Jan 18, 2023

The Connection Between Mental Health and Substance Abuse 

Mental health disorders and substance use disorders often occur together. Thankfully, many treatments are available to those with a dual diagnosis.

Recognizing and Understanding Addiction

One of the most important ways to understand addiction is to learn how to recognize it in those close to you. Recognizing an active addiction or substance abuse disorder can be relatively complicated. Some signs of addiction will be obvious. 

However, others will be much more challenging to notice, even in those close to the person with the addiction. Additionally, many people struggling with addiction will try to isolate themselves and hide their activities from friends and family. This often happens out of shame or embarrassment. 

Risk Factors for Substance Abuse and Mental Illness

Many factors combine to determine the risk of substance use, including environmental and genetic factors. Below are just a few of the significant factors. 


Genetics is one of the biggest influences, even if researchers still don’t know why. Individuals with an immediate family member with substance abuse or mental health issues are far more likely to develop similar conditions or struggles. Exact genetic or hereditary links still elude research, but the links can be inferred and preventative treatment sought.

Environmental and Social 

Many of the factors that have significant influence are environmental factors and social factors. Environmental factors include living in poverty and being exposed to drug abuse at an early age, to name a few. The social factors often include pressure from peer groups or other social constructs. Perceived normalization in popular cultures, such as moderate alcohol and nicotine abuse, is also prevalent.

Age of First Use & Drug Used

The age of the first use is another thing that can significantly influence the development of an addict. Using drugs at an earlier age exposes those individuals to a significantly increased risk of developing substance use disorders. 

Along with this, the drug used will also considerably affect the development of an addiction. Drugs like heroin, crystal meth, and Xanax are incredibly addictive and often dangerous to quit without professional help and medical supervision. Using drugs like these earlier in life creates a skyrocketing potential for addictive behavior.

Mental Health and Substance Abuse

One of the most challenging things to address with mental health and substance abuse is what’s known as dual diagnosis. Dual diagnosis is a combination of substance or alcohol use disorder and mental health conditions co-occurring. 

The disorders that occur in conjunction with substance use disorders are known as co-occurring disorders. Common co-occurring mental health disorders include depression, anxiety, bipolar disorder, and post-traumatic stress disorder (PTSD). Other common illnesses include panic disorders and schizoaffective disorders.

However, the biggest challenge with dual diagnosis cases is correctly diagnosing them. In many situations, particularly with individuals that may have received diagnoses at other facilities years ago, the diagnosis may not have been complete. This implies that while the primary disorder was identified, other potential conditions may have gone unnoticed.

One of the main reasons for this is the changes in behavior and psychology that mental illnesses and substance or alcohol use can create in a person. While they may have been diagnosed with a substance abuse disorder when first seeking treatment, that may have been the primary focus at the time. Sometimes, no other diagnosis may have happened.

With proper care and attention, not only can the substance or alcohol use disorder be treated, but any co-occurring mental health disorders can also be identified and addressed.

Does One Cause the Other?

While the NIMH reports that about half of all individuals suffering from severe mental health issues are also living with substance abuse problems, the reverse is also true. However, no definitive evidence exists that drug addiction can cause mental health disorders. There is still considerable debate among researchers and mental health professionals regarding the relationship between mental health and substance abuse. 

On the other hand, there are some considerations to be made for the reverse scenario. Many individuals with mental disorders, whether diagnosed or not, may turn to addiction as a form of self-medication. Self-medication is prevalent among those with substance abuse problems. Many behaviors associated with mental conditions will also reinforce addictions. 

What are the Treatments for Dual Diagnosis?

Effective treatment for dual diagnosis will typically involve several different therapies. Cognitive-behavioral therapy, motivational interviewing, and participating in a medication program to manage neurochemical imbalances are treatments that can be effective in a dual-diagnosis plan.

Dual diagnosis treatment commonly uses medications such as antipsychotics and antidepressants. Doctors prescribe these medications to patients along with medications for managing addictions or withdrawal symptoms. Common medications in this category include methadone and buprenorphine. 

In many cases, an inpatient or residential program is recommended, or at least a partial hospitalization program. These programs help to build a relapse prevention toolkit that will increase the chances of long-term sobriety. It’s important to remember that the most effective treatments are built more holistically around the patient’s needs.

Where Can Treatment Be Found?

If you or someone you love are facing challenges with mental health or substance abuse, the Massachusetts Center for Addiction is here to help. Reach out to one of our local addiction experts and start planning your personalized treatment plan today so that you can begin long-term recovery.

MCA Staff
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