Exploring the relationship between mental health and substance use

It’s not unusual for someone with a mental health condition to also have a substance use disorder. According to national data, 35% of U.S. adults with a mental health condition also experience challenges with managing their use of drugs or alcohol. Some of the more common co-occurring mental health conditions include anxiety, depression, post-traumatic stress disorder (PTSD), and personality disorders. 

Fortunately, it’s possible to manage symptoms of both mental health and substance use issues with a coordinated approach to care. 

How can drugs and alcohol affect your mental health?

Most adults in the U.S. have tried an alcoholic beverage at some point, and about half report having ever used marijuana. And while occasional use may not cause much harm, long-term substance use can have a serious effect on your mental and physical well-being. Other examples of harmful substances include nicotine, cocaine, and prescription medications such as opioids, benzodiazepines, and stimulants.

The relationship between substance use and mental health conditions is somewhat nuanced. Research shows that people with a substance use disorder have higher levels of anxiety and depression compared with those without substance issues. And while it may be tempting to use alcohol to cope with conditions like seasonal affective disorder, drinking usually makes symptoms worse.

In some cases, unhealthy substance use can actually trigger additional mental health issues. For example, marijuana, stimulants, and hallucinogens can all cause something called drug-induced psychosis. Chronic substance use may increase the risk of developing schizophrenia and other psychotic conditions in people who are genetically predisposed to them.

Substance use can also cause or worsen symptoms of mood disorders like depression and bipolar disorder. More than half of people with opioid use disorder or alcohol use disorder experience substance-induced depression, but symptoms may improve once they stop using these substances.

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How might a mental health condition lead to substance use?

Substance use contributes to mental health issues, but the relationship goes both ways. Research shows that people with mental health conditions may use drugs or alcohol to help cope with distressing symptoms and experiences. In fact, some counts suggest that 75% of people with a substance use disorder have experienced trauma at some point in their lives. 

Another possible reason for the link between mental health issues and substance use relates to brain structure. For someone with a mental health condition, changes to their brain’s reward system may increase their chances of continuing to use addictive substances. 

Signs of mental health or substance use issues

It’s not always obvious when someone is living with substance use issues, but knowing how to recognize the signs can help you find the right support for yourself and others. Symptoms vary by person, but there are several universal signs that someone may be facing mental health challenges:

• Sudden mood swings, irritability, or angry outbursts
• Anxious or paranoid behavior without reason
• Changes in eating or sleeping habits 
• Secretive or suspicious behaviors
• Problematic behaviors, like getting in fights
• Reduced performance at work or school
• Periods of unusual agitation or giddiness
• Unexplained financial problems or need for money 
• Physical signs such as weight change, bloodshot eyes, slurred speech, and impaired coordination

Help is always available, and reaching out to a trusted professional or support network can make a meaningful difference for those facing substance use or mental health challenges.

12 substance-free alternatives for coping

For some people, substance use is a way to deal with distressing thoughts, feelings, and situations. This may provide some temporary relief but will likely worsen or create more problems in the long run. 

Instead, here are 12 substance-free alternatives to help you reduce stress, regulate your emotions, and improve your overall well-being.

1. Take a daily walk
2. Find an exercise class you enjoy 
3. Journal
4. Use daily positive affirmations
5. Listen to your favorite music
6. Read a book for fun
7. Hang out with a friend
8. Spend time in nature 
9. Paint, draw, or color 
10. Establish good sleep habits
11. Practice deep breathing and mediation
12. Confide in others, whether it’s a friend, therapist, or support group 

Treating substance use and mental health issues together

Treating co-occurring mental health and substance use disorders isn’t always straightforward. The disorders often share symptoms, which can make it difficult for providers to make an accurate diagnosis. Plus, co-occurring conditions may involve symptoms that are more severe, persistent, and harder to treat compared with either disorder on its own. With the right treatment plan and support, however, it is possible to manage both conditions effectively and work toward a healthier, more fulfilling life.

Research makes a strong case for an integrated treatment approach that focuses on a person’s specific symptoms, substances, and combination of conditions. If you’re navigating an active substance use disorder, treatment might start with medically supervised detox to help rid your body of harmful substances. From there, your provider may suggest a combination of individual therapy, group sessions, and medication management. 

Some of the most effective therapies for substance use disorders and co-occurring mental health conditions include cognitive behavioral therapy (CBT), dialectical behavior therapy (DBT), and assertive community treatment. Many people also benefit from group therapy or support groups that allow them to connect with other people facing similar challenges. 

Depending on your condition, medication may be another effective option. For example, medication-assisted treatment has been shown to help treat opioid use disorder. Medication can also help people manage symptoms of co-occurring conditions, such anxiety, depression, and bipolar disorder. It’s important to work with a provider to determine the best treatment pathway and if medication is right for you. 

Find care with Rula

Living with substance use or mental health issues can be challenging, especially if you’re navigating both. Fortunately, recovery is possible with access to the right resources and support. 

Rula’s therapist-matching program helps people find a mental health professional who understands their unique combination of symptoms and is in network with their insurance. With Rula, you can have access to personalized, collaborative care as soon as tomorrow.

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