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Understanding the Relationship Between Mental Health and Substance Abuse

Explore the intricate link between mental health and substance abuse and how effective dual diagnosis treatment strategies can help you heal.

mental health and substance abuse

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Mental Health and Substance Abuse: What Is a Co-occurring Disorder?

The relationship between mental health and substance abuse is complex and can co-occur in individuals, meaning they can influence and exacerbate each other.

A co-occurring disorder is also known as a dual diagnosis. It refers to when a person has both a mental health disorder and a substance use disorder.1

The Relationship Between Mental Health and Substance Misuse

Someone suffering from depression may turn to alcohol or drugs as a form of self-medication. However, this inadvertently leads to substance abuse. 

On the other hand, substance abuse can also trigger or exacerbate mental health conditions. This creates a complex, cyclic relationship between mental health and substance abuse.

Challenges of Dual Diagnosis

The coexistence of mental health and substance abuse in co-occurring disorders presents unique challenges for diagnosis and treatment. Symptoms of mental health disorders can often overlap with signs of substance abuse. 

Additionally, substance abuse can obscure the symptoms of mental health disorders. The effects of substance abuse can also mask mental health symptoms.

The co-occurrence of mental health and substance abuse disorders requires integrated treatment. This refers to approaches that address both issues simultaneously.

Mental Health and Substance Abuse: How Are They Linked?

The relationship between mental health and substance abuse is complex and deeply intertwined. They can impact each other in various ways, increasing the likelihood of one condition when the other is present.
Here are the primary ways in which these two areas influence each other:


One of the most common reasons people with mental health issues may resort to substance use is to self-medicate. They may use drugs or alcohol to cope with their mental health disorder symptoms. 

This includes disorders like anxiety, depression, or post-traumatic stress disorder. However, this self-medication can quickly become dependence and eventually substance abuse.

Worsening of Symptoms

Substance abuse can worsen existing mental health conditions. For instance, alcohol can intensify symptoms of depression and anxiety. 

Similarly, stimulant drugs can heighten symptoms of anxiety and paranoia. Substances may initially alleviate symptoms but eventually may lead to increased severity and frequency of these symptoms.

Induction of Mental Health Disorders

Prolonged substance abuse can lead to the development of mental health disorders. For example, long-term alcohol abuse can lead to significant changes in the brain. 

This can increase the risk of developing major depressive disorder or anxiety disorders. This shows how substance abuse can directly impact mental health.

Increased Risk of Substance Abuse

Certain mental health disorders increase the likelihood of substance abuse. For instance, people with bipolar disorder are at a higher risk of developing substance abuse problems. 

This suggests certain mental health conditions can predispose an individual to substance abuse.

Shared Risk Factors

Mental health and substance abuse disorders often share common risk factors. These include the following:

  • Genetic predisposition
  • Environmental influences
  • Exposure to trauma or high levels of stress

Understanding this overlap can help in early detection and intervention. Ultimately, it prevents the spiral of co-occurring mental health and substance abuse issues.

Obstacle to Recovery

The presence of a substance abuse problem can create a significant obstacle to the recovery of an individual with a mental health disorder. 

Substance abuse can interfere with the effectiveness of treatment for mental health disorders. It can also decrease medication adherence.

Mental Health and Substance Abuse: Common Mental Health Disorders Frequently Associated With Substance Abuse

Several mental health disorders are frequently associated with substance abuse. Each influences the other in multifaceted ways.
Some of the most common mental health disorders associated with substance abuse include:2


Depression and substance abuse often co-occur. People may use substances as a form of self-medication to alleviate feelings of sadness. 

They may also resort to self-medication to relieve hopelessness or fatigue associated with depression. However, substances like alcohol can intensify depressive symptoms.

Anxiety Disorders

This includes disorders like generalized anxiety disorder (GAD), panic disorder, and social anxiety disorder. People with these disorders may misuse substances in an attempt to control their symptoms.

