Substance Use and Mental Health Problems

Topic Overview

Some people have an alcohol or drug use problem and a mental health problem. Doctors call this a dual diagnosis. You need to treat both problems to fully recover. Mental health problems that can happen with alcohol or drug use include depression, bipolar disorder, obsessive-compulsive disorder, post-traumatic stress disorder (PTSD), and schizophrenia.

Either problem may come first. If you have a mental health problem, you may use alcohol or drugs to try to feel better. Or a substance use problem may lead to mental health symptoms such as depression, anxiety, or rage.

People with mental health problems may use drugs and alcohol:

• To feel normal. You may use drugs or alcohol because it helps you feel normal and accepted. It may make you feel like you don't have a mental health problem or are not different from others.
• To self-medicate. You may use drugs or alcohol to reduce anxiety, depression, sleep problems, tension, hallucinations (like hearing voices), and the side effects of medicines.

Using drugs or alcohol when you have a mental health problem harms your health and your relationships. You may have more mental health symptoms, think about suicide, or need to stay in a hospital or other facility.

Treating substance use and mental health problems

It's best to treat the mental health problem and the substance use problem at the same time. If you don't get treatment, one problem can make the other one worse. If you treat only one problem, treatment may not work as well. When you treat both problems, you have a better chance of a full recovery and less chance of returning to drugs or alcohol.

The first step often is detoxification, or detox. During detox, you use no drugs or alcohol so your body can clear itself of them. You may have withdrawal symptoms, so detox usually takes place while you are getting medical care. If your problems are severe, you may need treatment at a hospital or another facility.

Detox is followed by therapy and sometimes medicine. You most likely will attend individual and group therapy for both problems. You also will learn about alcohol and drugs, exercise, and healthy eating.

A recovery program such as Alcoholics Anonymous or Narcotics Anonymous often is part of treatment and recovery.