Co-occurring Disorders

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If you struggle with drug or alcohol problems, there’s a strong chance that you may also be fighting depression, anxiety, mood swings or compulsive behavior. It’s not uncommon for people with mental health disorders to abuse street drugs, prescription medications or alcohol as a way to cope with their moods or control their fears.

In fact, the National Survey on Drug Use and Health (NSDUH) has shared some surprising statistics on the prevalence of mental health conditions and substance abuse:

  • Almost 9 million men and women who abuse drugs or alcohol have a mental health issue, also known as a co-occurring disorder or a Dual Diagnosis.
  • Out of all of the adults who go through addiction treatment, only about 7 percent are treated for both their substance abuse and their co-occurring disorder.
  • Over 55 percent of those who suffer from a co-occurring disorder get any help at all.
  • The rate of homelessness among people with co-occurring disorders is approximately 23 percent.
Living with co-occurring disorders makes it harder to hold down a job, develop and maintain personal relationships, get an education, raise children and build financial stability. Many adults who have schizophrenia, major depression, post-traumatic stress disorder or bipolar disorder combined with substance abuse end up living in marginalized circumstances, without a reliable support system.

If you have a co-occurring disorder or have reason to believe that you might have a mental health issue as well as a drug or alcohol problem, it’s crucial to get help for both conditions in order to lead a full, healthy life.

Mental Health and Substance Abuse: What’s the Connection?

Why are co-occurring disorders so common among teenagers and adults with a history of alcoholism or drug abuse? This question may seem to have obvious answers, but the relationship between mental illness and substance abuse is actually very complicated. Anyone who has lived with unmanageable emotions, chronic depression or uncontrollable anxiety knows how tempting it is to numb these feelings somehow. Self-medicating with tranquilizers, booze, meth or painkillers might seem like the fastest, most effective way to get relief from mental illness.

But self-medication is only one of the theories behind the relationship between mental health and substance abuse.

According to the National Institute on Drug Abuse (NIDA), which estimates that up to 60 percent of people with substance abuse problems have co-occurring disorders, there are several contributing factors:

  • Heredity. Recent clinical research suggests that your genetic makeup may predispose you to both substance abuse and a mental health disorder.
  • Brain development. Using drugs or alcohol in the teenage years, when the brain is still developing, may increase the chances of a co-occurring disorder later in life.
  • Stress or trauma. Living through a traumatic event, such as the loss of a parent, a painful divorce, physical or sexual abuse, may make you prone to both addiction and mental illness.
  • Neurological factors. Research has shown that addiction and mental illness may share neurological origins, in some cases. For instance, low levels of the neurotransmitters that affect your emotional stability may lead to both mood disorders and substance abuse.

The link between mental illness and substance abuse is complex.

Some addiction specialists believe that disorders like schizophrenia, depression or anxiety trigger substance abuse, while others believe that drug or alcohol addiction cause mental illness.

In many cases, the symptoms of a mental health disorder resemble the symptoms of substance abuse so closely that even a psychiatrist would find it difficult to tell where one condition begins and the other ends. Every person’s journey to recovery is different, and finding the best way to restore your physical and emotional health is a highly individualized process.

What Are the Most Common Co-Occurring Disorders?

An addictive disorder may occur along with any mental health disorder, but some psychiatric conditions seem to occur with addiction more often than others.

According to the American Society of Addiction Medicine (ASAM), people who seek treatment for drug or alcohol addiction often display signs of the following psychiatric disorders:

  • Depression, bipolar and other mood disorders
  • Anxiety disorders, such as obsessive-compulsive disorder or panic disorder
  • Post-traumatic stress disorder (PTSD)
  • Eating disorders, such as bulimia or anorexia
  • Attention deficit disorder
  • Conduct disorders (in children and teens)

In patients seeking treatment for psychiatric disorders, some of the most commonly abused substances include:

Unless treatment for addiction is combined with treatment for the co-occurring disorder, a complete recovery is not likely to take place.

