I’m Struggling. Is it Addiction or a Mental Health Disorder?

Where Mental Health and Substance Use Disorders Intersect 

If you or a loved one are stuck in a cycle of unhealthy patterns, you might be asking yourself, “Is this because of a mental health disorder? Or is this what happens with addiction?”

As the cycle continues, you can’t seem to remember a defined time of when it began and you’re unsure of how or if you can even change direction.

This is a common space for those facing a mental health disorder and those struggling with addiction to be in—and we understand that it’s scary and confusing. When overwhelming emotions, intrusive thoughts, and confusing or destructive behavior lead to yet also stem from substance use, it can feel like nothing’s working right for you. 

If you or a loved one are struggling today—or if today is a good day but you have a feeling the other shoe will soon drop—you’re not alone. And you, understandably, want a clear answer to your seemingly simple question. You want the confusion to end so you can understand what’s going on. So you can grasp a real-life definition and harness the power of knowing to find a stable path forward.  

You deserve an accurate diagnosis. You deserve to discover the person you want to be. And you deserve to get the help you need to reach long-term recovery. However, the answer may not be a straightforward yes or no or this or that. You or your loved one could be struggling with a mental health disorder, a substance use disorder or both, which we define as a co-occurring disorder. 

We’re here to help you untangle the relationship between addiction and mental health disorders—and help you understand where to go from here. 

How are addiction and mental health disorders related? 

Let’s start by differentiating substance use and mental health disorders, and seeing how the two connect. 

Mental health disorders: Depression, anxiety, PTSD, bipolar disorder—these are all common mental health disorders. By definition, a mental illness is characterized by a disturbance in a person’s cognition (thinking), emotion regulation or behavior that reflects a change or dysfunction in the psychological, biological or developmental processes. 

Addiction: Clinically known as substance use disorder, drug and alcohol addiction involves patterns of symptoms caused by consistently using a substance despite its negative effects. 

Unfortunately, hurtful stigmas surrounding drug and alcohol addiction remain. But the truth is that addiction is a mental health disorder that causes cognitive, behavioral and physiological symptoms. For example, you might find yourself drinking alcohol despite consistent hangovers, risky behaviors while under the influence and failing to meet your obligations. 

Even though mental health disorders don’t always involve addiction, addiction is always classified as a mental health disorder. It’s possible for a person to be diagnosed with one or the other separately, but the chances of simultaneously having both a mental health disorder and substance use disorder are very high.  

What is a co-occurring disorder? 

Sometimes referred to as a dual diagnosis, co-occurring disorders are the coexistence of both a mental health issue and a substance use disorder. If you think you have a co-occurring disorder, it’s completely normal to feel overwhelmed because the interaction of two disorders can make the weight of both feel heavier and harder to handle.  

Various mental health disorders and substance use disorders work hand-in-hand, making co-occurring disorders a common diagnosis. 

Actually, according to a 2018 National Institute on Drug Abuse report, 7.7 million adults have co-occurring mental and substance use disorders. Of the 20.3 million adults diagnosed with substance use disorders, 37.9% also had mental illnesses. And among the 42.1 million adults diagnosed with mental illnesses, 18.2% also had substance use disorders.  

For people with co-occurring disorders, it can be difficult to determine which condition came first. It’s critical to treat both at the same time with licensed addiction and mental health professionals to increase your likelihood of a successful recovery following treatment. 

Like any mental health disorder, co-occurring disorders can impact anyone and any number of substances could be contributing to a substance use disorder. Many people with co-occurring disorders struggle with the misuse of:  

• Alcohol
• Tobacco 
• Opioids
• Stimulants 
• Marijuana
• Hallucinogens 
• Prescription drugs

Am I drinking/using because I’m addicted or because of a mental health disorder?  

Do you ever get to a point where you just want to know why you don’t feel like yourself? Why you’re struggling to get through the normal day-to-day. Why that feeling of you should be happy but you aren’t won’t go away? Or why, even when you want to stop drinking or using drugs, you just keep turning to them?

When working to discern between addiction and a mental health disorder, it’s important to remember that simply using a substance doesn’t necessarily ignite a full-blown substance use or co-occurring disorder. For example, if someone drinks too much once or twice, and experiences the negative aftereffects, it doesn’t mean that they have a substance use disorder or that it will impact them for an extended period of time. 

However, if drug or alcohol use is impacting their life negatively over and over again, and is causing chaos in other areas of their life, the likelihood that a substance use disorder has developed or will develop significantly increases. 

To better understand your own substance use, it’s important to uncover your “why.” Why are you drinking or using? For example: 

• Am I using substances to self-medicate and quiet my anxiety, trauma, PTSD, depression, ADHD or other mental health issues?  
• Am I using substances to get through the stressful, day-to-day circumstances of my life? 

Everyone’s reasons for drinking or using are vastly different—and extremely personal. Create a judgment-free space where you’re comfortable sharing your most intense emotions and hard truths, whether that’s with a loved one, in an AA or NA group, with your doctor or just with yourself for now. 

As you discover the reasons behind your substance use, you’ll gain a clearer picture of how substances are impacting your life and whether a mental health disorder might be fueling an unhealthy relationship with drugs and alcohol. 

How do I get an accurate diagnosis?

Your journey to healing starts with an accurate diagnosis made by a mental health professional.  

Trained and licensed professionals who have experience with substance use and mental health disorders can provide an accurate diagnosis. In turn, your opportunity for receiving effective treatment, entering into long-term recovery and living a fulfilled life full of hope greatly increase. 

We understand that sharing your most personal thoughts and deepest emotions is incredibly intimidating. And while others along the way may have made you feel ashamed of or unsafe sharing your struggles with mental health or substance use, we want you to know that there’s more to you than this disease or these diseases. There’s more to your life and who you will become—and there’s hope in recovery.  

Receiving an assessment and accurate diagnosis will help you: 

• Feel validated 
• See that you’re not alone in this journey to recovery
• Find an effective treatment plan 

Professional treatment will help you understand the connection between your mental health struggles and substance use. Additionally, it will give you the tools needed to stop seeing substances as the pathway to reducing the symptoms of a mental health disorder or subduing the emotions associated with life’s challenges. 

You have the power to change your path. By learning about different directions and new routes to take, you can make the healthiest decisions for your life going forward. The other good news is, once you’ve chosen treatment, you’ll never have to walk through recovery alone.