Fifth Avenue Psychiatry Logo (typeface)

The Link Between Psychotic Disorders and Substance Abuse

A psychotic disorder is a mental health condition characterized by a profound disruption in a person’s thinking, emotions, and perception of reality. Substance abuse can worsen psychotic symptoms and, sometimes, can be the direct cause of the disorder.

The use of illegal drugs, prescribed or over-the-counter medications, alcohol, or other mind-altering drugs is linked to substance-induced psychosis disorders.

What is the relationship between substance abuse and psychotic disorders?

There’s a strong correlation between substance abuse and psychotic disorders, and the relationship between them is complex. These conditions often co-occur and can influence each other in multiple ways. Understanding this relationship is crucial for effective treatment and management of substance abuse and psychotic disorder.

Here are some key points:

  • Substance abuse is considered a significant risk factor for the development of psychotic disorders.
  • Abuse of substances can sometimes directly cause psychotic symptoms. For example, drugs like amphetamines or cocaine can induce hallucinations and delusions.
  • Some people with psychotic disorders may abuse substances to self-medicate their symptoms, alleviate anxiety, or cope with social isolation.
  • Abuse of substances can interact with genetic, neurobiological, and environmental factors that increase the likelihood of developing a psychotic disorder or exacerbate existing symptoms.
  • Substance abuse complicates the treatment of psychotic disorders. It can interfere with medication adherence, worsen symptoms, or increase the risk of relapse.

Many people with psychotic disorders have co-occurring substance use disorders, leading to what is known as a “dual diagnosis.” Treatment for such individuals requires addressing and treating both conditions simultaneously.

What are the four common substance-induced mental disorders?

Substance-induced disorders are conditions where the use or withdrawal of a substance results in significant mental health conditions.

Four common substance or medication-induced mental disorders include:

  1. Substance-Induced Depressive Disorder: Substance-induced depression symptoms include persistent sadness, loss of interest in activities, changes in appetite or sleep patterns, feelings of worthlessness or guilt, and possibly suicidal thoughts.
  2. Substance-Induced Bipolar Disorder: A person may experience elevated mood, increased energy, racing thoughts, impulsivity, and decreased need for sleep. Depressive episodes involve symptoms similar to those in substance-induced depressive disorder.
  3. Substance-Induced Anxiety Disorder: A person may experience panic attacks, phobias, obsessive-compulsive behaviors, or generalized anxiety symptoms that are directly linked to substance use.
  4. Substance-induced Mood Disorder: An individual experiences significant shifts in mood that are brought about directly and exclusively by the use of substances such as prescription medications, drugs, or alcohol.

What mental disorders are linked to a higher rate of substance abuse?

Several psychological disorders are associated with higher risk factors for substance abuse. Integrated treatment options that target both the disorder and substance use are often necessary for successful recovery and management of symptoms.

Some of these mental disorders include:

  • Depressive Disorders
  • Bipolar Disorders
  • Anxiety Disorders
  • Post-Traumatic Stress Disorder
  • Schizophrenia and Other Psychotic Disorders:
  • Attention-Deficit/Hyperactivity Disorder

What drugs cause psychosis?

Several drugs have the potential to cause psychosis, either through their acute effects or as a result of withdrawal. The Diagnostic and Statistical Manual of Mental Disorders-5-TR identifies substance-related disorders resulting from the use of 10 classes of drugs:

  • Alcohol
  • Caffeine
  • Cannabis
  • Hallucinogens
  • Inhalants
  • Opioids
  • Sedatives
  • Hypnotics, or anxiolytics
  • Stimulants
  • Tobacco

What does a psychotic episode look like?

Psychosis is characterized by a significant disturbance in a person’s thoughts, perceptions, emotions, and behavior. The onset, duration, and severity can vary. Some people may experience brief episodes, while others may have persistent symptoms. If left untreated, psychosis can have harmful, long-term effects on a person’s emotional and physical well-being. Common features observed during a psychotic episode include:

Sensory Hallucinations:

  • Hearing voices that others don’t hear—these voices may be commanding, critical, or conversational
  • Seeing things others don’t see, such as people, animals, objects, or patterns.
  • Feeling things on the skin, smelling or tasting things


  • Being plotted against, spied on, harmed, or harassed
  • Belief in exceptional abilities, fame, or importance
  • Belief that an external force is controlling thoughts, feelings, or behaviors
  • Belief that there’s something physically wrong within the body (e.g., a parasite inside them)

Disorganized Thinking:

  • Speaking in a way that’s jumbled, nonsensical, or difficult to follow
  • Jumping between unrelated topics in conversation
  • Incoherent words or phrases

Disorganized or Abnormal Motor Behavior:

  • Restlessness, pacing, or excessive movement
  • Immobility or excessive purposeless movement
  • Making repetitive gestures or adopting unusual postures

Emotional Disturbance:

  • Intense emotions inappropriate to the situation (e.g., laughing during a sad event)
  • Fluctuations in emotional expression, such as showing little emotion or exaggerated responses

Dual Diagnosis Treatment at Fifth Avenue Psychiatry

We are a team of highly trained Psychologists and Psychiatrists who use evidence-based clinical treatments and therapies for all sorts of conditions, including co-occurring mental health disorders.

We offer an array of treatments, such as:

Call us, and we’ll design a treatment program personalized to you or your loved one struggling with substance use and mental health disorders.

Dr. Britt Gottlich, Psy.D.

Dr. Britt Gottlich, Psy.D.

Dr. Gottlich is a Licensed Clinical Psychologist. Dr. Gottlich has expertise in the treatment of addictions and trauma in adolescents and adults, as well as symptoms of anxiety and depression. She is an expert in both evaluation and treatment of these disorders.

Recent Posts

The Importance of Routine for Adults with ADHD

If you’re a person with attention deficit hyperactivity disorder (ADHD), juggling the responsibilities of day-to-day life can be overwhelming. Adult ADHD is particularly challenging because you’re most likely balancing a...
ADD/ADHD and Treatment

What Nutrient Deficiencies Cause Anxiety?

Nutrition and mental health are closely connected. What you eat has a huge impact on how you feel, and many vitamins and minerals have a direct impact on your mental...
Mental Health

Why Alcoholics Can’t Recover On Their Own

Those who haven’t experienced alcoholism themselves may be inclined to believe that someone with a drinking problem can solve it if they simply stop drinking. As much as that is...
Alcoholism and Recovery