If My Child Has an Addiction Plus a Mental Illness, Where Do I Start?

November 19, 2023

Expert Advice | Barbara Decker

Key Takeaways

  • When dealing with addiction and mental illness in children, it can be overwhelming to understand where to start.
  • Signs that it’s time to address addiction first: changes in behavior/appearance, crisis after crisis, hiding information, feeling responsible/failure, medical professionals suspect mental illness.
  • Previous methods that may not have worked include hiring a medical professional, seeking rehab programs, and reading/researching about mental illness and addiction.
  • It’s important to accept that addiction must be solved first before underlying mental health issues can be addressed.

If your adult child struggles with addiction, you may already be aware of the connection1 between mental health and substance abuse: “Substance use disorders also co-occur at high prevalence with mental disorders, such as depression and bipolar disorder, attention-deficit hyperactivity disorder (ADHD), psychotic illness, borderline personality disorder, and antisocial personality disorder.”

Which do you address first — and why? Should you tackle the mental health diagnosis first? Would this resolve the issue of addiction? If we don’t tackle the mental health issue first, will your child be able to overcome substance abuse? These questions are common. When your family is faced with both challenges at the same time, it can be overwhelming to understand where to start.

When do I know is that it’s time to take a step forward to address the addiction first, and then the mental illness

Here are the signs you need to look for in your own life; the signs that it’s time to do something different when it comes to addressing your adult child’s addiction and prioritize your efforts.

  • Your child is using drugs or alcohol and may be addicted, and you know this because:
  • Your child no longer looks and/or behaves like the child you raised.
  • Your child has crisis after crisis in his/her life and is unable to navigate through them.
  • You hide a lot of what is happening from friends and family.
  • You feel responsible and like a failure as a parent.
  • Doctors or other medical professionals have told you and your child that they have something else going on. ADHD, depression, mental illness, social anxiety — these are all common diagnoses among those struggling with substance abuse as well. If you don’t yet have a diagnosis, you suspect your child is facing one of these issues.

What have you tried in the past to help address addiction first, before mental health struggles? Are you trying these methods now — unsuccessfully?

Method 1: You hire a medical professional — like a psychiatrist or psychologist — to address or medicate the underlying mental health issue. You create a treatment plan that you think will address the problems and hopme that will help the substance abuse issue disappear also.

Method 2: You’ve searched for a rehab program that not only deals with the addiction at hand, but also includes strategies that address co-occurring mental health conditions, and cross your fingers that it’s all your child needs to want to choose recovery.

Method 3: Read and researched all of the material written by “smart people” about mental illnesses and addiction, and how they connect, with the hope that you'll be able to one day leverage this wealth of knowledge and help your child make changes in their life.

If these methods have not worked for you, I have another approach to recommend. Here's why this approach is important to try.

It is very common for there to be both mental health and addiction issues co-occurring.

Accept that the addiction must be solved first, before underlying mental health issues can be treated or handled. Stop focusing on the underlying mental health issues as the “reason” for your child’s use of drugs or alcohol. They may be the reason or they may not.

The exception to this is when your child was diagnosed with a mental health issue years before any usage started, and you are 100% sure of that. In that case, please rely on the appropriate medical expert. If this is the case, you may also benefit from the family training NAMI offers.

Focus on learning the things you need to learn to love and support a child with an addiction. Loving them is very different from loving and supporting your other children, and it’s important to understand how to Love Another Way. You’ll be there to help support your child’s mental health journey once the addiction is addressed.

Why is it important to Love Another Way?

Understand that it’s impossible to know what actions of your child are due to addiction and which actions are a result of a mental illness — it could be months before they’re clean of all substances. My son Eric was diagnosed with several mental health issues, and after he completed recovery, I expected a long list of other things we needed to address. They never came up, however, and I’ve learned this is a very, very common situation.

As parents, we prefer to think that our child is primarily struggling because of their mental illness instead of addressing the addiction at the core of their difficulties in life. Remember -- addiction is no more a child’s fault than mental health issues. Focus on the addiction; it must be dealt with first to then sort through mental health issues.

Most importantly, those with addiction will blame anything around them for their troubles instead of ever blaming their actual addiction. This means they’ll place blame on their mental health issues, on you as a parent, or on other family members. Of course, these are all excuses and nothing will change until we stop buying into it.

Take this first step now.

I’ve put together a couple of short snippets on the topic of addiction versus mental illness. Listen to them here. When you talk about or think about what is happening with your child, say to yourself or out loud: My child has an addiction problem. My child may also have a mental health issue or issues. The first thing to resolve is the addiction problem. Then, the mental health issues can be tackled.

Click here to listen to these discussions

Then take step two: Listen to my workshop. Discover HOW to Actually Address the Addiction Issue.

