Comorbidity, or the co-occurrence of two or more disorders present in one individual, is common in the world of addiction. Substance abuse is often intertwined with some form of mental health diagnosis. Understanding comorbidity, however, can be a bit challenging.

(italic) There’s the question of which comes first, does one spurn the other or do they arise together?

 This can raise the debate of whether anyone without some form of mental health disorder would even develop an addiction in the first place.

(italic)Doesn’t some form of depression, anxiety, disease need to exist within an individual to lead them to drink in a manner that would lead to addiction?

This leads to larger questions regarding the source of addiction and what brings it about in some individuals and not others.

What are the difficulties in diagnosing a mental illness ?

Here are the significant difficulties in diagnosing a mental illness in an individual who is in the throes of substance abuse.

  • Disorders such as bipolar, depression, anxiety, and psychosis can be mimicked by the effects of substance abuse.
  • Going through the tumultuous experience of substance use can lead to great distress and dysfunction.
  • Erratic mood swings are common as are lack of sleep and concerning behavior.

 All of these could fall into the category of a mental illness.

This is why it is always encouraged when someone is seeking out treatment for symptoms such as depression, anxiety, stress, moodiness, and more that they are asked to stop using any substance in order for a clearer diagnosis to be made. 

Once various factors are ruled out, the appropriate treatment options can be determined. I previously worked as a Case Manager for a community based mental health program in Fairfield, CA. I had several clients who presented with symptoms of psychosis and bipolar.

However, these clients were also frequent drug users including meth and marijuana. It is very hard to tease apart what is going on for an individual when drug use is presently occurring because the symptoms are so similar to a true mental health disorder.

A professional can only really get a clear picture when the client has been off any form of substance for an extended period of time.


Methamphetamine use in particular can create severe symptoms that closely resemble psychosis. Yet when the individual abstains from the drug, their mood and mind set will often stabilize and it then becomes evident that a disorder is not truly present.

Once an individual has been stabilized and off any substances for a few days the appropriate treatment can be offered. In the case of a substance abuse issue, the person would be offered options for addiction treatment centers that work with substance abuse.

Either in-patient or outpatient route could be beneficial in order to further stabilize, detox, and get some sobriety time. It is still difficult to know right away whether or not a mental health disorder is present.

How Professional Team Supports?

The professional support team established including a therapist, psychiatrist and medical doctor would work together to monitor, observe and consult to determine what the client’s true condition is. Should a mental health disorder be diagnoses, the person would then be offered options for therapy, recovery work, and possibly medication.

It is important to be mindful in terms of taking all components into consideration when it comes to mental health. Sometimes mental illness and substance abuse are both present, relatively separate from one another. Other situations involve substance-induced mental health disorders that may subside once use is discontinued.

Get the Treatment You Need

Either way, comorbidity of mental illness and substance abuse is challenging and overwhelming. Be sure to seek out treatment and support from professionals if you’re suffering from this condition to achieve the peace you deserve.