However, substances like caffeine, alcohol, and illicit drugs can increase feelings of anxiety and lead to panic attacks. They worsen the cycle of mental health and substance abuse.

Bipolar Disorder

People with bipolar disorder experience extreme mood swings. Their moods often fluctuate between intense highs (mania) and lows (depression). Both phases can lead to substance misuse.

The depressive episodes often lead to self-medication. Manic phases are often characterized by risky behaviors, including excessive substance use. This intertwines mental health and substance abuse in a way that complicates the management of bipolar disorder.

Post-Traumatic Stress Disorder (PTSD)

People with PTSD may turn to substances to cope with symptoms. This includes symptoms like flashbacks, nightmares, and severe anxiety. This form of self-medication, however, can exacerbate PTSD symptoms.


There’s a significant correlation between schizophrenia and substance abuse. This is particularly true with nicotine and cannabis. Substance misuse can worsen schizophrenia symptoms and hinder treatment outcomes.

Attention-Deficit/Hyperactivity Disorder (ADHD)

Individuals with ADHD may be more likely to misuse substances. This is often in an attempt to manage symptoms like restlessness or difficulty concentrating. However, many substances can exacerbate ADHD symptoms.

Personality Disorders

Those with personality disorders, especially borderline and antisocial personality disorders, have a higher risk of substance abuse. This relationship is likely due to the impulsivity and risk-taking behaviors often associated with these disorders.

Factors and Mechanisms Contributing To Mental Health and Substance Abuse Co-occurrence

Several factors can contribute to mental health and substance abuse. These factors can be biological, psychological, and environmental. These will be detailed below.

Genetic Factors

Both mental health disorders and substance abuse disorders have genetic components. This means that individuals can be genetically predisposed to develop these disorders.

Specific genes or combinations of genes may increase an individual’s susceptibility to mental health and substance use disorders.3

Brain Chemistry and Structure

Substances can alter the brain’s structure and function. This may predispose an individual to mental health issues. Similarly, changes in brain chemistry due to a mental health condition can lead to substance abuse.

Psychological Factors

Various psychological factors can contribute to the link between mental health and substance abuse. For example, people with mental health disorders might use substances as a coping or escape mechanism. 

Conversely, the use of substances can lead to feelings of guilt, shame, and anxiety, which can worsen mental health conditions.

Environmental Factors

Elements in a person’s environment can also contribute to developing mental health and substance use disorders simultaneously. These factors include exposure to trauma, high-stress levels, or early exposure to substance use.

For example, people who have experienced trauma may develop post-traumatic stress disorder (PTSD). This will make them turn to substances as a form of coping, tying the spheres of mental health and substance abuse together.

Developmental Factors

Early onset of mental health disorders or substance use can influence the development of the other. For instance, adolescents who use substances are at a higher risk of developing mental health disorders later in life, and vice versa.

Societal and Cultural Factors

The stigma associated with mental health disorders can lead to substance abuse as a form of self-medication. 

Similarly, societal norms and cultural practices that encourage substance use can contribute to developing or exacerbating mental health disorders.


In some cases, mental health disorders and substance use disorders may occur together without one necessarily causing the other. This co-occurrence, or comorbidity, can be due to overlapping symptoms or the presence of shared risk factors.

Treatment Approaches and Interventions For Mental Health and Substance Abuse

The co-occurrence of mental health and substance abuse requires integrative treatment approaches. These approaches consider the unique challenges posed by these intertwined conditions. They aim to treat both simultaneously for the most effective outcome.
Here are some treatment approaches and interventions:

Integrated Dual Diagnosis Treatment (IDDT)

This approach considers mental health and substance abuse disorders together rather than separate issues. 

It involves a team of healthcare professionals who work collaboratively to develop and implement a comprehensive treatment plan. This can include therapy, medication, support groups, and social and vocational training.

