Naturally Gorgeous Results

7 Mental Health Challenges that Drive Addiction

7 Mental Health Challenges that Drive Addiction

Most people who struggle with substance use issues also struggle with at least one other mental health challenge. The National Institute on Drug Abuse estimates that at least half of people with substance use disorders have a co-occurring mental health issue. Typically, the mental health issue comes first and substance use is often a means of self-medicating.

However, drugs and alcohol only make symptoms worse in the long run. A strong recovery requires that you get integrated treatment for substance use and any mental health issues. The following are the most common mental health issues that occur with addiction.

Anxiety Disorders

Anxiety disorders include several specific conditions, such as generalized anxiety disorder, social anxiety disorder, phobias, panic disorder, obsessive-compulsive disorder, or OCD, and post-traumatic stress disorder, or PTSD. Anxiety disorders affect more people than any other mental health issue. The National Institute of Mental Health estimates that more than 30 percent of Americans will experience an anxiety disorder at some point in their lives.

Anxiety is also a significant factor in developing a substance use disorder. According to the National Epidemiological Survey on Alcohol and Related Conditions--a survey of more than 43,000 adults revealed nearly 18 percent of respondents with a substance use disorder also met the criteria for an anxiety disorder not related to withdrawal.

Perhaps not surprisingly, marijuana was the most commonly used substance among people with anxiety disorders. Perhaps more surprisingly, cocaine and amphetamine use was also common, while the association with alcohol was weaker. It’s important to note, though, that this survey didn’t include PTSD, which is a major risk factor in itself.


Post-traumatic stress disorder, or PTSD, may be one of the single biggest risk factors for developing a substance use issue. PTSD is far less common than anxiety disorders generally, affecting less than eight percent of Americans, but its effect on addiction risk is huge.

Some studies estimate that as many as half of people with substance use disorders also have symptoms of PTSD. PTSD itself has a complicated relationship with other mental health issues such as depression and anxiety. For this reason, addressing trauma is often a crucial element of addiction treatment.

Major Depression

Just over seven percent of Americans will have a depressive episode in a given year and the World Health Organization estimates that depression is the world’s leading cause of disability. Depression also significantly contributes to addiction risk. One study found that among people with major depression, 16.5 percent had an alcohol use disorder and 18 percent had a drug use disorder.

In other words, depression roughly doubles your risk of developing a substance use issue. This is especially true of men, who are less likely to seek therapy and more likely to self-medicate with drugs and alcohol. 

Bipolar Disorder

Bipolar disorder is technically considered a depressive disorder, but it’s a much different challenge than unipolar depression and a much greater risk factor for addiction. The study cited above also found that among people with bipolar disorder, 56 percent developed a substance use disorder at some point in their lives.

Bipolar disorder also complicates addiction treatment since it often requires some trial and error with medications and people experiencing manic episodes sometimes believe they’re cured and no longer need treatment. Bipolar is also frequently misdiagnosed as unipolar major depression, which slows treatment and recovery.


Attention deficit hyperactivity disorder, or ADHD, is a bigger risk factor than many people realize. It’s typically characterized by racing thoughts or jumping from one line of thought to another. In adolescence, this can lead to poor performance in school, social ostracism, and impulsive behavior--all risk factors for substance use.

One study found that more than 15 percent of adults with ADHD met the criteria for a substance use disorder, which is at least twice the rate in the general population. The good news is that that number appears to drop when ADHD is controlled with therapy and medication.

Borderline Personality Disorder

Borderline personality disorder, or PBD, is a condition characterized by volatile moods, unstable self-image, and turbulent relationships. While BPD only affects about 2.7 percent of adults, about 78 percent of people with BPD will develop a substance use disorder at some point in their lives. One reason that number is so high is that BPD also increases your risk of anxiety and affective disorders, including PTSD.

BPD also presents special challenges to addiction recovery, since people with BPD are more likely to drop out of treatment and remain sober for shorter periods. BPD requires special treatment methods and currently, dialectical behavior therapy, or DBT, is the best available treatment.


Schizophrenia affects just over one percent of Americans, but of those, around 50 percent have a co-occurring alcohol or drug use issue. The relationship between schizophrenia and substance use remains a bit more mysterious than that of other mental health challenges. For example, we aren’t quite sure why 70 percent of people with schizophrenia are nicotine-dependent, why they appear to use marijuana more heavily and at an earlier age, or why marijuana appears to precipitate symptoms in adolescents. As with bipolar and BPD, schizophrenia presents special challenges to addiction treatment since it often involves antipsychotic medication and difficulty sticking to a treatment regimen. 

Mental health issues significantly increase your risk of developing substance use issues, and they also increase your risk of developing other mental health issues. For example, major depression and anxiety disorders often go together. For this reason, it’s often hard to pin down the relationships between substance use and mental health issues and it’s often hard to pin down exactly what mental health issue is causing your problems. However, this is crucial to figure out if you want to sustain recovery from addiction and feel better in general.

At The Foundry, we understand the huge role mental health plays in addiction recovery. That’s why we employ a variety of proven methods to help our clients manage their mental health challenges. These methods include DBT, CBT, EMDR, and others. To learn more about our addiction treatment program, call us today at (844) 955-1066.

Recent Posts

Call today to get started on your journey or if you have any questions.

Contact Foundry

Call today to get started on your journey or if you have any questions.

(844) 955 1066