Co-Occurring Disorders: Substance Abuse & Mental Health
What Are Co-Occurring Disorders?
Co-occurring disorders refer to the simultaneous presence of both a mental health and a substance use disorder. Comorbidity, another term used in reference to co-occurring disorders, refers to the interaction between mental health and substance use disorders that can exacerbate the progression of both disorders.2 It is important to note that not everyone who is diagnosed with a mental health disorder will develop a substance use disorder and vice versa.
While the co-occurrence of mental health and substance use disorders is common, it doesn’t mean that one caused the other.3 However, they can influence one another. For example, studies have shown that individuals with certain mental health disorders (such as anxiety and depression) may be more likely to use substances as a way to self-medicate and cope with the symptoms of the mental illness they are experiencing.3 Furthermore, substance use can change the structure and function of the brain, which can increase a person’s risk of developing a mental health disorder.3
Certain mental health and substance use disorders occur more commonly with one another. Common co-occurring disorders include:3
How Are Co-Occurring Disorders Diagnosed?
A licensed medical or mental health professional can diagnose a co-occurring disorder. A formal evaluation by a professional is conducted to determine the presence of a mental health and substance use disorder; each type of disorder will be addressed and evaluated.3
Assessment tools are available to help in diagnosing a co-occurring disorder. Determining the presence of co-occurring disorders can be difficult, but comprehensive tools can help reduce the risk of misdiagnosis and to provide appropriate treatment options.3
Signs & Symptoms of Co-Occurring Disorders
In order to be diagnosed with a co-occurring disorder, you must meet the criteria for both a mental health disorder and a substance use disorder. Therefore, it can be beneficial to know the signs and symptoms of common mental health disorders as well as signs of a substance use disorder. Let’s look at some signs and symptoms of substance use disorders and common mental health conditions.
Depression—Symptoms of depression usually begin between 15–30 years old and can include:4
- Fatigue or loss of energy.
- Feeling down or sad.
- Anhedonia, or loss of pleasure in previously enjoyed activities.
- Problems falling or staying asleep.
- Thoughts of suicide or death.
- Feelings of worthlessness.
Anxiety—Generalized anxiety involves chronic feelings of dread as well as:5
- Feelings of fatigue.
- Feelings of restlessness or on edge.
- Difficulty falling or staying asleep.
- Body aches, including stomach aches, muscle aches, and unexplained pain.
- Problems falling or staying asleep.
Post-traumatic stress disorder (PTSD)—PTSD symptoms usually present within 3 months after a traumatic, life threatening event and can include:6
- Avoidance of situations, people, and circumstances that remind you of the trauma.
- Having flashbacks of the trauma and re-experiencing the trauma.
- Avoiding thoughts and feelings about the event.
- Experiencing angry outbursts and irritability.
- Feeling on edge or tense.
- Feeling blame or guilt.
- Memory problems related to the event.
Bipolar disorder—There are 3 different types of bipolar disorder, however, all 3 types involve distinct changes in energy, mood, and activity levels and can also include:7
- Feelings of irritability.
- Feelings of elation.
- High energy levels.
- Feelings of hopelessness.
- Feeling down.
- Feelings of indifference.
Substance use disorder—Symptoms can present as behavioral, social, and/or physical and can include:8
- Taking drugs or alcohol in larger amounts or for longer than was originally planned.
- Experiencing cravings.
- Continued substance use in situations that are physically hazardous.
- A desire to stop misusing substances, but being unsuccessful at attempts to do so.
- Giving up important social, occupational, or recreational activities due to substance use.
- A need to regularly increase amounts of the substance being used to achieve the desired effect (known as “tolerance”).
Commonly misused substances include alcohol, cocaine, benzodiazepines, opioids, sleep medications and amphetamines/methamphetamine.
What Causes Co-Occurring Disorders?
While there is no “cause” for co-occurring disorders, there are risk factors that can contribute to their development. Risk factors include:3
- Genetics—Your genes can make you more vulnerable to developing substance use disorders and/or mental health disorders.
- Environmental factors—This can include experiencing chronic stress and trauma due to one’s living, working, or learning environment.
- Family history—Having a family history of mental health and substance use disorders can make you more vulnerable to developing a co-occurring disorder.
- Mental health disorders—Having an underlying mental illness can increase your risk for substance use disorders due to self-medicating as a means of coping.
