The link between substance abuse and mental illness

The link between substance abuse and mental illness

Drugs and alcohol can cause profound mental health problems, as well as increase the severity of pre-existing mental illness symptoms. According to the National Institute of Mental Illness, drug abuse can bring about symptoms of other mental illnesses, as well as increase the risk of psychosis. On the flip side, mental illness can lead to drug abuse, usually as a means of self-medication.


Evidence shows that substance abusers are at a higher risk of developing psychosis, and psychotic patients are at a higher risk of abusing substances such as illicit or prescribed drugs or alcohol. Psychotic symptoms that already present symptoms of bipolar, borderline personality disorder and schizophrenia can be exacerbated with the use of illicit and prescribed drugs. Furthermore, people who have never exhibited any psychotic symptoms can experience psychosis like symptoms as a result of the side effects of certain drugs (Gillespie 2007).
Research suggests that information on the psychotogenic properties of specific substances may be a useful component in evaluating the risk of developing psychosis and other symptoms of mental illness, among drug users. Abused substances act on specific neurotransmitter systems, and scientists believe that studying the mechanism by which the substances impact these particular neurotransmitters would provide important clues regarding the pathophysiology of psychotic disorders (Thirthalli; Benegal 2006).
Studies show that shared risk factors between mental illness and drug abuse include overlapping predisposal to genetic vulnerabilities to both addiction and mental disorders, as well as overlapping environmental triggers such as stress, trauma and early exposure to drugs.

Comorbidity of bipolar disorder and substance abuse

Bipolar disorder brings on high to low mood swings. When a person with bipolar has mood swings that are high and positive, this elevated state can bring on symptoms of psychosis. A low or depressed mood can result in feelings of anger, sadness or fear that somebody is trying to harm him or her. Due to the escalated highs and lows that people with bipolar disorder experience, self-medication is very common. Studies show that over 50 percent of people with bipolar disorder have also been found to have a history of substance abuse or dependence (Sonne; Brady 1999).

Comorbidity of schizophrenia and substance abuse

Increasing evidence suggests that individuals with schizophrenia have higher rates of substance use disorders. Further evidence reports that clients with schizophrenia who also abuse substances, have a poor treatment response, higher recidivism rates in regards to relapsing on their substance, higher criminal recidivism rates, multiple hospitalization visits, increased violent outbursts, homelessness and health and family difficulties (Swofford; Kasckow; Scheller-Gilkey; Inderbitzin; Schizopher 1996).

Comorbidity of borderline personality disorder and substance

Two-thirds of people with borderline personality disorder abuse alcohol and illicit or prescribed drugs. Research on comorbidity of substance abuse and borderline personality disorder suggests that substance use addictions are one of the strongest predictors of poor short-and long-term outcomes of borderline personality disorder. Further evidence shows the possibilities of recovery or gaining control over borderline symptoms are greatly decreased when drugs or alcohol are used (Friedel 2004).

Treating mental disorders and substance abuse simultaneously

Therapy modalities can be tailored to treat both the mental disorder and the substance abuse disorder. Treatment plans can involve family and friends as well as intervention approaches. Certain medications can be prescribed that assist in treating the substance addiction, as well as the mental health disorder. For example, evidence suggests that bupropion (Wellbutrin and Zyban) were approved for treating depression and nicotine dependence, and is also helpful in reducing cravings for methamphetamine (NIDA 2011).

If you or a loved one would like more information on comorbid disorders such as mental conditions coupled with substance abuse disorders, please call the Mental Health Helpline at any time.