According to the National Institute on Drug Abuse, more than 60% of adolescents who are enrolled in substance abuse treatment programs also have met the diagnostic criteria for another mental illness; the most common disorders being depression and anxiety. This correlation notes a significant issue present in our society.

The concept of co-morbidity (the presence of multiple chronic disorders) in the area of substance and addiction presents a challenge for all individuals involved. The synergy of substance abuse and mental health disorders not only plays into the nature of why individuals would initially start using psychoactive substances (as a means of self-medicating) but also complications for treatment for other disorders.

While many may associate the term “mental illness” with more major depressive disorders or psychosis, a large majority of diagnosable mental illnesses consist of more subtle underlying disorders, the two most common being chronic depression and anxiety. Since many people either develop underlying depression or anxiety over time or have had it for so long, it may be difficult to even recognize it. These more subtle disorders, while less severe, still present a prevalent issue for many struggling with drug and alcohol addiction.

Self-Medicating for Anxiety and Depression with Illicit Substances

For many individuals living with depression or anxiety disorders, there is an innate attraction to seeking relief from the unpleasant effects of mental illness. This is why many people find themselves drawn to using psychoactive substances as a means of self-medicating. However, due to the subtle nature of chronic anxiety and depression, those using drugs and alcohol as a means of self-medicating may not have a clear understanding as to why they engaged in substance abuse.

For example, it is a common occurrence to see individuals with an anxiety disorder abusing Central Nervous System (CNS) depressants. Due to the sedative properties of substances like alcohol, barbiturates, or even ketamine, people with anxiety may use them to reduce the symptoms of their anxiety. This why many individuals using CNS depressants may give explanations such as “it helps me relax” or “I finally feel calm when I do this” to justify further use.

On the other side of the spectrum, it is also common to see individuals with depressive disorders abusing Central Nervous System (CNS) stimulants. Given the stimulating and energy-inducing properties of substances like Cocaine or Methamphetamine, people with depression may attempt to utilize these substances as a means of lifting themselves out of their depressive state. This why many individuals using CNS stimulants may give explanations such as “I feel better” or “I don’t feel so tired” to justify further use. However, individuals with depressive disorder have also shown to also abuse CNS depressants as well. While it would seem to only further exacerbate the effects of the depression (which it does), the euphoric effects of the depressant seem to give the illusion of relief from the feelings of dissatisfaction from depression.

The Arising Problem of Addiction

However, while many use drugs or alcohol as a means of helping to cope with depression and/or anxiety, they soon have a much larger problem. Given the nature of intoxicating substances, the pattern of addictive is sure to grow from repeated use. While some may feel better in the short-term, the neurocircuitry begins to change in the brain to revolve around continuing substance use. This is where addiction begins to destroy the individual’s quality of life by damaging all other facets of his/her life. In addition, what was once a means of coping with depression and anxiety, now becomes an element that actually exacerbates mental health issues, further continuing the spiraling cycle of mental illness and addiction.

Also, there is yet another factor that may cause further damage to the individual’s mental state. Oftentimes, individuals using psychoactive substances may develop other mental illnesses (such as added anxiety and depression, bipolar disorder and even psychosis) directly caused by the substances themselves. This is what is referred to as substance-induced disorders.

While it may seem like those in this position may be hopeless, rest assured that there is help available. Even though depression and anxiety may make the dependence on psychoactive substances more severe, our team at Stonewall Institute is ready to help. Please do not hesitate to give us a call at 602-535-6468 and we can help you get started.

Treating Addiction Alongside Depression and Anxiety

For individuals pursuing a life free from addiction while dealing with mental illness, there are a number of factors to take into consideration. For co-occurring disorders, it is vital that both the issue of addiction and mental illness are taken into account to treated simultaneously in order for there to be a greater degree of a successful treatment process.

The reason this element is vital is directly due to the synergy of both addiction and mental illness. If only one element were to be addressed at a time, the unaddressed factor would cause a severe hindrance to the treatment process, as well as present an immense relapse risk.

The Need for Holistic Care for Co-Occurring Disorders

For example, if a treatment facility were to provide care for substance abuse and addiction, but neglect the presence of mental illness, the treatment process itself would be impaired. If anxiety or depression were to not be addressed, there is a lesser chance that the client would be able to successfully retain the information and skills from the therapeutic sessions. In addition, the presence of unaddressed depression and anxiety may present a substantial risk of triggering a relapse.

On the other side of the spectrum, if a treatment center were to treat the presence of mental illness without also providing care for substance use, the treatment process would also be remarkably ineffective. If an individual is engaged in drugs and alcohol during a therapeutic process, there is a greatly reduced chance that the individual would be capable of retaining the knowledge and skills from the sessions. In addition, if treatment were to be completed without the problem of addiction being addressed, the issue of mental illness would only worsen from there. This due to the fact that the preferred coping mechanism would still default to substance use, and the severity of the mental illness would continue to be exacerbated by drugs and alcohol.

Screening and Assessing Anxiety and Depression in Addicted Clients

One of the most important steps for any treatment centers to take is to have clients’ issues of mental illness recognized and diagnosed in the screening and assessment period upon admission into treatment. However, it is important to understand how mental illness is determined during this stage. For many individuals who are still intoxicated, an accurate determination cannot be made regarding mental illness as the effects of intoxication may often give the appearance of a mental disorder. Therefore, it is imperative that an assessment for mental disorders is to be made after the client’s body is rid of the toxins through a medically-supervised withdrawal process.

After a client is no longer in a state of either intoxication or withdrawal, clinicians will then be able to perform a more accurate assessment of the client’s mental state through the use of several screening tools. For depression and anxiety, the most generally employed assessment tools include the Patient Health Questionnaire (PHQ-9) or the Generalized Anxiety Disorder (GAD-7) tests.

If you or someone you love is suffering from addiction while dealing with other mental illnesses, it vital that everyone receives the specialized care they need, our team at Stonewall Institute is ready to help. When you are ready, do not hesitate to call us at 602-535-6468.

Stonewall Institute’s Treatment for Addiction Alongside Anxiety and Depression.

At Stonewall Institute, we are firm believers in holistic care for our clients. Our licensed clinicians are specially trained to recognize and treat co-occurring disorders. Our admissions team is on standby ready to tailor your treatment needs to not only substance use recovery, but also for all mental illnesses, including depression and anxiety.

With our practice of dual-diagnosis, we are able to treat our clients’ addiction and mental illness simultaneously, ensuring that both issues are addressed and the synergy between the two does not feed on each other. We also work with other treatment teams to ensure that medications may also be implemented in order to help mitigate the symptoms of depression and/or anxiety in your journey in recovery. In addition to the knowledge and skills from the therapeutic sessions, we also provide our clients with the opportunity to receive social support from people with similar experiences through community groups.

There is no need for anyone to stay in addiction, regardless of their mental state. Everyone deserves to not only be free from drug and alcohol addiction but also to receive the help they need from depression and anxiety. While co-occurring disorders may be a complicated problem, our team is trained and ready to help. If you or a loved one is suffering from addiction, it is vital to know that there is help available. Please give us a call at 602-535-6468 and we can help create your plan to achieve wellness in your recovery.


NIDA. (2020, April 1). Common Comorbidities with Substance Use Disorders. Retrieved from on 2020, May 1