- Substance use disorders—Substances can change the structure and functioning of the brain which can lead to the development of a mental health disorder.3
How to Treat Co-Occurring Disorders
It is recommended to treat both mental health and substance use disorders simultaneously.4 Many substance use disorder and addiction treatment facilities offer specialized programs for co-occurring disorders.
AdCare offers a variety of co-occurring disorder treatments, including detox, inpatient, and long-term residential rehab.
Learn more about what to expect in inpatient rehab, explore outpatient rehab programs, and find out how to help a family member get into addiction treatment.
Call AdCare at to start addiction treatment and get admitted today. Admissions navigators can help determine your insurance coverage for addiction treatment and answer any questions you may have about treatment. You can also instantly check if your insurance covers rehab at AdCare with our .
Help for co-occurring disorders is available to you. Let AdCare help you along your path of recovery.
What is a Co-Occurring Disorder?
Co-occurring disorders refer to the situation where an individual experiences both a mental health disorder and a substance use disorder simultaneously. This dual diagnosis can complicate treatment and recovery, as the symptoms of one disorder may exacerbate the other, making it imperative to adopt a comprehensive approach to care.
It is important to distinguish co-occurring disorders (SUD and a co-existing mental health disorder) from substance-induced mental health disorders. The latter result from intoxication with agents such as opioids, stimulants, hallucinogens. They resolve, most often (though not always) with abstinence. The treatment strategy is the same as with co-occurring disorders, but the outcome will be different.
In terms of history, with co-occurring disorder most often the mental health issue predates the addictive disorder. In contrast, with drug-induced mental health problems. it is very likely that the mental health issue will resolve over time with abstinence, though this is not always the case.
What is Co-Occurring Substance Use Disorder?
Co-occurring substance use disorder specifically entails the presence of a substance use disorder alongside a mental health disorder. This means that a person might struggle with addiction to drugs or alcohol while also dealing with mental health issues such as depression, anxiety, or bipolar disorder. The interplay between these conditions can lead to more severe psychological and physical health challenges, requiring specialized treatment plans.
What is Integrated Treatment for Co-Occurring Disorders?
Integrated treatment refers to a coordinated approach that simultaneously addresses both mental health and substance use disorders within a unified treatment framework. This method emphasizes the need for mental health professionals and substance use specialists to work together, providing a holistic treatment plan tailored to the individual’s needs. Integrated treatment might include therapies, medication management, and support groups, all designed to help the individual achieve lasting recovery.
How to Treat Co-Occurring Disorders?
Treating co-occurring disorders typically involves a multifaceted approach that includes evidence-based therapies such as cognitive-behavioral therapy (CBT), dialectical behavior therapy (DBT), and medication-assisted treatment when appropriate. It’s crucial to create a personalized treatment plan that addresses both disorders comprehensively. Additionally, ongoing support and aftercare, such as community support groups and continued therapy, are vital for long-term success in managing these complex conditions.
What Are the Three Most Common Co-Occurring Disorders?
The three most commonly identified co-occurring disorders are:
- Depression and Substance Use Disorder: Depression can lead individuals to self-medicate with drugs or alcohol, creating a cycle of dependence and worsening mental health.
- Anxiety Disorders and Substance Use Disorder: Individuals may use substances to cope with anxiety symptoms, resulting in a dual diagnosis.
- Post-Traumatic Stress Disorder (PTSD) and Substance Use Disorder: Those suffering from PTSD may turn to alcohol or drugs as a means to numb painful memories or emotions linked to traumatic experiences.
How to Find a Specialist for Co-Occurring Disorders?
Finding a specialist for co-occurring disorders can involve researching local treatment centers or mental health facilities that offer dual diagnosis programs. It’s essential to look for licensed professionals who have experience in treating both mental health and substance use issues. You can also seek referrals from primary care physicians, mental health hotlines, or trusted community organizations dedicated to mental health awareness and substance abuse recovery.
Are Co-Occurring Substance Abuse and Mental Disorders on the Rise?
Recent studies and reports indicate that co-occurring substance abuse and mental health disorders are indeed on the rise, particularly in the context of the ongoing mental health crisis exacerbated by societal stresses, including the global pandemic. Increased substance use trends, particularly with substances like opioids and alcohol, have been linked to heightened rates of anxiety, depression, and other mental health conditions, underscoring the need for comprehensive awareness and integrated treatment strategies.