that any of us smoked!

Thanks for the info.

Annie

[ghjoest]

i respect ur proffesional opinion, and maybe ur right, but funk that mental illness stuff. to me everybodys got some sort of quirp or something and to use a name of something (diagnosis) for a crutch is nonsence. but, i stand on both sides of the fence because there is alot of information and studies about all of this, and u cant deny that type of thing. so, low and behold a smoker is a smoker regardless of the demographic they are in...ie ethincity creed or moral standpoint, even supposed illness (wether metal or physical). anyhow, how do u post a picture on here id like to do before and after type things of how smoking affects a body 🙂 have a good day all and keep striving for whatever makes u feel better and betters urself

[AutumnWoman]

Well, I will own up to having a long-term history of depression.  In the course of seeking treatment, I have brought up the fact that I wanted to quit smoking to the mental health practitioners I saw.  My experience was much as Dr. Hurt indicated: They were more concerned about my mental/emotional state than they were about my quitting smoking.  In fact, I was steered away from Zyban and Chantix because my therapist was afraid of adverse reactions.  The doctor who was most proactive in getting me to stop was my cardiologist.  I think the mental health practitioners are satisfied as long as the patient is functioning and stable.  I was told many times that I was "doing well", even though I was smoking a pack a day and having problems with emotional eating.  The patient has to find their own answers to addictions, although the doctors were pleased and suppoprtive when I announced I had been quit for a while, thanks to this site and the people here.

[jaynalynn]

Excellent topic that I am glad you brought up Dr. Hurt and extrememly important to me.  The only thing I can attribute to this discussion is explain what I am going through.  When I was younger I was very fortunate to have a very upbeat personality and rarely suffered even from a cramp while menstruating.  After the birth of my first child (then two more) my mental health slipped downward due to the chemical and hormone changes that occured in my brain.  Finally admitting I needed help and meeting with several physicians I was diagnosed with PMDD, MDD, and Anxiety.  I have been on antidepressants for many years and will most likely be for life. 

For you cynical ones, we are not discussing being sad, down, or having the boo-hoo's here.  We are talking clinical depression.

When I decided to quit smoking I did quite a bit of research and was ready for the first 78 hours, hell week, maybe a couple more weeks of cravings and a little depression because I was loosing "my best friend".  I was in no way prepared for the severe depressive episode quitting would throw me into.  There is a little information stating that various types of medications may need dosage changes due to the fact that the brain was no longer receiving nicotine.  This information was minimal and did not discuss what to expect or how to get help.  I have been smoke free 6 weeks in which 4 weeks have been absolute hell.  I had no warning that this was a possibility.  I have searched ,without much luck, everywhere for information regarding this type of situation.  There are zillions of books and articles on the first couple of weeks but not much about what happens to the body/brain after the first stages.  The couple articles relating to the months that follow are minimal and offer very little information or any scientific research.  Ironically, I do not want to go back to smoking but feel like I might have to in order to get my sanity back.  With my last quits I would have jumped at any excuse to go back to smoking but this time I really don't want to ever go back.  Fortunately I have a great psychiatrist who is helping me get my medication straightened out.   I am holding onto my quit with all I've got.  But I sure would like to know more about this problem, read scientific research regarding the changing mind, and have been better prepared for this.

I wonder when you speak of the people with mental health issues if these individuals have any access to the internet or support groups that we do.  This has been a life line for me.  Depending on the severity of the individuals mental health I have to question if they would have the ability to get through a severe depression like mine without the constant support of a doctor and the constant support of websites such as this one.

[lfran]

I a planning on quitting on 12/8 and I have been on antidepressants and also smoked cigarettes for most of my adult life, I'm 49.    I am well aware of the possibility that my depression may raise it's ugly head when I quit smoking and that is one of the main reasons I have avoided quitting all these years.  I'm not sure how quitting is going to affect me mentally but I can't go on poisoning myself for fear that I'll have a relapse when I quit.  I'm going to try hypnosis and relaxation techniques to help myself become an ex-smoker.  If I have to increase my medication when I quit, that's a choice I'll make at that time.  I think the benefits of being an ex-smoker will far outweigh any negative affects of more medication.  I sure could use some positive feedback from anyone out there who has quit successfully while also taking medication for depression.

Thanks.

Lisa

[shandrea]

I am really trying to quit smoking, i do have an anxiety disorder, and i think with cigs out of my life it will get better, i can go all day without a cig, but after a certain time i feel the itch and cant over come it, yet also in a way i try to use it as a weight loss helper, i know if i quit i will end up with an ass 4 axe handles wide, ohhh god  i dont want that , it does curb appitite, so maybe i have a mental illness cause i am all screwed up,. i just dont know anymore, but thanks doc for the info , Shandrea

[ninalana]

  

I see what your saying !!

  

I work at a behavioral health facility and work with people who have extreme diagnosis. I myself am bi-polar as well as PTSD. I spend 60 hours a week one on one with these peers and watch them comb the parking lots for a sort of cig-butt they can find. Their fingers are all stained deep cracking yellow and it's so sad there are plenty of times a day I cry. I am 3 day no smoking as of today and It's the second time in my life Ive ever quite. The first time was with chantix before they changed the ingredients and I was good one year.After they changed the ingredients I became extremely manic and was taken off by my dr. I decided 3 days ago I need to be healthy for ME but also my FAMILY as well as the people I work hard for, my peers.

  

Out of the 150 people I work with (clients) I can only think of 2 who do not smoke. I teach other's to learn new coping skills, and I feel I need to practice what I preach. I am not saying people who smoke have mental illness, I am agreeing that people who have been diagnosed what I have seen are smokers. We are all in this together.

[marie23]

Good Luck and God's Grace for us all when it comes to coping skills. That is what we all need in life to have a healthy balanced life. Whether we smoke or not life will always be a challenge and the better we can deal with it the happier and better quality of life we will have. I myself  deal with anxiery and depression and I know my smoking was connected with that. Bonnie gave us a great list of healthy foods to balance our body and minds. I was seeing a shrink a few years ago he precriped meds and told me not to worry about my smoking so I do understand this article and we should  ALL be non-smokers and get the help and support we need and all the medical filed should be aware of this.

[ninalana]

You Rock!!

[mosaic42]

I've actually had a psychiatrist advise me NOT to try to quit smoking.  I was undergoing some intense therapy and medications for mental health were not quite working at the time.  She felt that my smoking was actually helping me to cope and didn't want me to add the stress of quitting to my life.

[mosaic42]

One thing that is important to note is the effect of nicotine withdrawal.  Sleep disturbances and anxiety are increased.  So it makes sense that mental health professionals are more concerned with patient mental stability than with the unhealthy habit of smoking. 

I have quit smoking before but as one addict told me, smoking was harder for him to quit than heroin.  So I acknowledge that quitting is essential but very difficult.  With many drugs, the half-life of the chemicals is the key.  But with smoking, it is a way of life as well as a chemical drug.  Quitting smoking involves both changing lifestyle AND chemical withdrawal. 

So, I understand the psychological impact of smoking and why those in the mental health profession are not as concerned about smoking.  But I also understand that I am poisoning more than my lungs with cigarettes.  For example, with new bone growth, nicotine is actually going into the new growth.  For anyone recovering from a broken bone or spinal fusion where bone growth is encouraged, it is important to note that the poison is entering into the new bone.  That is what has got me so concerned about quitting smoking.