October 25, 2017

By Katie Stout

If you or someone you care about experiences a drug or alcohol issue, there’s a good chance that a mental health condition is present as well. In fact, the 2014 National Survey of Drug Use and Health estimates that one-third of people experiencing substance abuse issues also suffer from a mental illness. In the mental health field, the relationship between mental illness and substance use is often referred to as “co-occurring disorder” or “dual diagnosis” and a growing body of evidence supports a strong connection between the two.

Although pinpointing the exact link between substance use and mental illness is difficult, we do know that substance abuse and many mental illnesses are tied to similar centers of the brain. For example, depression depletes certain neurotransmitters while alcohol energizes the same system, offering temporary relief from depression’s symptoms. As symptoms re-emerge, individuals experiencing depression will often self-medicate with alcohol, leading to a vicious cycle of substance use.

As such, it’s in the interest of clinicians to consider the existence of co-occurring conditions when treating individuals with mental illness. Luckily, effective treatment methods that integrate care for substance use and mental health conditions exist. In fact, joint approaches offer the best chance for recovery. Here are a few examples of integrated treatment methods.

Motivational Interviewing

Individuals living with addiction often face intense internal conflict when making the choice to change addictive behaviors. To help address this conflict, a scientifically-backed therapy called motivational interviewing has emerged. Rather than try to convince an individual to stop using substances, trained counselors help clients explore a patient’s core values and life goals to determine whether substance abuse aligns with their concept of a positive, healthy life.


Individuals who are mindful notice things that are typically ignored or taken for granted; accept uncomfortable situations instead of wishing they were different; and notice and accept thoughts, feelings, sensations and urges without judgment or reaction. A study published in Clinical Psychology Review found that mindfulness is effective in treating stress and depression—conditions that fuel addictive behavior. Mindfulness is also commonly used to treat mood swings, impulsivity and grief.

Trauma-Informed Therapy

People who have experienced a significant trauma sometimes turn to substances to numb feelings or ease painful memories. To ensure best results, trauma-informed therapy addresses both addiction and trauma-specific treatment approaches. This type of treatment is characterized by its emphasis on physical, psychological and emotional safety, helping patients regain a sense of control.

12-Step Facilitation

Industry evidence supports the value of participating in 12-step peer support groups during recovery. For instance, a 2015 study tied 12-step meetings with alcohol abstinence. Some people are hesitant to attend their first group session, yet ongoing success often depends on a group support system. These proactive programs are built on a set of guiding principles, such as acceptance, self-awareness, achievement and compassion. They help improve outcomes by offering a specific course-of-action for reaching recovery.

Recovery often depends on treatment plans that consider the full picture of substance abuse and mental health issues. Because the probability of having a mental health diagnosis in addition to a substance abuse disorder is very high, individuals should seek out treatment programs that prioritize both identification and comprehensive treatment of co-occurring disorders. People with substance use issues typically want to break the cycle of addiction. Let’s help those individuals in reaching that goal.


Katie Stout is an Executive Director at Gateway Foundation, the largest nonprofit treatment provider in the country that specializes in the treatment of substance use disorders for men, women, adolescents. Katie has been working in the behavioral health care field since 2004 and has previous experience with treating eating disorders and co-occurring mental health disorders. If you or a loved one is struggling with addiction, visit RecoverGateway.com.

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