Can Mental Illness Lead to Addiction? Understanding Why Some People Turn to Alcohol or Drugs to Cope

Disclaimer: This article is for informational and educational purposes only, and does not replace expert medical or mental health advice. Co-occurring mental health and substance use symptoms require a comprehensive psychiatric and physical evaluation. So, always refer to a board-certified physician or mental health specialist for a proper diagnosis and treatment. In case of emergencies, call 9-1-1 in the U.S. or your local emergency number immediately.

When we speak of mental health disorders and addiction (also known as a substance use disorder), we often think of them as distinct entities. But more often than not, they are so deeply intertwined that one cannot be separated from the other. Some studies have found that 36.5% of those with a substance use disorder also struggle with a mental health disorder. Other studies have estimated even higher rates.

In this article, we will explore in greater detail can mental illness lead to addiction and why some will turn to alcohol or drugs to cope.

In straightforward words, yes, mental illness can lead to substance use disorders or addiction.

Peer-reviewed studies published in reputable journals have shown that co-occurring disorders involving substance use disorder occur at high prevalence with:

• Anxiety disorders
• Major depressive disorder
• Bipolar disorder
• Attention-deficit/hyperactivity disorder (ADHD)
• Post-traumatic stress disorder (PTSD)
• Borderline personality disorder
• Antisocial personality disorder (colloquially known as sociopathy and psychopathy)
• Eating disorders
• Schizophrenia.

Before we go further, we need to understand that not everyone with mental health conditions turns to alcohol or drugs to cope. But enough do.

Experts have not been able to understand the definitive reason why this happens, but they have suggested some theories:

• Both substance use and co-occurring mental health conditions can be traced back to the same genes and risk factors.
• Those with mental health conditions turn to substances as a way to cope with the pain and suffering from within, to numb the emotional distress. It is a type of self-medication.
• Substance use, on the other hand, leads to or exacerbates pre-existing mental health conditions. It offers a temporary escape from the pain and suffering, but in the long run, it only worsens the symptoms, as it does not treat the underlying reasons.

Because substance use and co-occurring mental health conditions often influence one another, effective care begins with understanding both as part of a comprehensive clinical assessment. When treatment is appropriate, this integrated approach is known as dual diagnosis treatment.

Self-medication occurs when someone uses alcohol or drugs to manage uncomfortable emotional or physical symptoms rather than seeking the care they need and deserve.

For instance, for someone experiencing anxiety, a drink or substance may seem to offer temporary calm. This connection between anxiety and addiction has been observed in some who rely on substances for short-term relief.

For someone living with depressive symptoms, substances might create a brief sense of relief from persistent sadness or numbness. The relationship between depression and addiction may develop when symptoms remain untreated.

For those coping with trauma, substances dull painful memories or reduce hypervigilance, while those experiencing chronic stress or ongoing difficulties may turn to substances hoping to feel more rested or relaxed.

In each case, the underlying reason is the same: an attempt to avoid or numb painful feelings that feel difficult to manage on their own. However, the relief these substances provide is typically short-lived. Over time, this can create a pattern where a person relies more heavily on substances simply to experience a sense of well-being, even if the underlying reasons remain untreated.

As we mentioned earlier, not everyone with a mental health condition struggles with substance use. 25.8% of those with a psychiatric condition met the criteria for dual diagnosis - this is not everyone, but a considerable number.

There are some reasons for this, such as:

• Early intervention. When someone recognizes their mental health symptoms early and reaches out for professional support, they can manage the symptoms before they worsen or lead to substance use and other unhealthy coping mechanisms.
• With therapy and medication management, mental health symptoms can be managed with consistent care.
• Some also have stronger social networks and communities, where they play a significant protective role by offering a shoulder to rely on during difficult periods.

Substance use is not an inevitable outcome of mental illness. It is one of the worst outcomes among many, shaped heavily by the above-mentioned factors.

Developing healthy coping skills can significantly reduce the likelihood of turning to substances during periods of emotional distress.

Therapy provides a safe, private setting where you can understand your emotions, identify triggers, and develop strategies tailored to your specific needs while strengthening emotional regulation.

Consistent medication management, when required, also enables you to manage your symptoms and prevent relapse.

Other lifestyle modifications, like a nutritious diet, consistent sleep, stress and anger management techniques, breathing exercises, mindfulness, and physical exercise, can enhance mood stability and reduce mental health symptoms of anxiety, depression, etc, while facilitating overall behavioral health.

Maintaining a strong social network consisting of trusted relationships offers a sense of connection that can ease isolation during difficult times.

Seeking early intervention, rather than waiting until symptoms intensify, gives people the opportunity to develop these skills and routines before unhealthy patterns take hold.

When a mental health condition and substance use disorder occur together, this is referred to as a co-occurring disorder, sometimes called dual diagnosis.

As emotional distress and substance use can impact one another, both conditions benefit from being treated as part of a single, comprehensive treatment plan rather than being treated separately. A comprehensive psychiatric evaluation allows the healthcare provider to understand how a person's mental health symptoms and substance use patterns may be connected, which becomes the skeleton for effective planning going forward.

Evaluating both conditions together also identifies which symptoms may be driving the other, offering a clearer beginning point for care.

A dual diagnosis is typically treated with therapies like cognitive behavioral therapy, dialectical behavior therapy, medication management, peer community, healthy living practices, and ongoing care. While it may take longer than treating one condition at one time, it also lays a strong foundation for a well-rounded recovery.

Recognizing the connection between mental health and substance use is a crucial step, but understanding why it happens is only part of the picture.

If managing your mental health symptoms and substance use is becoming harder to navigate, you do not have to do it on your own.

You can reach out to licensed and experienced mental health practitioners who will take the time to understand your symptoms, history, challenges, and goals to help clarify what your next step may be. Even if you are not ready to make a decision, learning about your options can provide the clarity needed to move forward with confidence.

While inpatient or residential care may be needed for more severe cases, many can manage their dual diagnosis symptoms with outpatient treatment programs like partial hospitalization programs and intensive outpatient programs that allow you to receive the care you need and deserve while also staying connected to your daily life. You do not have to compromise on one or the other anymore.

What are co-occurring disorders?

Co-occurring disorders, also called dual diagnosis, refer to the presence of both a mental health condition and a substance use disorder at the same time.

Can anxiety lead to addiction?

Anxiety itself does not directly lead to addiction, but persistent, untreated anxiety symptoms may lead some to use alcohol or drugs in an attempt to relax or feel more in control.

Can depression increase the risk of substance use?

Depression can increase vulnerability to substance use when symptoms such as sadness, emptiness, and hopelessness go untreated, prompting some to seek temporary relief through substances.

What is self-medication?

Self-medication refers to using alcohol or drugs to manage uncomfortable mental health symptoms instead of seeking the clinical care they need and deserve.

Does everyone with a mental illness develop addiction?

Not everyone with a mental illness develops addiction, but some do. Especially in cases where there is a lack of early intervention and social networks.

Why is a clinical assessment important?

A clinical assessment, such as a comprehensive psychiatric evaluation, enables mental health specialists to understand how a person's mental health and substance use may be connected, allowing both conditions to be evaluated together for a clearer, comprehensive treatment plan.

How can healthy coping skills reduce risk?

Healthy coping skills, such as therapy, healthy living practices, and social network systems, focus on the underlying reasons of emotional distress rather than masking them, which can reduce the likelihood of turning to substances.

When should someone seek professional help?

Professional help needs to be considered when mental health symptoms, substance use, or both begin interfering with daily functioning, relationships, or overall well-being.