The Cobra Effect – when the solution is worse than the problem

Addiction and Mental Illness - two heads of the same snake.

I have often rejected the use of the term “mental illness” to describe my depression due to the negative connotation. But I have recently recognized the benefit of properly classifying it as such. It is an illness, in the same way that diabetes is an illness. I cannot stop it or will it away any more than a cancer patient can stymie or wish a tumor away. So, for the purposes of this post, I will refer to it accordingly.

Addiction and mental illness are complex, often harrowing journeys that millions of people around the world grapple with. What can begin as a comfortable blanket often mutates to an imminent noose. An all-encompassing, overwhelming, and treacherous seduction. As with mental illness, addiction is a relentless battle against an overpowering force that can feel like a never-ending struggle.

Mental health problems and addiction often work side by side. Many people with substance use disorder (SUD) also suffer from depression, anxiety, and/or other mental health disorders. Mental illness may contribute to substance use and addiction. Substance use and addiction can contribute to the development of mental illness.

Establishing causality or directionality for which came first remains to be conclusively proved. While doctors and scientists are not sure of the exact link between SUD and mental illness, it is widely recognized that both conditions share several of the same key risk factors, namely: genetics, environment, stress, and trauma.

The "Cobra Effect" is a phenomenon likened to British colonialism in India. When pure intentions lead to perverse results. It is an analogy for the effect substance use has on mental illness and vice versa.

During the time of British rule of colonial India, the British government developed a program to combat the problem of deadly cobras roaming the streets of New Delhi. They introduced what appeared to be a clever solution, pay a bounty to any citizen who brought forward a cobra skin. The “cash for snakes” program worked like a charm for a while, and the streets were cleared of poisonous reptiles.

But a shift happened, and the payouts began to increase at a staggering pace. When British officials investigated, they discovered an unexpected consequence. Enterprising Indians, realizing the foolishness of the bounty system, took it upon themselves to breed cobras, and were being paid handsomely for their trouble.

Outraged and refusing to be taken advantage of, British officials immediately canceled the program. Consequently, all the cobras that were being bred by entrepreneurial Indians were released onto the streets, making the original problem of cobras far worse. As a result, the government wasted tons of cash, only to end up with a much bigger problem.

Now known as the “Cobra Effect,” the incentive refers to a situation in which a solution to a problem ends up making the problem worse. The plague of impulsive fixes that often backfire, resulting in unintended consequences, is a metaphor for the attempts many people make to self-medicate away their pain. If you give someone who is in pain the opportunity to get rid of that pain in an instant, more often than not, they will take it, even if they know that the pain will be worse in the future.

“The road to hell is paved with good intentions.” - Unknown

Thankfully, both mood disorders and alcohol and drug abuse problems are treatable conditions. Recovering from co-occurring disorders takes time, commitment, and courage, but people with substance abuse and mental health problems can and do get better.

The best treatment for comorbid disorders is an integrated approach, where both the substance abuse problem and the mental illness are treated simultaneously. Long-term recovery depends on getting treatment for both disorders. Treatment for mental health issues may include medication, individual or group counseling, behavioral therapy, lifestyle changes, and peer support. Treatment for substance abuse may include detoxification, managing withdrawal symptoms, behavioral therapy, lifestyle changes, and support groups to help maintain sobriety.

In addition to getting professional treatment, sustained recovery depends on learning healthier coping strategies and making better decisions when dealing with life on life’s terms. Helpful DBT skills include:

• Mindfulness

• Emotional Regulation

• Distress Tolerance

• Trigger Awareness

Recovery combines four primary centers of attention to support a healthy life. Action items include:

1. Health – making informed, healthy decisions that support physical and emotional wellbeing.

2. Home – a stable and safe place to live.

3. Purpose – meaningful daily activities and the resources to participate.

4. Community – connecting with others through support groups, friendships and socializing.

Addiction and mental illness are two heads of the same snake. Hiding in plain sight, masters of patience and strategy, waiting to strike. And like a snake, life sometimes requires us to shed the old to make room for the new. Recovery is a lifelong process that reminds us to cultivate these qualities in our own lives. Through patience, perseverance, and progress, not perfection or quick fixes.

“If nothing changes, nothing changes.” - Unknown

I hope you will join me in reconsidering the complexities and magnitude of these diseases and the lifelong battles that we wage to overcome them. Stay tuned for more!

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