Sometimes, using alcohol or other substances is a way to get through a bad day. Maybe you drink to shut off your thoughts, smoke to feel less anxious, or take something to get a break from emotions that feel too heavy. It may appear to help at first. And when those feelings keep coming back, substance use can slowly become part of your coping.
It can be hard to tell when that change occurs, particularly if you are already dealing with anxiety, depression, stress, or another mental health challenge. You may find yourself craving a substance more and more, feeling worse after you use it or having trouble getting through your day without it.
If this sounds familiar to you, you do not have a substance use disorder. But it may be worth looking more closely at the connection between how you’re feeling and how you’re using substances. Knowing the signs can help you understand what’s happening and when it might be time to get help.
What Is the Connection Between Mental Health and Substance Use?
Sometimes the link between mental health and substance use isn’t readily apparent. Somebody who has anxiety might drink to help them feel more at ease with other people. A person with depression could use drugs to feel something other than sorrow. It might be palpable in the moment, but it may not last.
The National Survey on Drug Use and Health (NSDUH) by SAMHSA reports that mental health and substance use continue to be prevalent issues in the United States in 2025. The 2025 National Survey on Drug Use and Health report provides more information about these experiences and the need for appropriate support.
Studies have also indicated that mental health disorders and substance use disorders can co-exist. The National Institute on Drug Abuse says, “These conditions may have common risk factors and may influence each other.” In other words, it’s not always easy to tell where one problem ends and the other begins.
What to look for is if your substance use is turning into a regular method of coping with feelings, escaping from hard thoughts, or getting through situations that feel overwhelming.
Why Can Mental Health Challenges Influence Substance Use?
When you’re upset, it’s tempting to look for something that will make you feel better fast. Sometimes, alcohol and other drugs can affect how you feel so that you relax, sleep, socialize, and forget about something painful.
The problem is, temporary relief doesn’t mean you’re addressing what’s causing the distress. Some substances can also disrupt sleep, impact your mood or make anxiety and depression more difficult to manage over time.
You might drink to relax after a hard day, only to wake up feeling more anxious. You can take a substance to stop unpleasant thoughts from returning, but they can come back when the effects of the substance are gone. When that occurs repeatedly, people can get into the situation of wanting something and having to face the repercussions.
That doesn’t mean everyone who experiences mental health challenges will develop a substance use problem. But if substances are becoming your main way of coping, paying attention to the pattern can help you decide what kind of support might be useful.
What Are the 7 Signs That Mental Health Challenges May Be Affecting Substance Use?
No one sign will tell you exactly what is happening. You may notice changes in your habits, your mood, your relationships, or how you cope with everyday stress. Sometimes change comes slowly, and it’s easier to ignore. These 7 signs can be a way to think about whether there might be a link between your mental health and substance use.
1. You’re Using Substances to Cope With Difficult Emotions
We all have those rough days. There’s a difference between drinking or using a substance socially every now and then and needing to use it to feel okay on a regular basis. If it is the answer you fall back on when you are anxious, lonely, upset, or overwhelmed, it may be worth paying attention to what it is you are trying to manage. You might notice that you:
- Reach for alcohol or another substance whenever stress starts building up.
- Use substances to quiet anxious thoughts or distract yourself from sadness.
- Feel uncomfortable facing certain situations without something to take the edge off.
- Find it harder to relax unless you’ve used a substance.
The use of substances does not necessarily indicate a disorder. If you feel like you cannot deal with the negative feelings without them, it means that you are in need of more than a quick fix.
2. Your Mental Health Symptoms Feel Worse After Using Substances
Perhaps you get a bit more relaxed after a few hours of drinking, but the next morning you are restless, irritated, or preoccupied with anxious thoughts. Or maybe you turn to a substance to escape sadness, only to come out of the experience even more emotionally drained.
The experiences can be confusing because the substance initially might appear helpful. However, some of these can have an impact on sleep, mood, concentration, and anxiety, and have effects that persist beyond the initial sensation. If you have this pattern, you may:
- Feel more anxious or low due to alcohol or other drugs.
- Have trouble sleeping or feel exhausted the following day.
- Notice mood changes that seem connected to when you use or stop using a substance.
- Keep using something for relief, even though you often feel worse afterward.
