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Navigation: The Connection Between Substance Abuse and Mental Illness, Common Mental Health Disorders Associated with Substance Abuse, The Impact on Recovery Journey, Treatment Options for Dual Diagnosis, Seeking Help for Co-Occurring Disorders, Treatment Options for Co-Occurring Disorders, Conclusion


Substance abuse and mental illness often go hand in hand. In fact, according to the Substance Abuse and Mental Health Services Administration (SAMHSA), approximately 9.2 million adults in the US have co-occurring disorders. This means they have both a mental health disorder and a substance use disorder (SUD) at the same time.

Substance use disorder is a treatable mental disorder. It affects a person’s behavior, making them unable to control their drug or alcohol intake.

The symptoms of this condition can range from moderate to severe. In some of the worst cases, SUD can develop into a full-blown addiction. [1]

Sometimes it’s not clear which condition causes the other. They are often interconnected, and one can often exacerbate the other. The relationship between substance abuse and mental illness is complex and bidirectional. There are times they are not connected at all.

In this article, we will explore the connection between substance abuse and mental illness. We will also talk about how it can impact someone’s recovery journey. Finally, we will tackle the importance of dealing with both problems simultaneously.

The Connection Between Substance Abuse and Mental Illness

Dual diagnosis is when a substance use disorder co-occurs with a mental health disorder. The relationship between the two is complex and can vary from person to person.

Some people turn to drugs and alcohol as a way to cope with their mental health issues. Others develop mental health issues as a result of their substance abuse. In some cases, the symptoms of one disorder may mask the symptoms of the other, making it difficult to diagnose and treat.

When a person with a mental illness turns to substances to cope with the symptoms, this is called self-medication. It may provide short-term relief, but it only causes more problems in the long run. Substance abuse can affect the brain’s chemistry and exacerbate existing mental health issues. For example, drugs and alcohol can disrupt the balance of neurotransmitters in the brain, leading to or worsening symptoms of mental disorders.

There are also common risk factors that make certain individuals vulnerable to both conditions. Examples are genetic predisposition, environmental factors, childhood trauma, early exposure, stress, and neurobiological factors. [1]

Living in an environment that promotes substance abuse can contribute to the development of mental health disorders. Additionally, people with mental illness may find themselves in difficult situations that increase the likelihood of substance abuse. For example, they may experience peer pressure or isolation. [1]

We can say that in some cases, substance abuse leads to mental health disorders and in some cases it’s the other way around.

It’s crucial to recognize the interconnected nature of substance abuse and mental health. This allows health care providers to approach treatment with a comprehensive understanding of both issues. Seeking professional help from mental health and addiction specialists is often recommended for those who are facing these challenges.

Common Mental Health Disorders Associated with Substance Abuse

More than one in four adults who have a serious mental illness also has a substance use problem. But substance use disorders occur more frequently with certain mental health disorders such as depression, anxiety, schizophrenia, and personality disorders. [2]

Substance abuse can contribute to the development or exacerbation of depressive symptoms. Individuals struggling with depression may turn to substances as a way to self-medicate and cope with their emotional pain.

Conditions like generalized anxiety disorder, panic disorder, and social anxiety disorder are also commonly linked with substance abuse. Some people with anxiety may use substances to alleviate their symptoms temporarily.

Bipolar disorder is a mental health condition characterized by extreme mood swings or episodes of mania and depression. People with bipolar disorder experience periods of intense emotional highs, known as manic episodes, and periods of deep sadness or hopelessness, known as depressive episodes. Individuals with bipolar disorder may be more prone to substance abuse during manic or depressive episodes.

Substance abuse is common among individuals with schizophrenia, a chronic mental health disorder that involves distortions or exaggerations of normal functioning. Schizophrenia is typically associated with hallucinations, delusions, disorganized speech, and dysfunctional thought patterns. Substance use can worsen the course of schizophrenia and interfere with treatment.

