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What Are Co-Occurring Disorders?
Co-occurring disorders mean someone is dealing with both a mental health issue, like depression, and a drug or alcohol problem at the same time. These challenges often go hand in hand and need to be treated together for recovery to last. When a person has an addiction with a co-occurring disorder, it is called a dual-diagnosis. At Blue Star Recovery, we understand how connected these struggles can be, and we’re here to help you heal both.
This article offers useful tips and advice to help people make smart choices about dual-diagnosis treatment for co-occurring substance use and mental health disorders.
Signs of Co-Occurring Disorders
Understanding the signs of co-occurring disorders can be vital to seeking help. Only a clinician can determine if a person has a dual-diagnosis, but recognizing signs of mental health issues can inspire people to seek the help they need.
Signs that may mean co-occurring disorders are present:
- Feeling the need to use substances to function normally
- Extreme mood swings (e.g., depression, mania, irritability)
- Using alcohol or drugs to relieve depression or anxiety (self-medicating)
- Emotional extremes when alcohol or drugs aren’t available
- Sudden behavior changes or personality shifts
- Feeling hopeless, numb, or emotionally flat
- Secretive and/or withdrawing from socialization
- Poor hygiene or self-care
Types of Co-Occurring Disorders
Many mental health disorders frequently occur alongside substance use disorders. These co-occurring disorders typically fall into five main categories:
- Anxiety disorders
- Mood disorders
- Personality disorders
- Psychotic disorders
- Eating disorders
Many disorders share similarities in their signs and symptoms. They may also overlap with symptoms of addiction, which can make them hard to diagnose outside and a drug and alcohol rehab setting. Let’s explore some common co-occurring disorders below.
Anxiety Disorders
Anxiety disorders include conditions like generalized anxiety disorder, social anxiety, OCD, and PTSD. Common symptoms are constant worry, panic attacks, racing thoughts, and trouble sleeping. These disorders often occur alongside substance abuse, making them one of the most common co-occurring issues.
People with both anxiety and substance use problems tend to have more intense symptoms than those dealing with just one. While anxiety is less likely to be caused by substance use than mood disorders, many people use drugs or alcohol to cope, raising their risk of addiction over time.
Mood Disorders
Mood disorders like major depressive disorder and bipolar disorder lead to significant mood swings that impact daily life. These disorders often coexist with substance use disorders, making diagnosis and treatment more challenging. It remains uncertain which conditions typically arise first, but each can influence the other.
Patients dealing with both mood and substance use disorders tend to experience more severe symptoms than those coping with just one. Treating substance use and mental health issues together leads to much better odds of long-term recovery.
Personality Disorders
Personality disorders are mental health conditions that lead to problematic thoughts and behaviors, significantly affecting everyday life and relationships. These disorders typically stray from cultural norms and can cause considerable distress.
Some personality disorders, such as borderline personality disorder (BPD) and antisocial personality disorder (ASPD), often go hand in hand with substance use disorders. BPD leads to emotional instability and a fear of abandonment, which can drive substance use. ASPD, characterized by manipulative behavior, also increases the risk of substance abuse.
Research shows a strong connection between personality disorders and substance use disorders. This is especially true for stimulants, opioids, and hallucinogens, rather than alcohol. People with certain personality traits may use drugs to cope with their emotions. Knowing this connection helps us create better diagnoses and treatment plans.
Psychotic Disorders
Psychotic disorders affect how people think, feel, and understand the world around them. Common types include schizophrenia, delusional disorder, and schizoaffective disorder. A key symptom is psychosis, which involves hallucinations or delusions that may come and go.
Diagnosing both a psychotic disorder and a substance use disorder can be challenging. Psychosis may be triggered by drug use or by stopping certain medications. To confirm a diagnosis, symptoms must also appear when the person isn’t using substances.
Schizophrenia often co-occurs with substance use. Drugs and alcohol can make symptoms worse. Some of the same genetic factors that raise the risk for schizophrenia may also increase the chance of addiction. Understanding these links helps providers build better treatment plans that address both conditions together.
Eating Disorders
Eating disorders like binge eating, anorexia, and bulimia are painful struggles tied to food, body image, and self-worth. They are not just about eating habits. They often come from fear, shame, or the need to feel in control.
Binge eating can feel like losing control. Anorexia is often about trying to stay in control by avoiding food. Bulimia mixes both, i.e. eating and then purging in secret. These patterns can be exhausting and isolating.
Many people with eating disorders also turn to drugs or alcohol to cope. That makes recovery even harder. Treatment needs to look at both the emotional and physical sides of these issues. When we lead with compassion and understanding, we create space for real healing. Not just from addiction, but from the pain underneath it.
