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First Things First: Mental Health or Addiction?


Addiction and concurrent mental illness are extremely prevalent. The National Institute on Drug Abuse says that nearly half of the people who have a mental illness will also have a substance use disorder, and vice versa. More than 60% of adolescents who seek treatment for substance abuse also meet the diagnostic criteria for another mental health condition, according to studies. Co-occurring disorders, or dual diagnoses, are when a mental health condition and a substance use disorder co-occur. A mental illness and a substance use disorder rarely develop simultaneously. Instead, the situation is more like a chicken-and-egg one. It is frequently different from person to person and difficult to determine which comes first, addiction or mental illness.

Addiction can sometimes cause mental health issues to arise. Sometimes, self-medication for a mental illness leads to addiction. Treatment for co-occurring disorders is the same because it aims to treat both disorders at the same time, regardless of whether mental illness or addiction came first.

Dual Treatment: Addiction and Mental Illness in Relationship

Despite the fact that substance use disorder and other mental health conditions frequently co-occur, this does not mean that one condition always causes the other. Sometimes, people struggle with dual diagnosis because addiction and mental illness share similar risk factors, such as the following:

People with mental health conditions like anxiety, depression, or post-traumatic stress disorder (PTSD) are more likely to use drugs or alcohol as a form of self-medication, according to research. Self-medication has the potential to quickly develop into an addiction. Studies, on the other hand, demonstrate how long-term use of alcohol and drugs can cause brain changes and the onset of mental illness. Doctors and therapists may be able to determine whether an individual suffered from mental illness or addiction first by looking at their previous patterns of behavior.

When mental illness takes precedence

When you inquire about “what comes first? Addiction or mental illness? A lot of people think mental illness is the answer. This is true in some situations, and self-medication is frequently the cause.

Take, for instance, a person with PTSD. This individual may struggle to function at work due to daytime anxiety and flashbacks. He or she may suffer from severe insomnia or nightmares that make sleeping frightening. It is common knowledge that living with post-traumatic stress disorder (PTSD) is challenging, to the point where many sufferers attempt to numb their symptoms through alcohol or drugs. In point of fact, people who suffer from post-traumatic stress disorder (PTSD) are two to four times more likely than people who do not suffer from PTSD to develop a substance use disorder[3]. Whether a person is attempting to cope with PTSD, anxiety, depression, schizophrenia, or any other mental disorder, using drugs and alcohol is never the best way to do so. To feel calm, relaxed, or happy, people begin to rely on substances. Soon, they feel like they can’t function without drugs. Additionally, substance abuse frequently only serves to exacerbate mental health issues, triggering a cascading effect.

When Addiction Takes Priority

Addiction can sometimes precede mental illness. Alcohol and drugs alter the brain’s structure and function over time. They change how the brain produces essential chemicals like dopamine, serotonin, and GABA and how receptors interpret information from neurotransmitters.

People begin to experience negative mental health symptoms when the brain’s chemical balance is off. Anxiety, depression, or bipolar disorder may begin to affect people who were completely healthy prior to their addiction. For instance, studies have shown that, even if a person has never experienced depression before, they are more likely to develop major depression if they drink more.

Addiction and mental illness ultimately worsen one another. Additionally, they can make recovery difficult.

Treatment is the same regardless of whether mental illness or addiction came first.

 In the end, it doesn’t matter which came first. Getting individualized treatment for both conditions is what matters. The National Institute of Mental Health says that it is always best to treat mental health conditions and substance use disorders at the same time. Dual diagnosis therapy typically includes

Behavioral therapies: CBT, DBT, CM, and family therapy are all promising treatments for people who also have other disorders.

Medications: A person’s symptoms may be alleviated with the help of medication. The individual’s mental health diagnosis and their response to behavioral therapy will determine the precise medication.

Changes in one’s way of life include keeping a regular schedule, creating a healthy routine, eating a well-balanced diet, getting plenty of exercises, and learning how to deal with everyday situations.

Peer support – While loneliness can elicit cravings for substance abuse and mental health symptoms, peer support can do the opposite. A person’s quality of life can also be improved by peer support.

The most important consideration in treatment should be the individual’s requirements, beliefs, circumstances, faith, and culture. The patient will have a better chance of overcoming their co-occurring disorders if the treatment they receive is more individualized.


It is not essential to focus on whether your mental illness or addiction came first if you struggle with co-occurring disorders. Instead, you should focus on getting the help you need and improving your life. 


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