Post-traumatic stress disorder or PTSD is a mental health condition that can develop in some people who have experienced or witnessed a traumatic event like combat or an accident. Some people turn to drugs and alcohol to cope with their trauma.

Similarly, individuals with attention deficit hyperactivity disorder (ADHD) may struggle with a dual diagnosis. It is a neurodevelopmental disorder that affects both children and adults. ADHD is characterized by persistent patterns of inattention, hyperactivity, and impulsivity that can impact various aspects of their life.

Other mental health disorders that are commonly associated with substance use disorders are: borderline personality disorder (BPD), eating disorders, and obsessive-compulsive disorder (OCD).

The Impact on Recovery Journey

It’s often difficult to tell which condition developed first. This is not always an issue, except for when mental health treatment services and addiction treatment services don’t overlap.

It can be difficult to handle a dual diagnosis through separate systems. Overall, it only makes diagnosis and treatment difficult. [3]

One of the biggest challenges for individuals with co-occurring disorders is getting an accurate diagnosis and receiving appropriate treatment. As mentioned earlier, the symptoms of one disorder may mask the symptoms of the other, making it difficult for healthcare professionals to identify and treat both issues.

This can lead to misdiagnosis and inadequate treatment, which can hinder an individual’s recovery journey. Without addressing both the substance abuse and the mental health disorder, the individual may continue to struggle and may be at a higher risk of relapse.

Increased Risk of Relapse

Patients with co-occurring disorders are at a higher risk of relapse compared to those with only a substance use disorder or a mental health disorder. If one condition is not properly addressed, it can trigger a relapse in the other.

For example, if a person with depression turns to drugs or alcohol to cope with their symptoms, they may experience a relapse in their substance abuse if their depression is not properly treated.

On the other hand, if an individual with a substance use disorder experiences a relapse, it can worsen their mental health symptoms and potentially lead to a relapse in their mental health disorder as well.

Difficulty in Maintaining Sobriety

Individuals with co-occurring disorders may also have a harder time maintaining sobriety compared to those with only a substance use disorder. This is because their mental health issues can make it challenging to cope with triggers and cravings, which are common in the recovery journey.

Without proper treatment for their mental health disorder, recovering individuals may turn to drugs or alcohol as a way to cope with these challenges, leading to a relapse. This can create a vicious cycle of substance abuse and worsening mental health, making it difficult for individuals to maintain their sobriety.

Treatment Options for Dual Diagnosis

To effectively address co-occurring disorders, it is crucial to treat both the substance use disorder and the mental health disorder simultaneously. This is known as an integrated treatment approach, where both disorders are treated as equally important and interconnected.

Integrated treatment involves a team of healthcare professionals, including therapists, psychiatrists, and addiction specialists. They will work together to develop a comprehensive treatment plan that is personalized based on the patient’s specific needs.

By acknowledging both problems, it helps reduce stigma associated with both conditions. It promotes a more compassionate and understanding approach to those who are facing these challenges.

A holistic approach to treatment addresses the complexity of the condition. It recognizes the individual as a whole and recognizes the interplay between mental health and addiction. This approach is more likely to result in long-lasting positive changes.

Addressing both substance abuse and mental illness simultaneously can even lead to improved outcomes. By treating both disorders, individuals can experience better mental health, reduced symptoms, and a decreased risk of relapse. During treatment, patients even learn healthy coping mechanisms and skills to manage their mental health and substance abuse. This will come in handy once they are out of rehab.

Seeking Help for Co-Occurring Disorders

If you or a loved one is struggling with co-occurring disorders, it is essential to seek help from a professional treatment center. A treatment center that specializes in dual diagnosis can provide the necessary support and resources to address both disorders simultaneously.

Remember that the best treatment for dual diagnosis is an integrated approach, wherein both disorders are tackled simultaneously. Whether addiction came first or the mental illness developed first, it doesn’t matter at the end of the day. A treatment facility that specializes in dual diagnosis will take care of both. [4]

The exact treatment approach may vary from person to person, but they generally include a combination of medication-assisted treatment (MAT), detoxification, counseling, therapy, and self-help measures.