The pattern will not be identical for all people, and symptoms can have multiple causes. However, if you repeatedly notice decreased well-being post consuming substances, it is worth talking about this with a health care provider.
3. You Use Substances More Often When Life Feels Overwhelming
Consider the following scenarios when you are under stress at work, experiencing a challenging relationship or facing a personal failure. In those times, are you using substances more often?
When challenging emotions get harder to deal with, for some, using substances escalates. A stressful week could lead to more than usual drinking sessions, or an unpleasant experience could motivate people to drink more than usual. This could be a recurring reaction in situations that are difficult in life. You may discover that you:
- Increase the use of substances during stressful times.
- Eat more than intended when feeling stressed out or overwhelmed.
- Have a hard time reducing your intake after a stressful situation occurs.
- Go back to substance use if the uncomfortable feelings return.
Using drugs and alcohol doesn’t necessarily mean that you’re under more stress than usual; it can affect anyone. The question is, is substance use now your primary coping mechanism for some tough times?
4. You Struggle to Control Your Substance Use, Even When It Causes Problems
You may say to yourself: “I’m going to drink just one; I’m going to have a break for a while.” However, when the time strikes it is harder than one expects to adhere to it.
This can be particularly confusing if you are aware that your use of the substance is impacting your health, finances, relationships, or responsibilities. It may be that you really want to change the pattern, but you find yourself reverting to it again and again, especially when you’re feeling depressed or anxious. There are indications to watch for, such as:
- Using more than you intended or for longer than you planned.
- Trying to cut back but finding it difficult to follow through.
- Continuing to use substances despite arguments, health concerns, or problems at work.
- Spending a lot of time thinking about using, recovering afterward, or trying to manage its effects.
Difficulty cutting back doesn’t mean you’re weak or that you aren’t trying hard enough. It may be an indicator that you might need professional assistance to learn the cause of the pattern and how to change it.
5. You Start Pulling Away From People or Responsibilities
Normal life can be exhausting enough when you’re having mental health issues. You may also begin to avoid plans, ignore messages, or fall behind on obligations if you are also having trouble controlling substance use.
Maybe you exercise to stay busy when you don’t feel like being social. Perhaps you’re avoiding family members because you don’t want to tell them what you’re doing, or perhaps you’re missing work in case you’re not feeling well after using substances. It’s not a problem if you have a plan that you miss, but if you have the same plan that you miss multiple times, that is something to pay attention to. You may experience:
- Avoiding friends or family more often than you used to.
- Loss of interest in previously pleasurable activities.
- Failure to arrive at work, school, appointments or other obligations.
- Hiding your substance use because you’re afraid of what people will think.
When you leave, you may be leaving behind less assistance than you might need. If you are feeling more and more isolated, it could be beneficial to speak with someone you trust or a mental health professional.
6. Your Sleep, Mood, Energy or Behaviour Starts Changing
The initial signs often don’t come in terms of how often you are using substances. These are changes that you observe in your daily activities. It might be hard to get a good night’s sleep; you may feel tired all day long, unusually frustrated, or unable to focus.
These changes may be associated with a variety of factors such as stress, mental health issues, substance abuse or a mix of these. Some signs and symptoms may be more obvious or may even start at a specific point, particularly if the use of a substance appears to trigger these signs and symptoms. For instance, you may find that you:
- Difficulty falling asleep, staying asleep, or feeling well-rested.
- Experience extreme levels of worry, sadness, restlessness, or irritability.
- Have difficulty focusing or staying on task.
- Noticeable change in appetite, energy, or behaviour.
With busy lives, it’s easy to overlook these changes as a rough patch. If these persist, have an impact on daily activities or worsen, then talk to a healthcare provider instead of assuming they will go away.
7. Managing Emotions Without Substances Feels Increasingly Difficult
Perhaps you used to relieve stress, loneliness or anxiety by talking to a friend, having a walk or taking time to think. At present, those choices might not seem so useful and it may appear like the only method to calm your mind is to take a substance.
The phrase doesn’t mean that you have lost the ability to cope. This can make it more challenging to access other strategies when dealing with challenging emotions, particularly when you’re feeling overwhelmed and out of control. You may find you feel like you:
- Feel uneasy or restless when you can’t use a substance.
- Find it difficult to sit with uncomfortable feelings without making attempts to move away from them.