My son was diagnosed with a laundry list of mental illnesses while he was in his addiction. I talk about this and how I had to navigate it in my workshop, Sign up at the button below.

Hop on my workshop now.

Watch this workshop to find out how to actually address addiction.

I hope you find a pocket of joy in your day today.
Reach out anytime, because I care.


Certified Family Recovery Specialist (CFRS)

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  1. I have a brother who has struggled with mental health (depresssion, anxiety, bi polar) and substance abuse issues for almost 10 years. He is 28, still lives at home, and deals with these issues but doesn’t seem motivated to try and solve them. My parents have send him to multiple rehab facilities, provided him healthcare to see the best doctors, and have helped him get through school and find a job. I’m a so resentful of what he has put my parents through. He deals with crisis after crisis and my parents are drained. Really need advice.

    1. That’s a very common feeling among the siblings of those with mind diseases like this. You are welcome in one of our coached programs if that is right for you, Carlos. -B

  2. My son, 24 – still living with us and not being able to keep a job due to mental illness struggles- has been diagnosed with ADHD at a young age but we never medicated as he performed so well academically and in sport. He now struggles with opioid use and mental health issues including depression, anxiety and OCD. He is working alongside an addiction doctor and psychiatrist on getting clean but we want to see him recover not only being clean. I’ve watched a few videos of yours Barbara but don’t really know where to start as there is a lot of info. Thank you for your help.

    1. Hi Monique – I’m not sure which videos you have watch and which you haven’t. I’ll ask support to reach out to you by email and see if we can’t give you a recommendation on a starting point. -B

  3. My son was diagnosed autistic adhd and leaning difficulty at four, he always got support at 18 all support ended I’m in the uk his behaviour got violent social services took him but deemed him capacity , since then he’s had 82 overdoses psychiatric hospital 26 times two comas he’s in a ward now but can go out if he wants , but he’s allowed his own money benefits and he still has a flat and they discharging him again soon with ten hour support daily for cooking cleaning going out activities as he cannot do all these alone they say he has disability’s but can choose right wrong so they allow him to have money he spends it all on benzodiazepines he orders on phone off dealers or online he’s now got schizophrenia and mania paranoia due to years of pills , I feel my life is took over by him as he’s got toddler mentality he does not understand with the autism anyone’s feelings or the damage he’s doing he begs me to see him daily , Iv lost my life work health through this he’s no family only me , a normal addict is hard but one with the mind of a teenage boy who cannot learn is hell , it’s broken me how do I step back and allow him to die as Iv been told to do from social care, in the uk no matter how disabled you are you are allowed your own benefits and with that he buys drugs he’s got brain damage through taking hundreds pills a week but all carers just step back watch wait for him to collapse then get ambulance it’s been 82 of these events as they are not allowed to grab pills out of his hand no force etc they have to watch him overdose then get ambulance, I have been court everything in ten years yet all everyone says it’s his choice he has financial capacity I know he has none he cannot even add up , I take his money try to limit but he gets so aggressive manipulative I give it over as I hate how scared I feel but I feel responsible as I give him the money social worker says it’s his money his choice , he has no job never paid bills been supported since four years old , he found drugs online and it went from there but I give up now and I suppose I’m asking how do I accept the death of someone who has no idea what he’s doing but the law says he does ?

    1. Angela – This sounds dreadful and must be causing you so much pain. I’ve asked my support team to reach out to you with a link to a workshop that talks about how we approach challenges like this. -B

  4. Barbara, I need help with my son. It's a very long story. Is there any chance to speak on the phone. He's been an addict and he definitely mental health issues, and I answered yes to all those questions. He's in jail looking at a very long time in prison. Please help. Prison drove him more into insanity. It's not helping.

    1. Hi Kathy – Sounds dreadful. I will ask support to reach out to you by email on the options available. Please watch your email, and it may not be until early next week. -B

    1. Tami – The person who needs treatment must be willing to accept treatment. Our work is about what we can do as moms to encourage that AND to reclaim our own lives, our peace, our joy. -B

    1. Hi Terri – I encourage you to watch the workshop (if you haven’t already) and I’ve asked support to reach out to you via email. -Barbara

  5. Most days my sons doesn’t want to even talk. He stays in the basement gaming. I limit the wifi to approximately 6 hours per day. He has been recently diagnosed with anxiety. He just turned 20 years old. My psychologist said that if I take more gaming away he may drink more. I don’t give him money. Except when he worked on our house..I don’t know how to motivate him or anything. I feel hopeless. I was going to make calls tomorrow to see what is available for help..I have no idea how much he drinks or if it’s just occasionally..To the nedt of my knowledge I don’t think it’s everyday. He started to go down hill when my husband and I divorced. I don’t know what to do…I am tired of it all. I just want to give up..please help. Thanks Renée

    1. Renee, These are complex questions, AND they can be navigated in a way that is right for your family. Have you watched my workshop? It is linked at the top of my website. If you can’t find it, please email [email protected] -Barbara

  6. Your message are informative and comforting. My son is 38 and was diagnosed as a young child with ADHD. He has been struggling with drug and most recently alcohol addiction. It has caused heart and liver problems and I really don’t know how to help!