No matter how overwhelming your situation may be, there is always hope. Even though they are co-occurring disorders, both of these are treatable conditions. They may take time, commitment, and courage, but you can recover from your dual diagnosis. [4]

Even if you relapse, remember that it is a part of the process. Don’t get too discouraged as relapses are common. Setbacks may happen during treatment. With hard work, you can make lasting changes in your life.

Treatment Options for Co-Occurring Disorders

Addressing co-occurring disorders requires a comprehensive approach that considers the complexities of both conditions.

Integrated Dual Diagnosis Treatment (IDDT) is an evidence-based approach that integrates mental health and substance use disorder treatments into a cohesive, comprehensive plan. This model recognizes the interconnected nature of these conditions and provides simultaneous, specialized interventions to address both aspects.

Therapists in IDDT programs are often trained in both mental health and substance use disorder treatment, fostering a more holistic understanding of the individual’s needs.

Medication-Assisted Treatment (MAT)

MAT involves the use of medications to assist in the treatment of substance use disorders. For patients with co-occurring disorders, medications can play a crucial role in managing both the mental health symptoms and substance cravings. Examples of medications used in MAT include buprenorphine for opioid use disorder and Acamprosate for alcohol use disorder.

Cognitive-Behavioral Therapy (CBT)

CBT is a widely used therapeutic approach that focuses on identifying and changing negative thought patterns and behaviors. In the context of co-occurring disorders, CBT can help patients recognize the connections between their thoughts, emotions, and substance use. This type of therapy equips individuals in recovery with coping strategies and problem-solving skills, contributing to a more stable recovery.

Motivational Enhancement Therapy (MET)

MET is a client-centered therapy that aims to enhance an individual’s motivation to change. Especially effective in addressing substance use disorders, MET helps individuals explore their ambivalence about change and develop a personalized plan for recovery.

This approach is adaptable to the unique needs of individuals with co-occurring disorders, fostering a collaborative and empowering therapeutic relationship.

Dialectical Behavior Therapy (DBT)

DBT combines cognitive-behavioral techniques with mindfulness practices. Originally developed to treat borderline personality disorder, DBT has shown effectiveness in addressing substance use and emotional dysregulation.

The emphasis on acceptance and change makes DBT particularly beneficial for those who are struggling with co-occurring disorders.

Peer Support and 12-Step Programs

Peer support groups, such as Alcoholics Anonymous (AA) and Narcotics Anonymous (NA), provide a sense of community and understanding.

Engaging in a supportive network can be instrumental in the recovery journey, especially for those with co-occurring disorders. 12-step programs offer a structured framework for addressing both substance use and mental health concerns, promoting ongoing recovery efforts.

Aftercare Planning

Aftercare is an essential part of the recovery journey for patients with co-occurring disorders. Aftercare involves ongoing support and resources to help individuals maintain their sobriety and manage their mental health.

Some aftercare options include: therapy sessions, support groups, sober living homes, and continuing medication management.


Simultaneous treatment of co-occurring disorders can lead to better overall outcomes. Treating only one aspect of the problem may leave the patient vulnerable to relapse or a recurrence of mental health symptoms. Integrated treatment approaches, which consider both mental health and addiction, have been shown to be more effective in promoting sustained recovery.

Substance abuse and mental illness are often interconnected, with one leading to the other. It is crucial to address both issues simultaneously to achieve successful outcomes in recovery. With the right treatment and support, individuals with co-occurring disorders can overcome their challenges and lead a healthy, fulfilling life.

If you or someone you love is struggling with addiction, mental health issues, or both, look for a rehab center near you today and learn about the various treatment options that are available.







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Fel Clinical Director of Content
Felisa Laboro has been working with addiction and substance abuse businesses since early 2014. She has authored and published over 1,000 articles in the space. As a result of her work, over 1,500 people have been able to find treatment. She is passionate about helping people break free from alcohol or drug addiction and living a healthy life.

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