- Has trouble enjoying socializing, relaxing without using something.
- Have a negative response to stress when substances are not available.
If you’re feeling this way, it’s not necessary to deal with everything at once. A mental health or substance use specialist can support you in examining what’s challenging you and finding other strategies to manage it, but shouldn’t try to convince you to make all your changes in one day.
How Can Mental Health Conditions and Substance Use Affect Each Other?
Mental health issues and substance use can frequently intersect, and both can make the other one more difficult to treat. For example, if you have anxiety, you might use drugs or alcohol to numb or dull the feeling, but these substances may lead to issues sleeping and increased anxiety later on.
There is a potential interaction between depression and substance use. While someone might use drugs or alcohol to manage their low mood, the shifts in sleep, energy, relationships, or routine could contribute to his or her low mood. In other instances, substance abuse could take precedence over emotional issues, which then become more apparent over time.
Do not presume one condition will always lead to another. Relationships can be complicated, and other factors may be at play. A professional assessment can aid in determining if you are having symptoms and what form of treatment may be suitable.
This can also be helpful to know the difference between using the substance to deal with emotional distress and when the emotional distress becomes a mental health and substance use disorder.
| Using substances to cope | Co-occurring conditions |
| A person uses substances to manage stress, sadness, anxiety, or other difficult feelings. | A person experiences both a mental health condition and a substance use disorder. |
| The pattern may be occasional or may become more frequent over time. | Both conditions may require assessment and coordinated treatment. |
| The person may or may not meet the criteria for a substance use disorder. | A healthcare professional can assess both conditions and recommend appropriate care. |
These experiences may not always be so easy to part ways from without the help of professionals. If you feel your actions are being problematic, an honest discussion with your health care provider will enable you to better understand what’s going on without making any assumptions.
When Should You Seek Professional Help?
There’s no need to wait until substance use has touched every part of your life to seek help. If you are worried about your substance use, having trouble managing your emotions, or experiencing changes in your relationships and daily routine, it is reasonable to talk to a healthcare professional.
Seeking help can be especially important if you have tried to cut back and been unable to, or if your mental health symptoms are becoming more difficult to manage. A professional will help you explore both concerns and work out what kind of support is best for your situation. If you’re unsure where to start, consider taking a few practical steps:
- Talk with a healthcare professional about your mood, symptoms, and substance use.
- Notice patterns in when you use substances and how you feel before and afterward.
- Reach out to someone you trust if you’re finding it difficult to manage everything alone.
- Ask about treatment options that address mental health and substance use together when both are concerns.
You don’t have to have all the answers before you ask for help. If you are worried about withdrawal, talk to a medical professional before you suddenly stop drinking alcohol or other substances. Alcohol withdrawal can be dangerous, and medical guidance may be necessary.
How Cholla Behavioral Health Can Help You Find Support
If mental health challenges and substance use are starting to feel difficult to manage together, you don’t have to work through everything on your own. Understanding what you’re experiencing is a good starting point, and the right support can help you explore the next steps.
At Cholla Behavioral Health you can explore behavioral health services that fit your needs and situation. The team can also help you learn more about the care options available to you, including outpatient levels of care and whether a particular service may be appropriate for your situation.
That first step can be intimidating, especially if you don’t know how to describe what you’ve been through. You don’t need a perfect explanation or plan to be able to reach out. Contact us today to ask questions, discuss your concerns, and learn more about the support options available to you.
Frequently Asked Questions (FAQs)
Q1. Can anxiety or depression lead to substance use?
Someone suffering from anxiety or depression might use alcohol or other substances as a temporary relief. But this is not for everyone, and there can be several factors to the use of substances.
Q2. Can substance use make mental health symptoms worse?
Yes, certain substances can affect mood, sleep, focus, and anxiety. The effects depend on the substance, the person, and the pattern of use. If symptoms keep worsening, speak with a healthcare professional.
Q3. What should I do if I think I have both a mental health condition and a substance use problem?
Talk to a healthcare professional about both of them first. They can help you evaluate your symptoms and discuss treatment options that are appropriate. You don’t need to diagnose your illness before you seek help.
Q4. Can mental health and substance use concerns be treated together?
Yes. If you have both concerns, you might be recommended to undergo treatment that addresses both. The correct method will be based on your requirements, signs, drug use, and your overall condition.
