How a substance use disorder can impact your mental health

Mental Health

Jun 9

Clinically reviewed by Dr. Chris Mosunic, PhD, RD, MBA

If substance use feels hard to manage, you’re not alone. Explore the link between substance use disorder and mental health, plus 9 ways to support your mental health.

For a lot of people, substance use started small. It might have begun as a way to unwind, or to get through a rough patch, and somewhere along the way, it stopped feeling optional.

If that sounds familiar, this is for you. Substance use disorder (SUD) is a medical condition that's more connected to mental health than most people realize — and it may affect mood, sleep, and mental health in ways that creep up gradually.

Here’s what to know about substance use disorder, what the signs may look like, and 9 practical ways to take care of your mental health, whether you're navigating this yourself or supporting someone you care about.

What is substance use disorder (SUD)?

Substance use disorder is a medical condition that develops when using alcohol or drugs starts to cause real problems in someone’s life, and yet they keep using anyway. NIDA describes SUD as a complex, treatable chronic condition from which people can and do recover.

SUD changes how the brain works, particularly around reward, motivation, and self-control. That’s why it can be so hard to just stop, and why it has nothing to do with willpower or personal failure.

Doctors diagnose SUD using criteria from the DSM-5, a reference manual used by mental health professionals. It covers a wide range of substances—alcohol, cannabis, opioids, stimulants, and prescription medications—and exists on a spectrum. The earlier it's identified, the more treatment options are available.

11 signs of substance use disorder

These are the common signs clinicians look for. You don’t need to have all of them for substance use to be affecting your well-being. Even noticing a few can be a signal worth paying attention to.

Using more of a substance, or for longer, than you meant to
Wanting to cut back or stop, but finding it hard to
Spending a lot of time getting, using, or recovering from a substance
Having strong urges or cravings to use
Finding it harder to keep up with responsibilities at work, school, or home
Continuing to use even when it’s causing problems in relationships
Losing interest in activities that used to matter to you
Using in situations where it could be unsafe (like driving)
Using even when it’s affecting your physical or mental health
Needing more of the substance to feel the same effect (tolerance)
Experiencing withdrawal symptoms when not using, or using specifically to avoid them

💙 Start with an Emotions Check In on Calm to sit with what you’re feeling, without judgment.

What causes a substance use disorder?

SUD doesn't have one single cause. It's shaped by a mix of psychological, biological, social, and environmental factors — often several at once.

Biology: Genetics may play a role in how the brain responds to reward. Some people are simply more sensitive to the effects of substances.
Mental health: Anxiety, depression, trauma, or ongoing stress may make substances feel like a reliable way to cope.
Environment: Early experiences, social circles, and how normalized substance use feels can all shape patterns over time.

At the center is often a search for relief. Substances can offer quick emotional comfort, especially when other coping tools feel out of reach. Over time, the brain starts to associate them with feeling better, even when that relief doesn’t last.

None of this is fixed or destined. SUD is a condition with deeper roots, and understanding those roots is part of what makes recovery possible.

How can substance use disorders affect mental health?

Substance use and mental health are deeply intertwined, often in ways that are hard to spot at first.

Substances may lift mood or ease anxiety in the moment, but emotional dips often follow. Over time, this can make mood feel less stable.
Anxiety may also increase. What once felt calming can start to raise baseline stress, especially between uses.
Even when substances help with falling asleep, they tend to disrupt deeper rest, which may affect mood, focus, and resilience.
When substances become the main way to manage emotions, it can be harder to work through difficult feelings — and those feelings may build up over time.
Memory, focus, and decision-making may feel less steady, too, adding to frustration or self-doubt.

9 ways to care for your mental health with SUD

Caring for your mental health while navigating substance use disorder doesn’t have to mean changing everything at once. Small, steady shifts can make a noticeable difference.

1. Notice your patterns without judging them

Start by paying attention to when and why substance use tends to happen. It might show up after stress, during certain social situations, or in quieter moments when things feel heavy.

You don’t need to change anything right away. Simply asking yourself when you reach for it, and what you’re feeling before you do, can help you understand your own patterns a little more clearly.

💙 Practice the art of Noticing — a short meditation that turns self-awareness into an act of curiosity, not judgment.

2. Create space between urge and action

There’s often a small window between the urge and the action, and mindfulness can help you find it. Even a 30 to 60 second pause can help you reconnect with a sense of choice.

You could try:

Taking 5 slow breaths, focusing on the exhale
Noticing physical sensations, like your feet on the ground
Asking yourself, “What am I feeling right now?”

💙 If the urge hits and you need a moment to reset, Finding Space to Breathe offers a simple breathing practice to help you find your footing again

3. Give your nervous system a little relief

When stress builds, the body looks for relief. Substances can become one way to get there, but small physical shifts can help take the edge off, too.

