Mental health and substance abuse
Lovato had suffered from bulimia nervosa, self-harm, and being bullied before her first stint in rehab at age 18. On November 1, 2010, Lovato withdrew from the Jonas Brothers: Live in Concert tour, entering a treatment facility for "physical and emotional issues". It was reported that she decided to enter treatment after punching backup dancer Alex Welch; her family and management team convinced her that she needed help. Lovato said she took "100 percent, full responsibility" for the incident. On January 28, 2011, she completed in-patient treatment at Timberline Knolls and returned home. Lovato acknowledged that she had bulimia, had cut herself, and had been "self-medicating" with drugs and alcohol "like a lot of teens do to numb their pain". She added that she "basically had a nervous breakdown" and had been diagnosed with bipolar disorder during her treatment. She later commented that she used to use cocaine several times a day and smuggled cocaine onto airplanes. In a 2022 interview on the podcast Call Her Daddy, Lovato added that she began using opiates at the age of 13 after a car accident and "was already drinking" by that time. She said that this eventually led her to use cocaine at the age of 17.
In April 2011, Lovato became a contributing editor for Seventeen magazine, penning an article that described her struggles. In March 2012, MTV aired a documentary, Demi Lovato: Stay Strong, about her rehab and recovery. She began work on her fourth studio album the following month. In January 2013, it was reported that Lovato had been living in a sober-living facility in Los Angeles for over a year because she felt it was the best way to avoid returning to her addiction and eating disorder. Lovato celebrated the five-year anniversary of her sobriety on March 15, 2017.
In her 2017 YouTube documentary Demi Lovato: Simply Complicated, Lovato revealed that her treatment at Timberline Knolls had not been entirely successful, stating that she still struggled with alcoholism and a cocaine addiction in the year following her stint in the treatment center and further admitting that she was in fact under the influence of cocaine while being interviewed about her sobriety for Demi Lovato: Stay Strong. She stated, "I wasn't working my program. I wasn't ready to get sober. I was sneaking it on planes, sneaking it in bathrooms, sneaking it throughout the night. Nobody knew."
Lovato also stated that her drug and alcohol addiction not only caused her to nearly overdose several times, but later began to impact her ability to perform live and promote her Unbroken album, referencing a 2012 performance on American Idol where she was severely hungover. After her management team had expressed their intentions to leave her, Lovato agreed to resume treatment and counseling for her addiction, leading to her move to a sober-living facility in Los Angeles with roommates and responsibilities to help her overcome her drug and alcohol problems. Although she had previously stated that she was entirely done with hard drugs such as heroin, Lovato revealed in March 2021 that she was not completely sober; she drank alcohol and smoked marijuana in moderation at that point, a choice that many of her friends openly disagreed with. She decided on moderation as she felt she was setting herself up for failure if she told herself she was never going to drink or smoke again. Lovato said it was because it had been drilled into her that "one drink was equivalent to a crack pipe." This changed the following December when she abandoned her "California sober ways" and declared herself "sober sober".
In 2021, Lovato said she had initially accepted her bipolar diagnosis and shared this in 2011 because it explained her erratic behavior, but later came to believe it was inaccurate: "I was acting out when I was 18 for many reasons, but I know now from multiple different doctors that it was not because I was bipolar. I had to grow the fuck up." Lovato also stated that the diagnosis has been revised to attention deficit hyperactivity disorder (ADHD).
On June 21, 2018, Lovato released the single "Sober" in which she revealed she had relapsed after six years of sobriety. On July 24, 2018, she was rushed to the Cedars-Sinai Medical Center in Los Angeles after emergency services were called to her home due to an opioid overdose. Lovato recalled, "The doctors told me that I had five to 10 minutes, like, if no one had found me, then I wouldn't be here." The singer was reported to be stable and recovering later in the day. She reportedly overdosed on oxycodone laced with fentanyl and was revived with naloxone.
Lovato also had multiple health complications stemming from the overdose, including multiple strokes, a heart attack, and brain damage, the latter of which caused lasting vision problems. She was hospitalized for two weeks and subsequently entered an in-patient rehab facility. Lovato's drug overdose received widespread media coverage, leading to her becoming the most googled person of 2018. CBS News ranked the overdose the 29th biggest story of 2018. In December 2018, Lovato took to Twitter to debunk rumors regarding her overdose and went on to thank fans, writing that one day she was going to "tell the world what exactly happened, why it happened and what my life is like today .. but until I'm ready to share that with people please stop prying and making up shit that you know nothing about. I still need space and time to heal."
Lovato addressed the matter during a 2020 appearance on The Ellen DeGeneres Show, elaborating on how her worsened struggles with bulimia in 2018 contributed to her eventual drug overdose as she relapsed three months prior to the incident due to being extremely unhappy. The singer attributed these struggles to the extreme measures that her then-manager, Phil McIntyre, took to control the food she ingested. Lovato further explained that, along with the controlling nature of her management team, they did not provide her with the help she needed. Moreover, she recounted that her thought process the night she relapsed after six years of sobriety was as follows, "I'm six years sober and I'm miserable. I'm even more miserable than I was when I was drinking. Why am I sober?"
In 2021, Lovato said she was raped at age 15 when she was an actor on the Disney Channel, and that the rapist was a co-star whom she had to continue seeing thereafter. The incident contributed to her bulimia and self-harm. She told someone about the incident, but the assaulter "never got in trouble for it. They never got taken out of the movie they were in." Lovato stated she did not acknowledge the act as rape at the time, because sexual activity was not normalized to her, and she was part of the Disney crowd who wore purity rings and were waiting until marriage. However, she decided to share her experience because she believed that everyone should "speak their voice if they can and feel comfortable doing so". Lovato also stated she was raped during her 2018 drug overdose, realizing a month after the incident that she was not in a place to consent at that point.
