Can Addiction Be A Mental Illness?

Struggling with mental health and substance abuse is incredibly painful and challenging for addicts and those close to them. This is exacerbated by the stigmas and misconceptions surrounding the connection between mental health and addiction.

Until fairly recently, substance addiction has been viewed as a lifestyle choice or character flaw rather than a diagnosable mental illness. Now, the National Institute on Drug Abuse, the American Psychiatric Association, and the DSM-V all categorize addiction and substance abuse as a mental health disorder.

Before professional recognition as a mental illness, addicts were seen as villains, or weak people lacking in willpower. There were no rehabilitation centers or programs designed to help people struggling with addiction. Instead, addicts were viewed as criminals and often imprisoned, rather than handled with compassion and treated for their illness.

How Addiction Affects The Brain

We can at least partially thank advances in technology for changes the perceptions of addiction. Brain scans show that substance abuse can physically change the brain in such a way that inhibits self-control and intensifies cravings. This helped shift the perception of addiction as a choice for mental illness. Removing the possibility that addiction is a choice or inherent character flaw allowed people to see the truth, that addiction is a disease a person cannot help having, just like cancer or diabetes.

Drugs affect the rewards and pleasure centers of the brain. The rewards center usually works to ensure that humans do healthy, vital things like sleeping and eating. It does this by releasing dopamine, the feel-good chemical associated with pleasure, into the brain whenever you do an activity that is crucial to survival. After repetition, the brain associates the activity with pleasure so the person will want to do it again.

Drugs work the same way, but even more intensely. Drug use releases 2 to 10 times the amount of dopamine as natural processes like eating and sleeping. This causes the euphoria, or high, that causes people to want to do the drug again. But the more a person uses the drug, the more they get used to the flood of dopamine and become increasingly desensitized to it. This is the process of building a tolerance to the addictive substance.


Not only will the addict need more of the drug as tolerance grows, but they will also not be able to derive pleasure from natural processes. The body becomes addicted to the substance as well and can suffer withdrawals, or painful, uncomfortable physical symptoms if the substance is not used. Instead of using the drug to get high or feel pleasure, the addict will need to take the drug to avoid feeling pain or discomfort.

The Risk Of Developing Addiction

Although there is evidence that substance abuse leads to brain changes, some may argue that addiction is different from other mental illnesses because an addict must first choose to do drugs in the first place. This assumes that those with enough willpower will never try drugs, to begin with.

But the truth is that many uncontrollable factors increase the risk or likelihood that a person will first try drugs. One example is growing up in a household with substance abusers, or attending a school with a high rate of drug use. Genetic factors also affect the likelihood that a person will become addicted or not once they have tried a substance. Research shows that genetics are about 50% responsible for the risk of becoming addicted.

Addiction is Still Stigmatized in Society

In order for widespread change, society needs to be educated and understand the science behind addiction. It is not a choice, but a diagnosable mental illness with uncontrollable environmental and genetic factors. The more society eliminates the stigma around addiction and mental health, the more effectively addiction can be treated.