Addiction and mental health disorders: when the two intertwine
Sleeping, calming down, getting through: many people who use do so to soothe something. When an addiction coexists with a mental health disorder (anxiety, depression, a mood disorder, post-traumatic stress, an attention disorder…), professionals speak of comorbidity. The two often reinforce each other, which makes the situation harder to untangle, but not hopeless.
The report by the French General Inspectorate of Social Affairs (IGAS), published in early September 2026 on care pathways for addictions, in fact lists psychiatric comorbidities among the factors that complicate the situations teams encounter. What this changes for the person concerned, and what they can do with it, is the subject of this text.
What does "comorbidity" mean?
The term simply refers to two disorders being present in the same person: here, an addiction (to a substance or a behaviour) and a mental health disorder. It says nothing about which came first or what causes what. In some paths the mental disorder existed before the use; in others it is the use that brought on or worsened symptoms; often the two progress together.
Why the two intertwine
Several mechanisms combine, and they vary from one story to another.
- Use as an attempt at regulation. A drink to fall asleep, cannabis to calm anxiety, a repeated behaviour to silence intrusive thoughts: in the moment, it relieves. Over time the relief fades and the original problem remains, with a dependence on top. The article on cannabis as a support for sleeping, coping or calming down illustrates this logic well.
- The substance's effects on mood and sleep. Alcohol, cannabis, stimulants or certain medicines can worsen anxiety, disrupt sleep or deepen low mood, which keeps the circle going.
- Shared vulnerabilities. An old trauma, difficulty managing emotions or insecure attachment can expose a person to both addiction and other psychological suffering. The article on addiction and attachment trauma develops this point.
- Stopping reveals. When a substance goes, what it covered can come back: anxiety, insomnia, sadness. The difficulty of sticking with stopping then also comes from there.
Why an unnoticed disorder complicates leaving addiction
If only the addiction is treated, the underlying reason for using remains. The person then faces the same symptoms without their usual "crutch", and the risk of going back increases. Conversely, treating only the mental disorder without taking use into account can leave an aggravating factor in place: alcohol, for example, can limit a treatment's effect or keep symptoms going.
Another difficulty: at the start of stopping, it is sometimes impossible to tell what belongs to withdrawal and what belongs to an underlying disorder. It is observation over time, with a professional, that lets you see clearly.
What joint care changes
Taking both dimensions into account doesn't mean treating everything at once or demanding abstinence before dealing with the rest. In practice it can mean:
- an overall assessment: use, sleep, mood, anxiety, life history, current treatments;
- coordination between the addiction specialist, the family doctor, the psychiatrist or psychologist, when several are involved;
- gradual, realistic goals, adjusted as support goes on;
- attention to medicines, some of which don't mix with alcohol or other substances.
An addiction specialist can coordinate this work or refer you to the right services.
How to talk about it with your doctor
You don't need to understand everything before seeing someone. A few markers help prepare the conversation:
- Describe your use as it really is, without playing it down: the doctor is bound by confidentiality and is not there to judge.
- Talk about the rest too: sleep, mood, anxiety, racing thoughts, significant events.
- Bring the list of treatments you take, including those without a prescription.
- Don't stop a psychotropic medicine on your own (antidepressant, anti-anxiety drug…): stopping abruptly can be dangerous or worsen symptoms.
Further reading
- Why do people become dependent? Substance, person, context
- Addiction and attachment trauma: why the bond matters in care
- Cannabis: when use becomes a support for sleeping, coping or calming down
- Relapse in addiction: what it tells you, and what helps you start again
Frequently asked questions about addiction and mental health disorders
Which comes first, the addiction or the mental health disorder?
It depends on the story. Sometimes the psychological suffering comes before the use; sometimes the use triggers or worsens symptoms; often the two feed each other. What matters isn't deciding alone but describing to a professional what happened and in what order.
Do you have to stop using before treating the mental health disorder?
Not necessarily. Depending on the situation, both are treated together, or you start with what is most urgent or safest. Demanding abstinence before any psychological care isn't a rule: the plan is built with the person.
Is using to calm your anxiety a solution?
The relief is real but short-lived, and it can sustain anxiety in the longer term (rebound, tolerance, dependence). It is a signal that a need isn't being met: sleep, calm, support. Other responses exist, with suitable follow-up.
Is a psychiatric disorder an excuse to use?
No, and it isn't a fate either. Understanding what the use is regulating lets you avoid judging yourself and look for alternatives. It is a starting point for care, not a justification.
If you recognise yourself in this situation, a first conversation lets you lay the groundwork without judgment: you can book an appointment or find out how addiction support works.
