Untangling the Web of Addiction: The Relationship between...

Untangling the Web of Addiction: The Relationship between Mental Health and Substance Use Disorders


(Part 1 in a 4-part series)

By: Madeline Kelly, LPCC, NCC, LADC, CCTP
Licensed Professional Clinical Counselor
Licensed Alcohol and Drug Counselor

“I am finally a present mother to my kids.” – Julie

Years of drug use and living a secret life finally caught up with Julie when friends and family began noticing her odd behaviors and confronted her about her drug habits.

“I came to treatment not knowing what I was getting myself into.”

Julie soon learned that she had a dual diagnosis, and that ultimate healing would come from a program that treated her addiction and mental health concerns, equally. Julie is not alone.

Since the beginning of the coronavirus epidemic, we have witnessed the continued rise of mental health issues such as anxiety, depression, and PTSD. Many who suffer from these symptoms also experience substance use disorders, leading to a tangled web of problems. The research shows that drugs and alcohol make mental health symptoms worse. This co-occurring condition is called “Dual Diagnosis,” and it is difficult to unravel without specialized treatment.

45% of people in the United States struggle with a dual diagnosis

Licensed Professional Clinical Counselor Madeline Kelly knows this subject matter well. Kelly and her colleagues help clients untangle the dual diagnosis web by addressing both substance use and mental health concerns, equally, so that individuals may experience long-term recovery. In the Q&A below, Kelly shares the causes that often influence a co-occurring disorder and how to recognize common behaviors that are associated with dual diagnosis.

Q: Why do mental health and substance use disorders co-occur so frequently?

A: Some people have the misunderstanding that mental health and addiction are choices. We know that it is much more complex than that. For example, about 40-60 percent of an individual’s vulnerability for mental illness and substance use comes from genetic components. Family history of mental illness and addiction can be indicators of potential predispositions.


Q: Are there other contributors to a dual diagnosis?

A: The environment plays a significant role in the development of these comorbid disorders. An individual’s exposure to stress, trauma, and adverse childhood experiences can increase the likelihood of mental illness and addiction issues. When risk factors for substance use and mental illness are overlapping, such as genetic predispositions and trauma, this makes a person more likely to develop these issues.


Q: How do you know if someone has a substance use disorder?

A: There are noticeable signs to determine if someone may have a substance use disorder. You may see changes in their physical appearance if they are not keeping up with self-care. Other identifiers include changes in appetite and their inability to manage responsibilities. This comprehensive list of behaviors will provide insight to determine if someone has a substance use problem.


Q: How do you know if someone is struggling with mental health issues?

A: The symptoms of a mental health condition can vary greatly. Looking for warning signs is the first step to help you identify if someone would benefit from mental health counseling or treatment. These signs include extreme mood changes, confused thinking or problems concentrating, avoidance of friends and social activities and thoughts of suicide. Sometimes those who suffer with mental illness may also use drugs or alcohol to mask their pain. This is referred to as “self-medicating.” Substance use may be the only coping mechanism of choice, but it exacerbates symptoms and leads to compounding issues. When this happens, it is important to seek help for both mental health and substance use disorders. In many cases, they are truly co-occurring, and treatment needs to untangle the interrelated issues.


Q: How do you recognize the behaviors of someone struggling with a co-occurring condition?

A: The defining characteristic of dual diagnosis is the evidence of a mental health and substance abuse disorder occurring simultaneously. Because many combinations of disorders can occur, the symptoms of dual diagnosis vary widely. A disorder does exactly that - it puts one’s life out-of-order. Someone struggling with dual disorders might find their substance use and mental illness leading to problems in relationships, at work, or leading to legal issues, financial problems, or health complications.


Q: How do you guide someone toward treatment after recognizing dual diagnosis symptoms?

A: It is important to understand that there are several next steps to navigate before enrolling in a treatment program. Part 2 of this series, Untangling the Web of Addiction: Overcoming Challenges Toward Treatment highlights best practices for:

  • Engaging in the initial conversation
  • Understanding the assessment process
  • Managing and removing barriers to treatment

In part 3 of this series, we’ll analyze unique treatment solutions and identify differences between them. Untangling the Web of Addiction: Effective Treatment Solutions.

Part 4 of this series will highlight the benefits of integrating faith and therapy if this approach is requested by a client. Untangling the Web of Addiction: The Role of Spirituality in Treatment

Learn more about the Christian Family Solutions Adult Dual Diagnosis Intensive Outpatient Program.

headshot of Madeline KellyMadeline Kelly is a Licensed Professional Clinical Counselor who works with the CFS Adult Dual Diagnosis Intensive Outpatient Program in the CFS clinic in Mankato, MN. She specializes in working with individuals who struggle with co-occurring mental health and chemical dependency issues.

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