    1. Hi Louise – I feel your pain. In my family, we’ve dealt with ADHD, drug addiction, alcohol addiction. The best way to help is to focus you your own well-being and develop strategies to make the choices that are best for you. Many times, this shift in what we do as parents creates a shift in our children also. Not always – there is no guarantee of that. What does happen always when parents do this work is that the parents arrive at a much better place. I encourage you to watch the workshop, link at the top of my website, and see if my approach resonates with you. -Barbara

  7. Barbara you helped over a year ago. My son has been in recovery since October 2020 but I believe he has depression and or some other mental illness preventing him from being happy and “normal”. I can tell he is struggling and I am fearful of relapse although he is committed to recovery. I want him to be happy.

    1. HI Tricia – It’s great to hear from you and I’m glad he is in recovery. He may have co-occurring disorders, or this could still be the lingering effects of the substances which screw up the brains natural reward system and make it difficult or impossible to experience happiness until that sorts out. And I get that you want him to be happy, and happy makes sustained recovery more probable. I’m going to have Patti send you an email. -Barbara

  8. Hi,
    My 22 year old son has stopped using marijuana which I’m very thankful for. However, he also stopped his bipolar meds and is starting hypomania/manic behaviors again. He will be moving out of my house soon (his decision, not mine). Can your workshop help with boundry setting with this type of situation?

    1. Hi Jayme,

      Yes, this approach works with anyone who has the disease of addiction and/or mental illnesses. Many of my students have only the mental illness piece, others have only the addiction piece, and many have both.

  9. Interested to know how to get them to take this step when they truly believe they are not mentally ill, rather it is the rest of the world that believes they are

    1. Hi Chaya, There is no “sure” way to make any person take a step. There are strategies that make it much more likely. Please take a listen to my workshop – you’ll hear some of how to do this and hear actual moms in a coaching meeting working their way through some of these challenges.

  10. My son passed from a fentanyl overdose 16 mo ago. From my experience, mental health evaluation must me done. Don’t wait. The hard part, finding proper treatment. There are run of the mill and there are top notch. We did both. Most importantly don’t stop loving your child because of addiction. They need you now more than ever.

    1. Oh Lynn, I’m so very sorry for your loss. I agree that it it is most important to not stop loving because of the addiction. That is a disease, like any others. Where many of us get stuck is in how to love and support our child and not enable the disease to grow stronger. And, I agree that if the person is open to mental health evaluation, it must be done. The trouble in my own life and with many of the moms I work with is that the “child” is not open to considering that they have a mental illness and, even when they are, not willing to follow the advice of the professionals. And when addiction is co-occurring, that is almost always the case.

  11. I’m at my wits nd . I’ve been dealing with my sons addiction for 18 years . The visions cycle.. the abuse . Rehab . He quit 4 months . Relapsed and more angry and abusive than ever . I love him to my core but I’m so worn out . He has isolated the entire family from me because I’m to blame . No father involvement or assistance in raising my 3 children .

    1. Janice – I recognize this cycle and am sorry for what you are going through. Have you watched my workshop? If not, I encourage you to do this. There are strategies that help the Mom, when the Mom is ready to try a new approach:)

  12. I truly enjoy reading your articles. Our son has numerous Mental Health Diagnoses after 5 hospital stays and 3 psychologists. The substance abuse continues so whether there are actual mental health issues will remain unknown until he is ready to choose recovery. Our Family is living in hell trying to decide which is harder?
    Hanging on or letting go
    Thanks for sharing your wisdom & life experiences
    Trying to find pockets of joy each day 🙏🙏🙏

    1. Good for you Stephanie! And I content that it is possible to hang on in a way that is healthier for you and your child while at the same time letting go again in a healthy way. Make sense? That is what it took me so many years to figure out how to do:)

  13. I am so thankful for this information. My daughter has addiction and mental health issues and it has been a long, heartbreaking road. It is still going on and very difficult for me as her Mother. I appreciate the support more than I can say…

    1. Hi Lori – I emailed my support team and asked them to connect with you about this via email and sort it out. Barbara

  14. Very good informative program. Teaches what a boundary is and how to create effective boundaries and why that is so important. Teaches about the interplay between mental health and substance abuse. Teaches effective communication strategies. Teaches what codependency is and how harmful it is. This program reduces your stress immediately because you start to learn what is happening. Having a framework to understand it and what you can do to begin to improve things. I would highly recommend this program.

    1. Thank you so much, Joan. You are such an excellent student and such a caring and wise support to other moms. Special lady, you are!

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