What Causes Co-Occurring Disorders?
There’s no single cause for co-occurring disorders. Dual-diagnoses are complex by nature. Co-occurring disorders often develop from a combination of factors. It may be a mix of genetics, brain chemistry, trauma, and life stress.
Some people use drugs or alcohol to cope with anxiety, depression, or other mental health struggles. Others may develop mental health symptoms after long-term substance use or addiction. Most people with addiction and a co-occurring diagnosis can be helped with dual-diagnosis treatment that treats both conditions at the same time.
Factors that can help cause co-occurring disorders:
- Family History
- Genetics
- Stress/ability to cope with stress
- Environmental factors
Is it Common to have a Dual Diagnosis?
Co-occurring disorders are fairly common, with over 9 million adults in the U.S. diagnosed in 2022. Almost 61% of people received treatment for either a substance use disorder or a mental health disorder. Only 8.3% received treatment for both.
Which is Diagnosed First? Addiction or the Mental Health Disorder
Substance use disorder and mental illness can occur in any order. Good dual-diagnosis treatment can spot both conditions so a comprehensive treatment plan can be applied. Co-occurring disorders often intertwine, making it essential to grasp their complex relationship for successful treatment that leads to lasting sobriety.
Mental illness and its ability to drive substance use
Mental illness can play a crucial role in addiction, as people may turn to substances as a means of self-medication. This coping strategy can increase tolerance and pave the way to addiction.
Additionally, mental health challenges can alter brain function, intensifying cravings and making individuals more vulnerable to developing substance use disorders. Understanding this connection is vital for effective treatment that leads to lasting recovery.
Substance abuse effects on mental health
When a person has a mental health issue and uses drugs, it can worsen their symptoms. Drug use often makes mental health problems more severe.
Substance abuse can also create other challenges for people with mental health issues. Those with a substance use disorder may not stick to their medication for mental health, making it harder to control their symptoms. Additionally, substance use disorders can sometimes lead to aggressive and even violent behavior.
Co-Occurring Disorder Diagnosis
Assessing mental health and substance use disorders is guided by the Diagnostic and Statistical Manual of Mental Disorders (DSM). The latest edition, DSM-5, has greatly enhanced our understanding of co-occurring disorders, highlighting that symptoms can overlap.
A substance use disorder does not always worsen a mental health condition. This insight encourages a compassionate and holistic approach to treatment, paving the way for hope, healing, and recovery.
Treatment Options for Co-Occurring Disorders
Effective treatment for co-occurring disorders focuses on both substance use and mental health. Dual diagnosis care helps people manage addiction while also getting support for emotional and psychological symptoms.
Integrated programs combine addiction treatment with therapy for conditions like anxiety, depression, or trauma. In some cases, once substance use is under control, doctors may recommend medication to help with mental health symptoms. It is usually best to wait until the system is clear of drugs or alcohol before starting medication. This helps avoid harmful interactions and gives a clearer picture of how the medicine is working.
Integrated treatment (dual-diagnosis) for both conditions together gives people a better chance at long-term recovery.
Recovery from Addiction and Co-Occurring Disorders Begins Here
Many people who struggle with addiction also live with mental health challenges. While there are treatments that can address both at the same time, they’re still often treated separately. In many cases, substance use is treated first, and mental health comes later. But research shows that treating both together leads to better outcomes.
Creating the right treatment plan isn’t always easy. It depends on the person and the specific issues they’re facing. Some combinations of disorders are more complex than others. We still have a lot to learn about how mental health and addiction interact, but ongoing research and real-life case studies are helping us move forward.
If you or a loved one is facing a mental health issue along with a substance use disorder, we can help. Blue Star Recovery provides tailored treatment programs for both conditions. Contact us today for solutions to addiction and mental health issues.
References:
National Institutes of Health: Prevalence and Consequences of the Dual Diagnosis of Substance Abuse and Severe Mental Illness
Substance Abuse and Mental Health Services Administration (SAMHSA): Co-Occurring Disorders and Other Health Conditions
Substance Abuse and Mental Health Services Administration (SAMHSA): 2024 NSDUH Annual National Report
National Institutes of Health: Current Status of Co-Occurring Mood and Substance Use Disorders: A New Therapeutic Target
National Institutes of Health: Substance Use and Co-Occurring Mental Disorders
National Institutes of Health: Comorbitity of Personality Disorder Among Substance Use Disorder Patients: A Narrative Review
National Institutes of Health: The Self-Medication Hypothesis of Substance Use Disorders: a reconsideration and Recent Applications
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