top of page

The Silent Struggle: Understanding the Relationship Between Mental Health and Substance Abuse

Individuals with mental illness often resort to alcohol or drug misuse to cope with overwhelming symptoms, leading to a dual diagnosis, also called co-occurring disorders. Mental illness and drug misuse are interrelated problems affecting millions worldwide. These issues significantly impact individuals' lives and can result in a long-term negative impact on your physical and mental health.

According to the the NSDUH (National Survey on Drug Use and Health), co-occurring mental and drug use illnesses affect 17 million persons in the United States. Given their significant influence on a person's life and the long-term detrimental effects they can have, understanding the complex interplay between these issues is essential to provide those in need with adequate treatment and assistance.

Substance-Specific Association with Mental Illness

Substances can predictably interact with certain mental health issues. The effects of a particular substance often counteract the symptoms of the corresponding psychological condition. For example, people with anxiety-related disorders tend to use relaxing drugs, while individuals with mood disorders such as depression tend to use "feel good" drugs.

Prevalent Mental Health Disorders in Dual-Diagnoses

Substance abuse problems are typically linked to specific mental health disorders in dual diagnoses. These prevalent mental health issues include anxiety disorders, posttraumatic stress disorder (PTSD), schizophrenia, personality disorders, depression, and eating disorders such as bulimia nervosa and anorexia nervosa.

For example:

● One study found that alcoholism was diagnosed in 60-80% of individuals with antisocial personality disorder, and 20-40% of individuals with alcoholism also received a diagnosis of antisocial personality disorder.

● Individuals diagnosed with schizophrenia are likelier to use stimulants like nicotine, amphetamines, cocaine, and marijuana. However, whether the substance abuse or the mental disorder developed first is frequently unclear.

● Depression and anxiety are commonly linked to alcohol abuse. According to a study, individuals diagnosed with alcohol use disorder are four times more likely to experience depression and three times more likely to have an anxiety disorder.;

● Bipolar disorder is the mental illness most significantly associated with substance abuse, with lifetime prevalence estimates ranging from 50% to 60%. It implies that the likelihood of substance use and bipolar disorder co-occurring is between 50% to 60%.

The Blurred Lines between Substance Abuse and Mental Health Disorders

Substance abuse can sometimes produce symptoms that mimic those seen in organic mental disorders but with distinct differences. Unlike primary mental illnesses, these symptoms directly stem from substance use and can often be resolved quickly by ceasing substance use.

These symptoms may arise from a specific pattern of abuse, intoxication, or withdrawal syndrome associated with the substance.

Examples of such symptoms are

● methamphetamine-induced psychosis or mania,

● depression due to discontinuing stimulants,

● cognitive and memory challenges(Korsakoff's syndrome) resulting from chronic alcohol abuse.

The Connection Between the Two!

Mental health disorders and drug misuse frequently coexist, which means they show up simultaneously in a person. Substance abuse may surface as a coping mechanism to manage symptoms of mental health disorders. For instance, a person grappling with an anxiety disorder could turn to drink or drugs to calm their nerves, but someone depressed would do the same to soothe their mental suffering. Determining which condition caused the other or which appeared first can be challenging.

Does One Cause The Other?

Although there may not be a clear link between mental illness and substance use problems, it is nevertheless likely. You may be more vulnerable to substance use disorder if you have a psychiatric disorder. Data shows that substance abuse is twice as prevalent among adults with mental issues due to the tendency to self-medicate symptoms. Sometimes, you may not even notice that your substance use is a disorder. Prolonged drug use, however, can increase the underlying risk of mental disease, aggravate pre-existing mental health disorders, and exacerbate their symptoms.

According to official government statistics, Americans with mental illnesses use over 38% of the nation's alcohol, 44% of its cocaine, and more than half of its opioid prescriptions. Also, the risk that someone may take drugs increases with the severity of their mental condition.

The Impact of Mental Health Issues and Substance Abuse Disorders

Mental health and substance abuse disorders can significantly affect your life, influencing your relationships, work, and overall quality of life. If you have these conditions, you may experience:

● Social isolation

You may find it difficult to maintain relationships with your friends and family if you have mental health and substance abuse disorders. Such issues could result in social isolation, exacerbating your mental health symptoms.

● Financial problems

If you have substance abuse and mental health disorders, keeping a job or managing family wealth may be difficult, resulting in financial challenges.

● Health problems

If you struggle with substance abuse, you may experience physical health problems, such as liver damage and heart disease. Similarly, mental health disorders can also contribute to physical health issues, such as headaches and digestive problems.

Recent research indicates that individuals with schizophrenia may experience a 25-year reduction in life expectancy. Among people with schizophrenia, 40% of premature deaths result from accidents and suicide, while physical health issues cause 60%. These physical health issues may include smoking, substance misuse, alcohol consumption, poor diet, lack of physical activity, and unsafe sexual practices.

You may experience various health problems with a dual diagnosis, including diabetes, infectious diseases, and cardiovascular disease. Prolonged alcohol and substance misuse can harm your immune and gastrointestinal systems and your liver and cardiovascular health, increasing the risk of transmitting infectious diseases like hepatitis B and C, HIV, and sexually transmitted infections. Individuals with major depressive disorder, bipolar disorder, and schizophrenia are at a higher risk of premature death due to cardiovascular disease.

Additionally, using stimulants such as cocaine and substance abuse can increase your blood pressure and heart rate, further increasing your risk of developing cardiovascular disease. You are at a greater danger of developing diabetes if you have schizophrenia than the general population. High blood glucose levels can cause nerve and kidney damage, as well as visual impairment and blindness.

Treatment Options for Mental Health Issues and Substance Abuse Disorders

To treat mental health and substance abuse disorders, healthcare providers tailor the treatment based on the unique needs of each individual. However, combining therapy, medication, and support groups is usually the most effective approach.


In therapy, you can address the underlying issues contributing to your mental health and substance abuse disorders. You can choose to do therapy individually or in a group setting, and it can help you learn coping mechanisms and develop healthy habits. Talk therapies, such as cognitive-behavioral therapy (CBT) and dialectical behavior therapy (DBT), are examples of effective therapies that can help you manage your symptoms and improve your overall well-being.


You can use medication to manage the symptoms of your mental health and substance abuse disorders. Your healthcare provider may prescribe antidepressants, anti-anxiety medications, or medications for addiction to help manage your symptoms.

Support Groups

You can benefit from support groups, which offer a safe environment for sharing experiences and connecting with others dealing with similar challenges. Support groups can be particularly useful if you feel alone or isolated. Examples of these groups include Alcoholics Anonymous (AA), Narcotics Anonymous (NA), Dual Recovery Anonymous (DA), and SMART Recovery.


Don't let substance abuse and mental health disorders hold you back from living your best life! While these two conditions are separate, they often occur together, creating a complex relationship. Pinpointing the cause can be tough, but one thing is clear: they're connected. Seeking proper treatment, like therapy and medication, can help you manage your symptoms and improve your overall quality of life. Understanding this vital relationship is the key to receiving the right support and treatment. Take control and thrive!

17 views0 comments


bottom of page