What Are Co-Occurring Disorders?
A co-occurring disorder, or comorbidity, occurs when an individual has a substance use disorder (SUD) and a mental health disorder either simultaneously or one after the other. Co-occurring also suggests that these health disorders interact with one another and impact the course of both illnesses, as well as the prognosis and treatment of each. Oftentimes, when a person has co-occurring disorders, one disorder exacerbates or worsens the other and vice versa.
When it comes to co-occurring disorders, people often want to know which disorder came first. For example, if someone has an alcohol use disorder (AUD) and depression, they want to know whether the alcohol issue caused the depression, or whether untreated depression led to AUD. Unfortunately, sussing out which problem came first isn't always possible. Thankfully, treatment and prognosis for recovery are the same regardless of which comorbidity came along first.
Common Co-Occurring Disorders
Co-occurring disorders, or dual-diagnosis as it’s also called, can come in various combinations. However, certain combinations are more common than others. Here are some examples of common co-occurring conditions:
- Alcohol addiction and depression
- Schizophrenia and substance use disorder
- Anxiety disorder and drug addiction
- Intellectual disability or learning disability and mental illness
The rate of comorbidity with serious mental illness (SMI) is much higher as compared with the rest of the population. One out of four individuals with an SMI also has a SUD. A serious mental illness is defined as having a serious mental, emotional, or behavioral disorder that interferes significantly with daily functioning in life. SMIs include bipolar disorder, major depressive disorder, schizophrenia, and more.
As mentioned, co-occurring disorders can interact with one another and worsen the symptoms of each. Often, using drugs or alcohol can cause symptoms of mental health conditions such as depression, anxiety, and even psychosis. It is also common for someone with a mood disorder or other mental health issues such as anxiety to use alcohol or drugs to ease their symptoms, or in other words, self-medicate.
How Co-Occurring Disorders Impact Addiction
The relationship between a substance or alcohol use disorder and another mental health disorder can be complex. However, there are certain factors that impact a person developing both a substance use disorder and another mental health problem.
The National Institute on Drug Abuse (NIDA) indicates three main reasons for comorbidity between substance use and other mental health disorders. These are:
Genetics. Genetics can contribute to the development of both a substance use disorder as well as behavioral health disorders. Certain genes are a risk factor for developing an addiction. Additionally, specific genes can determine how a person’s body responds to drugs. It’s also important to note that certain environmental factors, such as childhood trauma, can cause genetic changes over time making an individual more likely to have a SUD, AUD, or other mental health issues such as depression.
Mental Illness. Mental illness can contribute to drug use and developing a substance use disorder. Research has revealed that certain mental illnesses put a person at greater risk for a substance use disorder. One reason for this is individuals self-medicate with substances to help ease uncomfortable feelings associated with a mental illness such as anxiety. And while initially, alcohol or a drug may seem to relieve symptoms, in the long run, the mental health issue is usually worsened by drug or alcohol use.
Substance Use. Substance use and subsequent addiction can contribute to the development of a mental health disorder. Ongoing alcohol and drug use, can lead to changes in the brain. The longer the substance is used and abused, the greater risk for these changes not only occurring but lasting. These changes in the brain make the person with the addiction more likely to develop a co-occurring mental health disorder.
Co-Occurring Disorders and the Brain
Areas of the brain involved with decision making, rewards, impulse control, and emotions can be impacted by both drug use and mental health disorders such as substance use disorders, depression, schizophrenia, and other psychiatric disorders.
There are also some neurotransmitters linked to both substance use issues and other mental health disorders. These include GABA, serotonin, dopamine, glutamate, norepinephrine, and more.
In addition, environmental factors can increase the likelihood of developing both a substance use issue and another mental health issue. Some of these are:
- Chronic stress
- Childhood trauma
- Access to drugs
- Peer drug use
- Family factors
- Cultural, media, and social acceptance of drug or alcohol use
Because of the high rate of comorbidity between substance use issues and mental health issues as well as the complex interactions between them, comprehensive assessment and treatment for both are essential. Many times uninformed health care professionals may miss one or the other, as it is very common for one to hide or mask the other. This is why it’s vital to seek substance abuse treatment at a reputable addiction treatment center with experience and success in treating co-occurring disorders.
Common Mental Health Issues In Co-Occurring Disorders
According to research, about half of individuals with a substance use problem will also have a mental health issue at some point over the course of their lives. Some of the most commonly seen mental health disorders coinciding with an alcohol use disorder or substance use disorder are:
- Anxiety Disorders. Anxiety disorders such as generalized anxiety disorder (GAD)are mental health disorders in which the person with the disorder experiences fear, nervousness, worry, and other negative emotions to the point where it interferes in their daily life.
- Attention-Deficit Hyperactivity Disorder (ADHD). ADHD is a chronic condition in which the individual with ADHD experiences hard-to-control impulses, difficulty with focus and attention, and hyperactivity.
- Bipolar Disorder. Bipolar disorder is a mental health disorder characterized by extreme mood swings ranging from deeply depressive lows to manic highs.
- Conduct Disorders. Conduct disorders are mental health disorders in which the person exhibits aggressive, destructive, deceitful behaviors and engages in illegal activities or refuses to adhere to rules.
- Major Depressive Disorder (MDD). MDD, also called clinical depression, is a mental illness where the person is in a consistently depressed mood and has a loss of interest in activities that impact their ability to function on a daily basis.
- Post-Traumatic Stress Disorder (PTSD). PTSD occurs when a person is unable to recover after experiencing or witnessing a terrible event. Nightmares, flashbacks, anxiety, and depression can all be experienced with PTSD.
- Schizophrenia. Schizophrenia is an SMI that impedes a person’s ability to think, act, and feel clearly. Often behaviors and thoughts seem out of touch with reality and disorganized.
Common Process Disorders In Co-Occurring Disorders
In addition, there are certain process disorders that can occur with substance abuse problems. These are:
- Addiction Interaction Disorder. Addiction interaction disorder, or cross-addiction, is the condition in which a person has one addiction and then another right after.
- Internet Addiction. Internet addiction is characterized by excessive use of and the inability to control impulses to use the computer or internet.
- Video Gaming Use Disorder. Video gaming use disorder is a disorder in which the person spends hours playing video games and neglects responsibilities to do so.
- Sex or Relationship Addiction. This type of addiction involves hypersexuality, and person with a sex or relationship addiction is generally unable to control urges to engage in sex or relationships.
- Gambling Addiction. Gambling addiction is a type of process addiction that is characterized by the inability to cut down on or stop gambling despite the negative consequences occurring.
- Eating Disorders. Disordered eating is characterized by persistent disturbances in eating patterns or behaviors and distressing emotions and thoughts.
As you can see, there are numerous types of mental health disorders and process disorders that can co-occur with substance abuse disorders. While a dual diagnosis may seem daunting, the good news is that co-occurring disorders are highly treatable. It’s important to get treatment for both disorders at the same time for the best chance at long-lasting recovery.
If you or someone you love has a co-occurring disorder, Caron has dual diagnosis treatment and treatment plans that may include inpatient or outpatient, cognitive behavioral therapy CBT, group therapy, individual therapy, or a combination. We offer specialized treatment for young adults, adolescents, older adults, and other populations. We have helped thousands of people recover from co-occurring disorders. At Caron, we believe recovery isn’t just possible—it’s probable. Contact us today to learn more about our treatment options. Call 1-800-854-6023 to learn more.