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Monday, 18 Jan 2021

How Mental Disorders Co-Exist with Drug Abuse

By Dr Becky Spelman
How Mental Disorders Co-Exist with Drug Abuse | Private Therapy Clinic

There’s a been a well-established relationship between substance abuse and mental disorders for quite some time now. Even before the advent of modern psychology, the mechanisms were still at play – we just hadn’t put the piece together yet. According to the substance abuse and mental health services administration, around 9 million people suffer from a co-occurring disorder in addition to a pre-existing condition. And by far one of the most common of these comorbid factors is addiction and substance abuse. However, in many instances, this will go unrecognised and therefore, untreated. In fact, a staggering 60% of people with comorbid conditions don’t receive the treatment they need.

Getting to Grip with Comorbid Conditions

If you’re unfamiliar with the term, comorbid can appear to be quite a frightening turn of phrase upon first hearing. It evokes a sense of fatality. But in reality, it simply refers to two separate but co-existing mental health conditions. And when substance abuse is involved, it’s nearly always the case that the addictive tendencies at play are a compensatory that itself is a symptom of having experienced trauma or else being deeply unsatisfied on an emotional level. And while one condition doesn’t necessarily lead to the other, the two can often interplay and exacerbate each other’s symptoms.

But to really get a handle on what comorbidity means, it helps to be aware that both substance abuse and other associated mental health conditions are both chronic brain diseases. When someone struggles with addiction, it causes a permanent change to the wiring of their brain not only because of the behavioural aspects but also due to the substance itself. So just as people who suffer from physical conditions such as diabetes need to manage their health for the remainder of their life, so too, does addiction need to be given that same attention. The habits may cease, but the programming that will trigger a relapse still exists and needs to be guarded against.

This similarity in brain response and neuro-networking also correspond with the areas of the brain that are impacted by conditions such as depression, anxiety, bipolar and schizophrenia, etc. So when viewed in this light, it’s hardly surprising that there is such a strong link between mental health conditions and addiction. Although there has been no absolute or definitive commonality that connects all mental health issues with addiction, the weight of anecdotal evidence clearly backs up this supposition. Many people with underlying mental health problems will turn to substances as a coping mechanism.

Why Do Addiction and Mental Co-Occur?

It should be stated that even though there is a high incidence of comorbidity between addiction and mental illnesses, it doesn’t always mean that one has caused the other – even if the two conditions appear in close proximity. There are still a number of variables that need to be taken into account to provide an accurate picture. So, to establish which came first, there are actually three factors that create this common co-occurrence.

  • Research has found that there are in fact, many genes that can contribute to the development of both substance abuse and mental health issues. One such example is a hereditary gene that makes certain individuals more susceptible to mental health issues as an adult if they used marijuana in their earlier years.
  • Certain mental health issues have also been red-flagged of putting people at a higher risk of developing substance abuse issues. The reason for this is that people will use the effects of substances to self-medicate specific symptoms and possible to dissociate altogether. In some instances, this may help in the short-term, although it’s never recommended. And in cases of depression, for example, where alcohol is being depended upon, it can make things worse with it being a known depressant.
  • The use of substances in general can contribute to the further onset of mental issues. Depending on the mental health issue in question and the types of substances involved, they can greatly alter a person’s brains chemistry to the point of creating further damage. An extreme example of this might involve a person with schizophrenia who is abusing psychedelic substances. The distorted audio/visual nature of these substances can further blur the line between reality in someone who’s already ungrounded.

How Do You Treat Comorbid Conditions That Accompany Substance Abuse?

The nature of having a dual diagnosis means that treatment will inevitably be a more involved process than if you were suffering from a single condition. Unfortunately, you can’t be treated simply as someone with mental health issues. But instead, each condition needs to be treated in isolation. Each one needs a specialised approach, so there is really no one-size-fits method that can be employed. That’s means if you suspect you’re struggling with depression and substance abuse, you’ll need to be evaluated for both.

Fortunately, there are a whole host of behavioural therapies that have proven effective treating comorbid conditions. And each of these serves as a framework which can be tailored to your individual needs. They can be used in conjunction either with or without medication if the need arises. Some of these therapies include:

  • Cognitive Behavioural Therapy (CBT): This approach was designed to address specific behaviours and create permanent changes by using a practical and collaborative approach to therapy.
  • Dialectal Behavioural Therapy (DBT): This is a variation of CBT which uses a similar approach while incorporating elements of mindfulness, interpersonal problem-solving, distress tolerance and emotional regulation.
  • Assertive Community Treatment (ACT): This approach is rooted in community as the name suggests and is about providing a support network for those who’re struggling to maintain their social obligations and experience other related issues.
  • Therapeutic Communities (TC): This is a form of long-term residential treatment that focuses on the ‘resocialisation’ of an individual.

About the author:

Dr Becky Spelman is a leading UK Psychologist who’s had great success helping her clients manage and overcome a multitude of mental illnesses.

***If you’re struggling with substance abuse and think you might benefit from speaking to someone, we offer a FREE 15-MINUTE CONSULTATION with one of our specialists to help you find the best way to move forward. You can book yours here.


National Institute of Drug Abuse (Aug2018)Comorbidity: Substance Use Disorders and Other Mental Illnesses DrugFacts. Retrieved on 28thOctober, 2020 from,

Very Well Mind (5thJul2019)Why Mental Health Disorders Co-Exist With Substance Use. Retrieved on 28thOctober, 2020 from

Psychology Today (2ndJan2014)Substance Use, Abuse, and Addiction. Retrieved on 28thOctober, 2020 from,

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