Underlying Mental Health Conditions in Addiction Recovery

Substance abuse has a high correlation to secondary mental health conditions. 

For some, this is because they haven’t been diagnosed, so they don’t know that they are living with a mental health disorder, such as depression or anxiety. All they know is that they don’t like how they feel, and they want to try and improve it or control it, so they turn to drugs and alcohol.

For others, they’re aware of the symptoms and the issues, but they still want to mask them or get temporary relief from them, so again, they use drugs and alcohol. 

Someone struggling with an anxiety disorder might use alcohol to ease their discomfort temporarily, just the same as someone with depression or a bipolar disorder might use something like cocaine or amphetamines to try to change their mood and bring them up when they feel very down. 

But what are the most common underlying mental health conditions in addiction?

Top Underlying Mental Health Conditions in Addiction

The most common underlying mental health conditions in addiction include depression, anxiety, bipolar disorder, and personality disorders. 


Depression is often the result of neurobiological imbalances in the brain. For many people diagnosed with depression, the dorsolateral prefrontal cortex does not work the way it should. This means that messages are not sent between neurons correctly, so the brain doesn’t get the information it needs to fire correctly. It also leads to problems with regulating negative emotions.

Similarly, atrophy or poor blood flow to those regions can result in the brain not producing enough serotonin or similar neurochemicals. When this happens, it has a detrimental impact on mood and mental health, leading to symptoms that people may try to mask or temporarily relieve using drugs or alcohol. 


One of the most common underlying mental health conditions in addiction is anxiety. For many people, anxiety disorders are caused by imbalances in areas of the brain like the prefrontal cortex, dorsal anterior cingulate cortex, amygdala, and hippocampus. When these neurotransmitters are disrupted or imbalanced, they can’t properly send messages that control feelings, and this leads to high levels of anxiety symptoms. Because of this, some people may turn to drugs or alcohol to self-medicate. Unfortunately, much the same as with depression, long-term reliance on drugs and alcohol can cause changes to the brain that result in worsening anxiety. 

Bipolar Disorder

Bipolar disorder is often misdiagnosed as depression because many people seek treatment during the depressive episodes that mirror the same symptoms. However, bipolar disorder is a severe mental health disorder that is cyclical and has unpredictable changes in behavior and mood.

Those who have bipolar disorder are at a much higher risk of addiction and substance use disorders, particularly for substances such as:

  • Alcohol
  • Cocaine
  • Amphetamines
  • Opioids

In some cases, people self-medicate to mask their symptoms, while in others, they make impulsive decisions. This depends on the cycle, whether manic or depressive, and the individual. Unfortunately, the use of illegal drugs like cocaine or amphetamines can also mimic the symptoms of a manic episode and potentially exacerbate those symptoms, much the same as alcohol can exacerbate depressive symptoms. 

Personality Disorders

People living with personality disorders struggle with a range of mental health symptoms depending on their precise diagnosis.

In general, personality disorders can cause:

  • Overwhelming negative emotions
  • Detachment
  • Problems with relationships and trust
  • Dramatic behavior
  • Problems with self-regulation
  • Impulsive behaviors

Between 10 and 14 percent of the population lives with a personality disorder, though the prevalence of personality disorders are much higher among those who have been treated for addiction, hovering between 34 and 71 percent.

Getting Help for Underlying Mental Health Disorders in Addiction

If you are struggling with mental health disorders and addiction, help is available in the form of dual diagnosis treatment. At Sequoia Recovery Centers, our addiction treatment center specializes in the full continuum of care, including medical detox, inpatient drug rehab services, and outpatient services, all of which provide dual diagnosis therapy.

A big part of the success of this program is the ability to move through the different levels as needed, stepping up or down based on your performance. Dual diagnosis treatment gives you therapy, coping skills, and medication management for both substance abuse and mental health disorders concurrently so that one does not exacerbate the other. 

Overall, there are several underlying mental health conditions in substance abuse, and if you are struggling with any of them or you think you might have one, contact a treatment center like Sequoia Recovery Centers to discuss which level of care is right for you.

Reach out to our team now to get help.