The Collision of Mental Health and Substance Abuse


I woke up this morning like any other day. Shower, play with the dog, take my mental health medication, head to work. Little did I know that across town another woman was waking up, with a similar mental health condition, but in a very different environment. She woke up in a crack house, next to men she didn’t know, thirsty because there was no running water in the house and hungry because she had been on a bender for days. Her drug of choice: cocaine.

I look at her now and can’t help but think “What’s the difference? Why have I succeeded where she hasn’t? And why isn’t more being done to help these people who are struggling?”

She’s not the first to sit across the desk from me and tell me this story. Unfortunately, she’s just the most recent. Each year I see more and more mental health clients resorting to substance abuse to cope with their disorders.

I can’t help but wonder why I don’t hear anyone talking about her. Perhaps because we absolve ourselves of guilt if we pass her off as another junkie who chose that lifestyle over being stable and successful. Perhaps because we want to believe we are better than that and we could never end up that way. But you know what? When I listen to her describe how she just wanted to be numb and get her mind to stop for a few minutes, I realize there are days I feel the exact same way. Maybe we’re not really that different after all. Maybe I’m just lucky enough to be surrounded by people who remind me in my toughest times I’m not alone.

You know, she didn’t start out this way. Just last week she had a job, was taking her medication as prescribed, mending fences with her child, and succeeding at being independent of an abusive relationship. She came a long way in a short time and had all the potential in the world. But that was last week. This week her mental health issues got the best of her.

The only difference I see when I compare myself and her is the people in our lives. People make the difference. It’s not the medication, counseling, or supportive programs, although these help. It’s the people you encounter along the way who give you value as a human being, the people who believe in you until you’re finally able to believe in yourself, that make all the difference. I had many of these along the way. Clearly she wasn’t that lucky.

I don’t want her to be another statistic, another victim to her illness. But I also know I can’t change her until she’s ready for help. So instead of forcing her into something she’s not ready for, I told her she was beautiful. And that we see potential in her. I recalled for her the progress she had made. And then we took her back to the house she came from with the reminder that we will be here for her when she’s ready to fight.

But in the darkest part of my mind, I wonder what will happen if she’s never ready to fight again and we have lost our shot, as we have with so many other mental health clients. How do we change our society into one that values and supports those with different diagnoses so we no longer judge them by their reactions but help them be proactive? How do we keep her, and millions like her, from ending up on the other side of my desk?

If you or a loved one is affected by addiction and need help, you can call SAMHSA’s hotline at 1-800-662-4357.

Thinkstock photo by Discha-AS


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