What are co-occurring disorders?

Individuals who have substance use disorders, as well as mental health disorders, are diagnosed as having “co-occurring disorders.”

The coexistence of both a mental illness and a substance use disorder is not uncommon. People with mental illness are more likely to experience a substance use disorder than those not affected by a mental illness. Symptoms of addiction can mask symptoms of mental illness, and symptoms of mental illness can be confused with symptoms of addiction. There are some patterns that do present themselves, though. Individuals diagnosed with mental health disorders often use substances to feel better. People who struggle with anxiety may want something to make them feel calm; people who struggle with depression may want something to make them feel “up” or “happier; people who experience a lot of fearfulness, may want something to make them feel more relaxed; and people who are experiencing psychological pain may want something to help them feel nothing at all, to make them feel numb.

Using alcohol or other drugs not only fails to help the mental health disorder, it prevents a person from developing effective healthy coping skills, having satisfying relationships, and feeling comfortable with themselves. Using alcohol or other substances also interferes with medications prescribed for mental health disorders.

To put it simply, drug and alcohol use makes mental health disorders worse.

People with co-occurring disorders may stop using alcohol or other drugs, but this does not “fix” the problem and they will most likely find difficulties as the symptoms of their mental health disorders persist. This can often lead to increased depression, anxiety, frustration, and the inability to cope, resulting in going back to substances as a coping mechanism. Treating just one disorder will not magically make the other one disappear.

According to the National Institute of Mental Health, mental health disorders that commonly co-occur with substance use disorders include, but are not limited to, anxiety disorders, depressive disorders, ADHD, bipolar disorder, schizophrenia and personality disorders.

On dualdiagnosis.org, “Over half of 7.9 million individuals having co-occurring disorders are male. Additionally, a high rate of suicide attempts is associated with co-occurring disorders. Studies claim anxiety sufferers are almost double as likely to abuse substances as the general population. People with bipolar disorder, schizophrenia and untreated anxiety disorders are most at risk of abuse. Almost half of all people with a co-occurring disorder get no medication at all although the fact is that treatment is critical for recovery. Co-occurring disorders account for 7.9% of all mental illnesses, yet only 7.9% of those with a co-occurring disorder ever complete treatment for both illnesses.”

How does treatment work when it is co-occurring disorders? Historically, providing treatment for co-occurring disorders was done separately. However, it is recommended by SAMHSA (Substance Abuse and Mental Health Association) to use an integrated approach. An integrated approach means treating both the substance use disorder and mental health disorder together, and not seeing them as separate without consideration for the other. The goal of integrated treatment is to help people with co-occurring disorders learn how to maintain sobriety or significantly reduce their substance use, as well as, manage the symptoms of their mental health disorder. This is accomplished through the use of effective counseling and behavioral therapy interventions and, sometimes, with medications. There is really no “one size fits all” approach, but integrating treatment has shown to be much more effective.

If you or someone you know is struggling with co-occurring disorders, please reach out and seek help. It IS possible to learn to manage your mental health disorder and achieve your goals to reduce your substance use.