Mental Health and Substance Use Co-Occurring Disorders

Mental health problems and substance use disorders sometimes occur together. This is because:

• Certain substances can cause people with an addiction to experience one or more symptoms of a mental health problem
• Mental health problems can sometimes lead to alcohol or drug use, as some people with a mental health problem may misuse these substances as a form of self-medication
• Mental health and substance use disorders share some underlying causes, including changes in brain composition, genetic vulnerabilities, and early exposure to stress or trauma

More than one in four adults living with serious mental health problems also has a substance use problem. Substance use problems occur more frequently with certain mental health problems, including:

• Depression
• Anxiety Disorders
• Schizophrenia
• Personality Disorder

Substance Use Disorders

Symptoms

It can be hard to identify a Substance Use Disorder sometimes because people can have a wide degree of functioning and often can hide their alcohol or drug use. Symptoms of substance use disorders may include behavioral changes, such as:

• Drop in attendance and performance at work or school
• Frequently getting into trouble (fights, accidents, illegal activities)
• Engaging in secretive or suspicious behaviors
• Changes in appetite or sleep patterns
• Unexplained change in personality or attitude
• Sudden mood swings, irritability, or angry outbursts
• Periods of unusual hyperactivity, agitation, or giddiness
• Lack of motivation
• Appearing fearful, anxious, or paranoid, with no reason

Physical changes, such as:

• Bloodshot eyes and abnormally sized pupils
• Sudden weight loss or weight gain
• Deterioration of physical appearance
• Unusual smells on breath, body, or clothing
• Tremors, slurred speech, or impaired coordination

Social changes, such as:

• Sudden change in friends, favorite hangouts, and hobbies
• Legal problems related to substance use
• Unexplained need for money or financial problems
• Using substances even though it causes problems in relationships

Recovering From Mental Health Problems and Substance Use

Someone with a mental health problem and substance use disorder must treat both issues. Treatment for both mental health problems and substance use disorders may include rehabilitation, medications, support groups, and talk therapy.

Looking for More Information or Support?

• Read more about how individuals living with both mental health and substance use disorders and their families can actively engage in their recovery process.
• Learn how to talk about mental health or how to get help for yourself or someone you care about.
• Read about the science behind substance use and get facts about how drugs affect the brain and body.
• The Surgeon General’s Report on Alcohol, Drugs, and Health reviews what we know about substance misuse and how we can use that knowledge to address substance misuse and its related consequences.