Boy this sure is a loaded gun, sort of the chicken before the egg argument. It seems many posters have the idea that mental health issues lead to substance abuse. I am not sure that I agree with that sentiment. Mental health issues are a very broad spectrum of things and causes, some are behavioral and some are thought to be biological. What Peninha said is so true Life is stressful!! Sometimes we do just lose it, but this is a temporary state, what that means is maybe you have a day or two that's off but you bounce back. Maybe you need to have a beer or a glass of wine, but you don't need it everyday just to function or to keep from getting sick. I think what I am trying to say is mental illness does not always mean that you will become a substance abuser. I was told once that the reason most people self medicate is to kill the pain- well I guess each of us has to be real with what the cause of that pain really is. No surprise the surge of painkiller abuse.