Until now, you have been mainly thinking about your addiction. However, most people with addictions also have mental health issues like depression and/or anxiety. The term co-occurring disorders describes a situation in which someone has both a substance use problem and a mental health problem at some point in their lifetime. Substance use/addiction and mental health problems can lead to symptoms and behaviors that look very similar, so not only you, but also treatment professionals may find it difficult to determine whether your current symptoms are being caused by substance use problem or a mental health problem, or both.
It has been my experience that it does not really matter. Depressed, clean people are not likely to stay clean for very long—especially if they have not developed new coping skills to deal with the depression yet. The toll that most addictions (including things like gambling and sex addiction) take on the brain leads to a brain chemical imbalance and problems in your life cause at least temporary depression and/or anxiety. Many physicians will prescribe a short course of antidepressant medication to help you get through the “gray phase.”  This is the time that it seems like there is no color in the world. Everything is blah. There are no highs, but there are still frequent lows. You can’t get excited about staying clean when everyday feels like drudgery. The awesome thing is that, over time, your brain and body will likely recover.
If you are depressed or anxious or struggling with another mental health issue before the addiction starts, you may have tried to self-medicate with your addiction.  If your brain did not make enough of certain chemicals responsible for helping you feel happy, you may have “assisted” it through your addiction.  This chemical imbalance may need to be treated indefinitely with medication. Most of these medications cannot be abused in a way that allows you to get high. They are used to help you have a similar amount of “happy chemicals” in your brain as other people do. It is important to make sure you talk with your doctor about any medications, making sure he or she knows that you are also struggling with addictive behaviors.
In the next few pages, you will learn about some of the different diagnoses and how they may be impacting you in your addiction and in your sober life. Remember that mental health issues exist along a continuum. Don’t get too bogged down in whether or not you are “diagnosable.”  Everyone has days when they are depressed, anxious or cannot concentrate. If you are mindful of your symptoms on a daily basis, you can do a lot to prevent them from getting out of control and causing a relapse.