Stepping outside, stretching, or taking a short walk can release some of that built-up tension. It may also make it easier to think clearly and respond more intentionally.

💙 When tension is sitting in your body, try a Daily Move session on Calm to release what’s building up.

4. Stay connected, even when it feels hard

It’s easy to pull back from others, especially when you’re struggling. But connection can help regulate mood and reduce the sense of carrying everything alone.

This doesn’t have to mean big conversations. It might look like sending a quick message, sitting with someone, or spending time in a shared space without needing to explain how you feel.

💙 Feeling the pull to withdraw? The Aloneness meditation from the Emotions Series is a gentle exploration of solitude and the difference between being alone and feeling lonely.

5. Schedule a moment to check in with yourself

Rather than trying to stay aware all day, it can help to build awareness into specific moments, like before using, after work, or before bed.

A simple check-in might look like:

What am I feeling right now?
What do I need?
Is this what I actually want, or just what I usually do?

These small moments of reflection can make patterns easier to notice over time.

6. Create a few steady anchors in your day

When things feel inconsistent, a few steady moments can help bring some structure. It could be something simple, like a morning check-in, a glass of water before your first drink, or a short walk at the same time each day.

These small anchors can create a sense of stability without adding pressure.

💙 Try Anchoring With the Breath with Jay Shetty — a simple grounding practice for when the day starts to feel unsteady.

7. Understand what you’re really reaching for

Substances often serve a purpose, like easing anxiety, helping with sleep, or numbing difficult emotions. Understanding that role can open up other options over time.

For example, if alcohol helps you wind down at night, you might try adding something alongside it first, like a warm shower or calming music. The shift doesn’t have to happen all at once.

💙 When difficult emotions are driving the urge, Care for Difficult Emotions is a compassionate guide to sitting with what's there, rather than pushing it away.

8. Remember you don’t have to figure this out alone

You don’t have to figure this out on your own. Support can take many forms and make a meaningful difference, especially when mental health is part of the picture.

A good place to start might be:

Therapists who understand substance use and mental health together
Support groups where you can hear from others with similar experiences
Medical professionals who can guide safe and realistic next steps

Whichever feels most approachable is the right place to begin.

9. Focus on what feels doable right now

Big changes can feel overwhelming, especially if your energy or mood is already low. It’s okay to start small — that might mean adjusting one situation, adding one supportive habit, or simply paying closer attention.

💙 On days when everything feels like too much, Small Steps with Jay Shetty is a reminder that the tiniest moves forward compound over time.

Substance use disorder FAQs

What does substance use disorder mean?

Substance use disorder means that the use of alcohol, medications, or other substances has become difficult to control and is starting to affect your daily life.

An SUD might impact your mood, health, relationships, or responsibilities. It’s not about how often you use, but whether that use is creating patterns that feel hard to manage or step away from.

What are the signs and symptoms of a substance use disorder?

Signs and symptoms of a substance use disorder can include cravings, using more than intended, difficulty cutting back, and continuing to use despite negative effects.

Many people also notice changes in mood, anxiety levels, sleep, focus, or relationships. These signs often build gradually, so it’s the overall pattern, rather than any one symptom, that tends to matter most.

How do I know if my substance use is a problem?

If your substance use is starting to affect how you feel, think, or function in your day-to-day, it may be worth paying attention to. This could look like relying on it to cope, feeling uneasy when you’re not using, or finding it hard to cut back.

Your concerns deserve attention long before a crisis point. Noticing a shift is enough to start exploring it with care.

Can anxiety or depression cause a substance use disorder?

Anxiety and depression don’t directly cause substance use disorder, but they may increase the risk. Substances are often used to ease difficult emotions, which can create a pattern of relying on them for relief. Over time, this can make the mental health symptoms and the substance use feel increasingly hard to separate.

Are there different types of substance use disorders?

Yes, substance use disorder can involve different substances, including alcohol, prescription medications, and other drugs.

Each type can vary in how it shows up, but they all involve patterns of use that become hard to control and begin to impact daily life. The severity can also range from mild to more complex, depending on the situation.

Is a substance use disorder treatable?

Yes, substance use disorder is treatable, and many people see meaningful improvement with the right support.

Treatment doesn’t look the same for everyone, but it can include therapy, medical care, support groups, or a combination of approaches. Change often happens gradually, with small steps building on each other over time.

What kind of support helps most with SUD recovery?

Support that feels safe, consistent, and non-judgmental tends to be the most helpful for SUD recovery. This can include professional support like therapy or medical guidance, as well as peer support from others who understand your experience.

Strong personal connections—even just one trusted person—can also make a meaningful difference in feeling less alone.

Calm your mind. Change your life.

Mental health is hard. Getting support doesn't have to be. The Calm app puts the tools to feel better in your back pocket, with personalized content to manage stress and anxiety, get better sleep, and feel more present in your life.

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Calm Editorial Team