The relationship between addiction (or substance use disorders) and mental health is intricate and often intertwined. It is extremely common for individuals that are suffering from addiction to also experience mental health issues, where the same is common for individuals with mental health issues to also deal with a substance use disorder. This relationship, when an individual is dealing with both an addiction as well as a mental health issue, is often referred to as “dual diagnosis” or having a “co-occurring disorder.”

The relationship between addiction and mental health is complex and multifaceted. The prevalence of co-occurring disorders can vary depending on the individual’s situation, as well as on the specific substances an individual may be using or misusing and the considered mental health diagnoses that they may have or are experiencing. There is also other demographic, environmental, biological, or social factors that come into play when looking at individuals that have a co-occurring disorder of substance use and mental health.

Research indicates a strong overlap between addiction and mental health disorders. Some important information to consider:

  • A significant portion of individuals with substance use disorders also experience mental health disorders. According to the Substance Abuse and Mental Health Services Administration (SAMHSA), approximately 9.5 million American adults had both a mental illness and a substance use disorder in 2019.
  • Mental health conditions like anxiety and depression, some of the more common mental health conditions, commonly occur with substance use disorders. Using drugs and alcohol can often be a way for someone with a mental health condition like anxiety and depression to self-medicate their emotional or psychological pain, alleviate anxiety, and in a general manner, “treat” their mental health disorder. This regular use of drugs and alcohol can then lead to having a substance use disorder. So, an individual’s self-treatment of a mental health condition with drugs and alcohol can easily lead to a harmful cycle of addiction.
  • Individuals who have experienced trauma of post-traumatic stress disorder (PTSD) are at an increased risk of developing a substance use disorder as a way of coping with the symptoms that they regularly experience due to their trauma.
  • Serious mental illnesses such as bipolar disorder and schizophrenia are associated with higher rates of substance misuse and substance abuse. Individuals with bipolar disorder often experience episodes mania (an extremely elevated mood) that can lead to risky behaviors related to drugs and alcohol. Individuals with bipolar often also experience major depressive episodes, which can also lead to substance use to try to alleviate the symptoms of depression, like using cocaine or Adderall. Individuals with schizophrenia may use drugs and alcohol to self-medicate or alleviate distressing symptoms that occur due to their mental illness.
  • Personality disorders are mental health conditions where people that lifelong patterns of behaviors and inner experiences that differ significantly from what is typically expected in society. Certain personality disorders, such as borderline personality disorder (BPD), are linked to higher rates of addiction and substance misuse.
  • America’s ongoing opioid epidemic, specifically, has highlighted the interconnectedness of addiction and mental health. Many individuals who were victims of America’s opioid crisis have been found to have underlying mental health conditions.

Delving even further into the relationship between addiction and mental health, there are some key aspects of the relationship to consider and many factors that come into play.

  • Bidirectional Influence

Addiction and mental health disorders can influence each other in a bidirectional manner. Substance abuse can lead to or exacerbate mental health issues, and pre-existing mental health conditions can increase the risk of developing a substance use disorder. For example, someone with depression might turn to using drugs and alcohol as a way to cope, which can then lead to active addiction. On the other hand, substance misuse can alter brain chemistry and worsen symptoms of mental health disorders.

  • Shared Vulnerability Factors

Both addiction and mental health disorders share common vulnerability factors, such as genetic predisposition, environmental influences, and neurobiological factors. Genetic factors can also contribute to an individual’s susceptibility to both addiction and mental health issues.

  • Self-Medication

Some people with mental health issues use drugs and alcohol as a way to self-medicate, attempting to alleviate distressing symptoms. This is sometimes due to shame or stigma. This self-medicating behavior places a person at greater risk for developing an addiction.

  • Neurobiology

Substance Use Disorders and mental health disorders can affect similar regions of the brain and the brain’s neurotransmitter systems. For instance, using or misusing substances can alter the brain’s reward pathways, leading to addictive behaviors. Similarly, mental health disorders are often associated with imbalances in neurotransmitters, affecting mood and cognitive functioning.

  • Dual Diagnosis Challenges

Co-occurring disorders can complicate diagnosis and treatment. Professionals attempting to diagnose someone that is dealing with addiction and mental health issues often can find it difficult to make an accurate diagnosis on whether the substance use disorder or the mental health issue is the primary diagnosis. Likewise, many people can be misdiagnosed because they do not share with a professional that they are using substances, underreport their substance use, or symptoms that related to addiction are misdiagnosed as mental health issues, or vice versa. Also, symptoms of addiction and mental health issues can overlap, making it challenging to get an accurate diagnosis and, thus, an appropriate clinical treatment. Integrated treatment that addresses both addiction and mental health conditions concurrently is essential for successful recovery.

  • Cycle of Escalation

Addiction and mental health issues can create a cycle of escalation. For example, substance abuse can worsen mental health symptoms, leading to increased substance misuse as an attempt to cope. Conversely, the consequences of addiction, such as strained relationships, legal problems, or financial difficulty, can contribute to stress and worsen an individual’s mental health.

  • Risk Factors

Certain mental health conditions are associated with higher risks of addiction. For example, individuals with post-traumatic stress disorder (PTDS), trauma, bipolar disorder, and borderline personality disorder are more vulnerable to substance abuse and therefore at a higher risk for having a substance use disorder or addiction.

  • Treatment Challenges

As mentioned above, treating co-occurring disorders or individuals with a dual diagnosis requires a comprehensive, integrative behavioral health approach that addresses both addiction and mental health issues. Failure to address one component of the co-occurring disorder can impede the treatment of both as well as the patient’s overall recovery.

The vital piece of information to remember with co-occurring disorders is, given the complex relationship between addiction and mental health, is it necessary for individuals with a dual diagnosis to receive specialized treatment that considers and addresses both aspects. Someone in need of treatment should always get a professional assessment and evaluation, to figure out if they are in need a treatment for co-occurring disorders and, if so, make sure that whatever professional or treatment center is delivering care is able to treat addiction and mental health issues concurrently and in a comprehensive approach.

If you or someone you know needs help for addiction or co-occurring disorder issues, please give us a call. Maryland Addiction Recovery Center offers the most comprehensive dual-diagnosis addiction treatment in the Mid-Atlantic area. If we aren’t the best fit for you or your loved one, we will take the necessary time to work with you to find a treatment center or provider that better fits your needs. Please give us a call at (866) 929-4318 or email our team at For more information on all of our drug addiction, alcohol addiction, and co-occurring disorder services and recovery resources, please visit our website at

A group therapy session discussing Addiction and Mental Health

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