• Nicole Arzt

5 Reasons Co-Occurring Mental Illness Can Negatively Impact Sobriety

Research shows that 50% of people struggling with severe mental illness also struggle with substance abuse. Unfortunately, co-occurring mental illness doesn’t always receive the attention or recognition it deserves.


Individuals who are struggling with co-occurring issues can often fall through the treatment cracks. While they may receive support for one condition, failing to address the other problem may lead to relapses and decompensation in all areas of functioning.


And while recovery is possible, co-occurring mental illness often requires professional treatment and long-term management. Let’s explore the challenges associated with this phenomenon.


Sobriety Trigger #1: Insufficient Treatment For Mental Illness


Many people struggling with a substance use disorder enter addiction treatment to get help with their drug or alcohol problem. And while getting sober may be the first step towards physical and emotional well-being, sobriety doesn’t tell the whole picture.


If treatment doesn’t address mental health, the recovery remains incomplete. Individuals may be equipped for managing substance triggers. But if they don’t account for other symptoms that may arise, they are especially prone to relapse.


Comprehensive treatment for mental illness needs to be integrative and client-centered. Effective treatment may includes some or all of the following components:

  • Individual therapy focused on coping skills and symptom management

  • Medication evaluation

  • Peer support via support groups and recovery coaching

  • Emphasis on self-care (nutrition, exercise, sleep hygiene)

  • Family therapy focused on boundaries and healthy communication

  • Alternative therapies (experiential therapy, yoga and mindfulness, equine therapy)

  • Recovery groups (12-Step Groups, SMART Recovery)


Furthermore, effective treatment is about treating both conditions simultaneously. Because both conditions often affect one another, it is essential to address and target both at the same time.

Sobriety Trigger #2: Hopelessness and Despair


Hopelessness and despair are two common symptoms associated with depression, a common medical condition that affects over 17 million American adults. It’s no surprise that, when people are in the midst of a major depressive episode, their physical and emotional health both suffer.


On a moderate level, people may move through their days in a sluggish fog. Their appetite and sleep often suffer. They may feel more irritable and distracted around others. On a more severe level, however, they may doubt if life is even worth living. They may think, plan, or attempt suicide.


When someone feels hopeless or worthless, drugs and alcohol can provide a brief sense of relief and euphoria. In many ways, these substances appear to “soften” the intense effects associated with depression.


Unfortunately, this attempt to escape is short-lived. While drugs and alcohol can undoubtedly offer a temporary numbing effect, the problems do not disappear. In fact, substances usually add more problems, which can perpetuate even greater feelings of hopelessness.


Sobriety Trigger #3: Interpersonal Problems


Mental illness often affects interpersonal relationships. Parents or other caregivers may experience a sense of burnout in supporting their loved ones. Partners might feel neglected or resentful if the individual isn’t taking adequate care of themselves.


Interpersonal problems related to boundaries, poor communication, or resentment can undoubtedly impact someone’s recovery. Relationships are a fundamental part of one’s sense of purpose and self-esteem. When issues and tension arise, it can feel catastrophic. To cope with these challenging feelings, individuals often feel tempted to drink or use. They may assume that the relationship is already doomed, or they may crave the substance just to “take the edge off.”


Sobriety Trigger #4: Medication Problems


Many people struggling with mental illness benefit from psychiatric medication to alleviate their symptoms. There are many kinds of medications available, and finding the right one can be a trial-and-error process. Likewise, some medications can take several weeks to go into full effect.


Some psychiatric medication can be controversial in sobriety. That’s because some medication can be abused, which can perpetuate addictive problems. Controversial controlled medication includes stimulants (Adderall, Vyvanse, and Ritalin), benzodiazepines (Valium, Xanax, and Klonopin), and antiepileptics (Gabapentin).


Sobriety looks different for everyone, and each person has varying risk tolerances. Therefore, all individuals should consult with their treatment team about the risk associated with controlled medication.

Sobriety Trigger #5: Other Compulsive Issues


Individuals entering recovery for drug and alcohol addiction also tend to exhibit other compulsive issues related to:

  • Disordered eating (overeating, restricting, purging, excessive exercise)

  • Overworking

  • Spending (online shopping, gambling)

  • Hoarding

  • Technology (Internet, video games, television)

  • Sex (pornography, infidelity)


Individuals may or may not be aware of these co-occurring compulsive issues. They might rationalize or deny the problems altogether. Moreover, even when someone enters sobriety, they may struggle more with the other compulsion. That’s because they haven’t yet integrated healthier coping strategies to manage their distress tolerance.


Final Thoughts On Addressing Co-Occurring Mental Illness


Co-occurring mental illness requires unique attention, care, and treatment. Recovery requires looking at all areas of a person’s life. Failing to treat one’s mental health only increases the chance of relapse.


At The Resurface Group, we provide comprehensive care for all conditions. We work with clients from all backgrounds, and we believe everyone deserves the chance for recovery. Contact us today to learn more about how we can help you.

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