Medication-Assisted Treatment (MAT)

MAT combines behavioral therapy and medications to treat substance use disorders. It can be helpful for individuals with co-occurring mental health disorders.

The medications can help manage withdrawal symptoms, reduce cravings, and normalize brain functions. The therapy component addresses mental health issues.4

Cognitive Behavioral Therapy (CBT)

CBT helps individuals understand the relationship between their thoughts, feelings, and behaviors. This type of therapy can teach coping skills to manage symptoms of mental health disorders and tools to resist substance use.

Dialectical Behavioral Therapy (DBT)

DBT is a form of cognitive behavioral therapy. It is particularly effective for people with severe personality disorders.

Examples include borderline personality disorder and substance abuse problems. It teaches mindfulness, distress tolerance, emotional regulation, and interpersonal effectiveness skills.

Motivational Interviewing (MI)

MI is a counseling method that helps people resolve ambivalent feelings to find the internal motivation to change their behavior. 

It’s often used to treat substance abuse. It can be combined with other therapies to treat co-occurring mental health disorders.

Contingency Management (CM)

CM uses positive reinforcement to encourage sobriety and treatment adherence. Patients receive rewards or incentives for reaching treatment goals. 

Examples of goals include maintaining sobriety for a certain period or attending therapy sessions.

12-Step Facilitation Therapy

This approach aims to guide people toward engagement in 12-step programs. This includes programs like Alcoholics Anonymous (AA) or Narcotics Anonymous (NA). 

These programs provide a supportive community for recovery and coping strategies for substance use and mental health symptoms.

Family Therapy

Family involvement can be crucial for individuals dealing with co-occurring disorders. Family therapy educates the family about the disorders and teaches impactful communication skills between family members. Having a strong family support system is beneficial for long-term recovery.

Holistic Therapies

Holistic strategies like yoga, meditation, acupuncture, and art therapy can supplement traditional treatments. 

They can help people manage stress and express emotions. They can also help them improve mindfulness and enhance overall mental well-being.

Residential Treatment

In severe cases, residential or inpatient treatment might be necessary. These programs offer a structured, supportive environment. Here, individuals can focus on recovery without the distractions or triggers of daily life.

Each individual’s journey with co-occurring mental health and substance abuse disorders is unique. Therefore, treatment plans should be tailored to meet each individual’s needs. 

It should take into account the following:

  • The severity of their conditions
  • Their personal circumstances
  • The specific disorders involved
mental health and substance abuse

Find Help For Mental Health and Substance Abuse at Iris Healing

At Iris Healing, we understand how challenging co-occurring mental health and substance abuse conditions are. We offer patient-first holistic therapies designed to address dual diagnosis.

Through a structured and well-balanced environment, our certified therapists craft individualized treatment plans that help to heal co-occurring conditions. Our purpose is to guide each patient through their sobriety while resolving the life factors contributing to their addictions.

How Iris Healing Can Help

At Iris Healing, we recognize that different evidence-based therapies benefit healing. Our comprehensive staff provides various therapies, including CBT, DBT, and somatic therapy, to help patients understand the root of their co-occurring disorders. 

By changing negative thought patterns, individuals can learn essential coping skills to help them live healthy lifestyles.

Whole-Person, Holistic Treatment

Our facility also offers nutritional therapy and family therapy sessions. We understand the importance of proper nutrition and the positive impact of a strong support system in recovery.

As a part of our program, we also provide the necessary education for individuals to learn more about their disorders. This information can help patients understand their conditions and how to maintain their well-being.

Iris Healing provides a compassionate environment for individuals to explore holistic activities like yoga, meditation, and sound bath healing. We will also include an extensive aftercare plan for each patient to prevent relapse. Our team teaches proactive approaches to ensure sobriety after treatment.

Find Lasting Recovery Today

Contact us today to learn more about our unique approach to mental health and substance abuse. 

We’re here to help you lead the happy, healthy, and fulfilling life you deserve.

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