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What Are Co-Occurring Disorders?

When a person has co-occurring disorders, they have been diagnosed with both a substance use disorder and another mental health condition. Co-occurring disorders, which are sometimes referred to as a dual diagnosis, are most appropriately treated using comprehensive, integrated treatment that focuses on both problems simultaneously.

According to the Substance Abuse and Mental Health Services Administration (SAMHSA), in 2014, among the 20.2 million U.S. adults who experienced a substance use disorder 50.5% or 10.2 million adults also had a co-occurring mental health disorder.

The brain is unquestionably a complex and relatively fragile organ. Therefore, it’s not surprising that drugs and alcohol can induce symptoms of mental illness or make them worse. These substances alter the way in which the brain operates—not in a positive way. People who use substances to experience a “high” do so because drugs and alcohol affect chemicals in the brain and the way that brain cells interact with each other.

In response to such changes, the brain becomes accustomed to the presence of alcohol and drugs, thereby increasing the likelihood that the person will develop a substance use disorder (SUD). SUDs are types of mental health conditions that are more commonly referred to as chemical dependence or addiction.

It’s possible to experience more than one mental health disorder. Substance use disorders often co-occur in conjunction with other psychiatric conditions. As noted, it is estimated that more than half of people with substance use disorders also struggle with mental illness. 

In some cases, the mental illness precedes substance abuse, while in other cases, substance abuse occurs first. In either situation, each disorder compounds the symptoms of the other and perpetuates a vicious cycle of mental and emotional upheaval.

Other common co-occurring conditions include personality, behavior, and psychotic disorders. Fortunately, when the appropriate comprehensive treatment is rendered, people can recover from addiction and reduce the symptoms of most co-occurring mental health disorders. Failure to address co-occurring conditions during addiction treatment significantly increases the likelihood of relapse.

What Are Mental Health Disorders?

The term “mental health disorder” is used by the American Psychiatric Association to mean “a syndrome characterized by clinically significant disturbance in an individual’s cognition, emotion regulation or behavior that reflects a dysfunction in the psychological, biological or developmental processes underlying mental functioning.”

A mental health disorder is also commonly referred to as “mental illness” or “mental health condition.” Terms such as “crazy,” “mad,” and “lunatic” have long since fallen out of favor among medical professionals, as they have derogatory connotations and further perpetuate the stigma surrounding mental health issues.

Mental Disorders that Co-Occur with Substance Abuse

Any mental health condition can occur along with a substance use disorder. Some mental illnesses (e.g., anxiety and depression) are relatively common, and, fortunately, the most severe (e.g., schizophrenia) are correspondingly rare. However, each mental disorder can range in severity from mild to severe. 

Mood Disorders

Mood disorders include all types of depression and bipolar disorders. They are mainly associated with chronic feelings of profound sadness or hopelessness that are more intense and last longer than normal feelings of melancholy. A person with major depressive disorder may remain perpetually sad for weeks or months at a time.

Those with bipolar disorders will also experience episodes of mania in which they will feel profoundly confident and energetic. Episodes of extreme highs and lows will cycle, sometimes rapidly, and the person and those around him or her may quickly grow weary of the constant emotional upheaval.

Anxiety Disorders

What Are Co-Occurring Disorders?

Anxiety, stress, and fear are normal human emotions, but if these feelings are prolonged or get worse over time, they may be driven by an anxiety disorder. Many anxiety disorders intrude upon a person’s normal life and can make working and other important activities challenging. The feelings of terror experienced by people with an anxiety disorder are often well out of proportion to the perceived threat.

Examples of anxiety disorders include:

  • Post-traumatic stress disorder
  • Separation anxiety
  • Social anxiety disorder

Psychotic Disorders

Psychotic disorders cause two severe symptoms: hallucinations and delusions. People who are experiencing psychosis are disconnected from reality and may have the potential to cause harm to themselves and others. Types of psychotic disorders include schizophrenia, schizoaffective disorder, and postpartum psychosis.

Eating Disorders

Like substance use disorders, eating disorders are largely misunderstood. People who suffer from eating disorders, such as anorexia or bulimia, do not actively choose unhealthy diets. They have a serious mental disorder that drives them to engage in harmful eating behaviors. These behaviors may include starvation, the abuse of laxatives, excessive exercise, and vomiting up food after binge eating.

Personality Disorders

Personality disorders are mental health conditions associated with harmful thoughts, feelings, and actions. They may be triggered by everyday stressors, and they can interrupt daily activities and strain relationships. Some personality disorders, such as psychopathy, are closely associated with chronic criminal activity.

Types of personality disorders include the following:

  • Antisocial
  • Avoidant
  • Borderline
  • Dependent
  • Histrionic
  • Narcissistic
  • Paranoid
  • Psychopathy
  • Schizoid
  • Schizotypal

Behavioral Disorders

What Are Co Occurring Disorders 2

Behavioral disorders most often occur in children. Many otherwise healthy youth will, at times, exhibit some behavioral problems, such as disobedience and hyperactivity. However, behavioral disorders are hallmarked by chronic behavioral problems that last at least six months. If left unaddressed, some young people who grow up with these disorders may develop a personality disorder as an adult.

Why Substance Use and Other Mental Health Conditions Occur Together

Mental illness increases a person’s likelihood of using drugs or drinking alcohol as a misguided attempt to self-medicate. Substance abuse, in turn, also increases the risk of developing a mental health disorder. However, it’s not always easy to determine which condition caused the onset of the other. 

Researchers are still studying the brain in an effort to ascertain how it is that mental disorders develop, although, currently, they do have several theories. In addition to self-medication, there are many reasons why people with mental illness may be more likely to develop substance use disorders.

Risk factors for co-occurring disorders include the following:

  • Genetic predisposition
  • Environment—stress and trauma can produce mental health problems that make substance abuse more desirable
  • Brain systems involved with feelings of reward or stress may be affected by both drug use and mental health disorders
  • Being exposed to alcohol or drugs during childhood and adolescence affects brain development, making a person more vulnerable to addiction and other mental health conditions

Also, some otherwise healthy individuals develop mental health disorders after abusing substances. For instance, alcoholism is closely associated with depression, and chronic methamphetamine use can cause a great deal of anxiety and paranoia.

Drugs can also provoke an earlier onset of mental illness. For example, a person with a genetic predisposition for schizophrenia can develop symptoms of the disorder earlier in life if he or she uses marijuana.

Fortunately, abstaining from alcohol or drug use can relieve many mental health problems. However, some substances of abuse can produce long-lasting or irreversible damage, and treatment is necessary to help people deal with the ongoing symptoms of mental illness.

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Comprehensive addiction treatment includes therapy that addresses the underlying causes of substance abuse—detox alone is not enough. For a person to recover fully from addiction, every aspect of his or her mental and physical well-being must be addressed.

Midwood Addiction Treatment offers integrated treatment programs that are customized to meet each patient’s specific health needs. If you or someone you love is suffering from addiction and a co-occurring mental health disorder, contact us today and find out how we can help!

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