Relapse rates are high among rehab graduates with co-occurring disorders, especially those who don’t receive fully integrated care. From the initial screening process to the aftercare stage, both your addictive disorder and your mental health disorder should be addressed by compassionate, experienced addiction treatment specialists.

How Do I Know if I Have a Co-Occurring Disorder?

The only way to know for certain whether you meet the diagnostic criteria for a co-occurring disorder is to have an evaluation with a mental health professional or an addiction specialist. But there are warning signs that may point to underlying reasons for your substance abuse:

Warning Signs

  • You’ve felt sad, tearful or hopeless for more than two weeks, even when you aren’t under the influence of drugs or alcohol.
  • You tend to drink or use drugs in response to painful memories or feelings of anxiety and fear.
  • You don’t believe you can control the intensity of your moods without drugs or alcohol.
  • You rely on drugs or alcohol to face situations that frighten you, such as social gatherings.
  • You have trouble focusing on tasks or completing projects without drugs or alcohol.
  • You’ve become increasingly isolated from others as a result of your substance abuse.
  • You have trouble keeping a job, a home or a relationship because of your substance abuse.
  • You’ve been treated for depression, anxiety or another psychiatric disorder in the past.
  • You have a history of abuse or trauma that you’ve never addressed with a mental health professional.

Poverty, unemployment, chronic health problems, a lack of adequate housing, unstable relationships and social isolation are common among people who don’t receive the right treatment for co-occurring disorders. Fortunately, with the right level of care, you can avoid these devastating consequences. The sooner you identify and treat a co-occurring disorder, the greater your chances of achieving a complete recovery.

What Kind of Help Is Available?

Getting the treatment you need to cope with a co-occurring disorder isn’t always easy. Many rehabilitation facilities address a variety of addictive behaviors, but they don’t necessarily provide comprehensive treatment for underlying psychiatric conditions. Traditionally, addictive and psychiatric disorders have been treated separately. More recently, addiction specialists have realized the importance of treating substance abuse and mental health conditions as part of a single, integrated recovery program. As the Partnership at Drugfree.org notes, the treatment of co-occurring disorders should be approached as its own discipline, combining the most effective components of substance abuse treatment with the best evidence-based practices in psychiatric care.

Before you enter rehab, it’s important to seek out a facility that offers specialized treatment for a Dual Diagnosis.

The facility should be staffed by consulting clinicians who have training and credentials in integrated treatment for co-occurring disorders. Counseling sessions and group meetings should accommodate the symptoms of mental illness, such as:

  • Difficulty focusing for extended periods of time
  • Fears of socializing with others
  • Intrusive thought patterns
  • Low motivation to recover
  • Problems with denial

An individually tailored treatment plan addresses the needs of each client rather than applying a cookie-cutter approach to recovery. The components of a personalized recovery program may include:

  • A careful, thorough evaluation of your substance use history and your psychiatric health
  • Individual psychotherapy that addresses the relationship between your mental health disorder and your use of drugs and alcohol
  • Group therapy with other rehab clients who are facing the challenges of Dual Diagnosis
  • Pharmacological therapy to treat the symptoms of depression, anxiety, PTSD or schizophrenia
  • Education and counseling for spouses, partners and children to create a healthy home environment
  • Holistic therapies like acupuncture, massage, yoga or Reiki to support internal balance
  • Aftercare programs that continue to provide support after you’ve graduated from rehabilitation

If you are fighting off fear or depression while battling drug or alcohol addiction, hope and help are available through specialized treatment programs. If you are close to someone who shows the signs of a psychiatric disorder and substance abuse, you can help them get their lives back on track by educating yourself about co-occurring disorders and by offering your encouragement and support. Because denial is common among substance abusers with co-occurring disorders, a family intervention may be necessary to get your loved one into treatment.

Our admissions counselors can give you answers to your questions about co-occurring disorders. We can also provide referrals to treatment facilities that are staffed by caring, highly trained professionals who understand the challenges you face in treatment. Call us today to start the process of recovery and build the future you deserve.

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