Co-Occurring Conditions: Exploring the Link Between Mental Illness and Substance Use

Mental Health Awareness Month provides a meaningful opportunity to improve understanding and provide compassionate support for the millions of Americans impacted by overlapping mental illness and substance use disorders (SUD). Recent effects felt from the COVID-19 pandemic have compounded these issues amongst adults and children. It’s important to recognize that mental health disorders and SUD are not character flaws. Rather, they are medical conditions that can have complex dual roles in a person’s overall health and well-being.

Impact by the Numbers

Consider the impact of mental illness and addiction in the United States. According to the Centers for Disease Control and Prevention (CDC), one in five Americans will experience a mental illness each year, with one in 25 experiencing a serious mental illness, such as schizophrenia, bipolar disorder, or major depression. Research shows that mental illnesses and substance use disorders occur together at high rates. In fact, one in four people experiencing a serious mental illness will also experience a substance use disorder.

According to the National Survey on Drug Use and Health (NSDUH), adults 18 years and older who experienced serious mental illness or anxiety or mood disorders in the past year were more likely to have used illicit drugs compared to those who did not experience any mental illness. Nearly 1 in 3 adults had either a substance use disorder or any mental illness in the past year and approximately 6.4 million adults had both SUD and serious mental illness. Notably, while mental illness and SUD frequently co-occur, it is essential to recognize that not all individuals with a mental illness also have SUD, and vice versa, and a significant number of people with both conditions are not receiving adequate treatment.

The Complex Relationship Between Addiction and Mental Illness

Various factors can contribute to the co-occurrence between substance use disorders and mental illnesses including:

  • Common risk factors can contribute to both mental illness and substance use and addiction.
  • Mental illness may contribute to substance use and addiction.
  • Substance use and addiction can contribute to the development of mental illness.

For people contending with a dual diagnosis of a mental illness and SUD, the help they receive should be sensitive to the nuances of each in addition to the complicated ways in which one influences the other. Perceptions based on incomplete or mistaken understanding and stigma can contribute to barriers to recovery for those living with these illnesses, which commonly disrupt personal relationships and professional opportunities as well as potentially pose life-threatening risks to health and safety, including risk for overdose. Pathways to treatment and recovery are made easier and more accessible through support from family, friends, and peers.

Support often starts with understanding. Conversations about mental and behavioral illness and its relationship with addiction and SUD should appropriately identify each as a standalone category of medical illness, capable of occurring together, a status known among healthcare providers as comorbidity. These are diagnosable, symptomatic, treatable diseases, which present important challenges to individuals and the public.

Recovery Is in Reach

People living with mental health disorders and addiction can and do get better, and long-term recovery is more likely with treatment. Treatment programs take a variety of approaches and may include combinations of medication, individual or group counseling, self-help measures, lifestyle changes, peer support, management of withdrawal symptoms, or behavioral therapy. When researching available options, make sure that the program is appropriately licensed and accredited, is backed by research, and has experience with your particular mental health issue.

Given the frequency with which mental disorders and substance use disorders are reported in the United States, understanding the problem is an effective means of fostering a more inclusive and thriving community. Mental Health Awareness Month creates a helpful framework for public discussion and education about topics that disrupt lives, cost dollars, and damage valuable social connections. Public health leaders know that an important component of stigma reduction is engaging in open learning about a subject that may seem intimidating or unpleasant. There is no age range, demographic group, or geography that these diseases do not reach. If you’re struggling with addiction or other mental health issues, you don’t have to do it alone. The path forward begins with reducing stigma, increasing awareness, and access to support and treatment to live a healthy, productive, and satisfying life.

If you or someone you know is in need of mental health or substance abuse treatment, please visit the Substance Abuse and Mental Health Services Administration (SAMHSA) Behavioral Health Treatment Locator at https://findtreatment.samhsa.gov/ or call their national helpline at 1-800-662-HELP (4357).

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