Co-occurring Disorders

Co-occurring disorders are diagnosed when a person has both mental illness and a substance use disorder. Also referred to as a dual diagnosis or dual disorder, it means a person may be struggling with PTSD, bipolar depression, or other diagnoses in addition to their substance or alcohol use disorder.

It is difficult to know if someone is struggling with just an addiction or mental illness alone, and it can be even more challenging when they are dealing with both at the same time. The 2016 National Survey on Drug Use and Health found that 8.2% of adults living in the United States have a mental illness and substance abuse disorder.

Some examples of co-occurring disorders are:

• Cocaine addiction and major depression

• Panic disorder and alcohol addiction

• Schizophrenia and alcoholism with multi-drug abuse

• Borderline personality disorder and binge drinking

• PTSD and substance and/or alcohol use disorder

What Causes Co-occurring Disorders?

There is a genetic risk factor for both mental illness and substance abuse disorders. However, there are other important factors associated with co-occurring disorders. Some of the other factors that play a role in developing this disorder include environment, stress, family, poverty, loss, and trauma. Experiences people go through that may be stressful can trigger genetic factors that result in co-occurring disorders.

Individuals with a mental illness can be more sensitive to the effects of mood-altering substances. Often, a person will begin using drugs or alcohol to cope with the symptoms they are experiencing from their mental illness; this behavior is often called “self-medicating.” Just as people with a substance abuse addiction are at a higher risk of developing a mental illness, it is the same for those individuals who already have a mental illness.

Addiction or Mental Illness: Which Comes First?

Every person is different, and it will vary for each individual. Some people may use drugs or alcohol to deal with symptoms of mental illness. Mental illness is overwhelming, and some people find temporary relief from their symptoms in drugs or alcohol. Since chronic use of substances can alter brain chemistry, some people develop a mental illness due to using drugs and alcohol.

Signs of Co-occurring Disorders

Many signs can be present in people that suffer from co-occurring disorders such as:

• Alcohol and drug abuse that is used as an escape from problems and pain associated with their mental illness

• Mental illness that gets worse because of the use of drugs or alcohol

• Finding it challenging to seek help for both disorders

• Difficulty benefiting from treatment given

• Substance abuse that gets worse as a result of mental illness

• Trouble finding support from others

Symptoms of Co-occurring Disorders

Symptoms relating to the use of drugs such as heroin, prescription pain relievers, marijuana, and cocaine include:

• Decreased appetite

• Insomnia

• Sweaty palms

• Depression

• Irregular heartbeat

• Mood swings

• Paranoia

• Euphoria

• Social isolation

Symptoms associated with mental illnesses resulting from depression, bipolar depression, and schizophrenia can include:

• Suicidal thoughts

• Anxiety and fear

• Anger issues

• Delusions

• Hallucinations

• Social isolation

• Mood swings

• Depression

• Euphoria

Treatment for Co-occurring Disorders

Integrated treatment is the best approach for individuals suffering from co-occurring disorders. To begin treatment, an individual will need a diagnosis for both conditions. Evidence shows that treatment involving education, frequent monitoring, therapies, medications, and peer support groups is extremely beneficial.

Treatment for co-occurring disorders is tailored to the individual. Each person responds differently to therapy or medications; residential treatment programs or inpatient rehabs will develop a plan for each person.  

There are also outpatient treatment programs or outpatient rehab for people whose clinical needs may benefit from outpatient treatment. They are still able to go to work and live at home while they seek treatment through rehab. Outpatient therapy requires a strong dedication from the individual for it to be successful.

Some medications prescribed during treatment help with mood swings, anxiety, hallucinations, and the prevention of flashbacks to traumatic events.

How Loved Ones Can Help with a Co-occurring Disorder

Family members and other loved ones play a huge role in the treatment of a person. It is essential to educate yourself about the mental health and addiction issues that your loved one is experiencing. It is also beneficial to learn how these disorders impact you and other family members.  Support groups are available for family and friends; some include the National Alliance on Mental Illness (NAMI) or Al-Anon.

Do you or a loved one struggle with a co-occurring disorder? You are not alone. We are here for you, and we are here to help.