What are Co-Occurring Disorders?

It is crucial to understand what co-occurring disorders are, in order to identify the link between mental health conditions and substance use. If a person suffers from both, he may require assistance with both. With proper mental health treatment, individuals can learn to control their symptoms, overcome substance abuse and strive to live healthy lives.

Any age group and background can have co-occurring disorders. May make daily life, relationships, work and personal duties more challenging. But, two conditions doesn’t mean that it isn’t possible to recover. If individuals and families are aware of the signs, causes and options for support, they are better equipped to make informed choices about obtaining support.

Key Takeaways

• A co-occurring disorder is a person who suffers from a mental health disorder and a substance use disorder.
• Often depression, anxiety, and alcohol or drug use disorders are co-occurring.
• Mental health symptoms and use of drugs and alcohol can interact.
• Some of the causes of co-occurring disorders involve genetics, trauma, stress and the environment.
• Treatment can involve ongoing recovery support, counseling, and managing the use of medications, and treating both conditions at once.
• With early professional help, people can cope with symptoms and enjoy a better quality of life.

What Are Co-Occurring Disorders?

Co-occurring disorders are when a person has a mental health disorder and a substance use disorder. Also referred to as a ‘dual diagnosis’.

For instance, an individual could be dealing with depression along with alcohol use. Another person might have anxiety and often misuse prescription drugs. In both cases, the issues are co-occurring disorders.

Conditions are able to act on one another. Alcohol or drugs may be used to manage unhappy feelings, problems with sleeping or anxiety. With repeated use, the symptoms may become worse.

Substance use also can cause the emergence of new mental health symptoms. The relationship is not always so simple and it is unique to every person.

People with co-occurring disorders are not weak-willed. This may include complex factors that require suitable professional help in both circumstances. 

Common Types of Co-Occurring Disorders

Co-occurring disorders may be both mental health and substance use disorders. Some combinations are common, and any mental health disorder is a possibility with a substance use disorder.

Common examples include: 

• Depression and alcohol use disorder: Some people use alcohol to deal with sadness, lack of energy or hopelessness. But when you drink alcohol, it can make depression symptoms worse.
• Alcoholism or drug dependency: Individuals with anxiety can seek to be relaxed by using substances. Over time, people may become more and more worried about using substances.
• PTSD and substance use disorder: Individuals who have been through traumatic events may turn to drugs or alcohol to ease their distress or to numb painful memories or nightmares.
• Bipolar disorder and substance use disorder: Mood swings and impulsivity can also be seen along with the use of alcohol and drugs, which can make symptoms harder to manage.
• ADHD and substance use disorder: There can be issues in impulsivity and substance use in some people with ADHD, but it is not always the same.

The two conditions are recognized to better guide professionals in developing the right care plan for a person. 

What Causes Co-Occurring Disorders?

There is no single cause of co-occurring disorders. They may arise from a combination of biologic, psychological and environmental factors.

For some, mental health symptoms occur first, prior to having a substance use issue. Others start to take drugs and develop mental health problems. Sometimes, both conditions develop around the same time.

Typically there are a number of factors responsible for it: 

• Genetics: If a family member has a mental health or substance use disorder, it may make an individual more susceptible.
• Traumatic experiences: The emotional impact of childhood adversity, abuse, neglect, accidents or other traumatic experiences can also have an impact.
• Chronic stress: Long-term financial issues, relationship issues, job stress and other stressful situations can contribute to mental health problems.
• Brain chemistry: Emotional regulation and behaviour are affected by brain function and the impact of some chemicals.
• Environmental influences: Being raised in a household with someone who has a substance use disorder or with little social support can create some risk.
• Mental health illness: Individuals with depression, anxiety and other psychiatric disorders may be more at risk for substance abuse.

This does not mean that these will ensure the development of co-occurring disorders. Every person is unique in his or her situation and experiences.

Signs and Symptoms of Co-Occurring Disorders

The signs of co-occurring disorders depend on the mental health condition, the substance involved, and the severity of each problem. Some symptoms may be easy to recognize, while others develop gradually.

Common signs include:

• Sadness or hopelessness for a long time or a loss of interest in activities.
• Regular feelings of anxiety, panic or worrying
• Changes in sleeping or eating habits
• A rise in alcohol and/or drug consumption
• Inability to control use of a substance.Problem with controlling use of a substance.
• Withdrawing from friends and family
• Difficulty focusing or with daily activities
• Changes in mood, or unusual irritability
• Neglecting personal responsibilities 
• Any action taken to avoid or suppress a feeling is considered to be using a substance to regulate an uncomfortable feeling.
• Withdrawal symptoms with the withdrawal of some substances 

There may be some symptoms that overlap. For instance, sleep disturbances may be associated with depression, anxiety, alcohol abuse or dependence.

Individuals need not have all of the symptoms to have a co occurring disorder. A professional evaluation can help to determine what is going on and set the stage for action. 

How Mental Health Disorders and Substance Use Disorders Are Connected

There are several ways mental health disorders and substance use disorders can affect each other.

Some use alcohol or drugs to help them deal with emotional pain. For instance, a person with anxiety could consume alcohol to help him or her feel better in social scenes. Depressed individuals may find themselves using substances to numb out and stay away from some of the more challenging emotions.

But these impacts might not be permanent. Alcohol and drugs can interfere with sleep, mood and functioning. Over a period of continued use, mental health symptoms may become more severe.

Use of substances may also cause a person to become less aware of the initial problem. For instance, anxiety can be a symptom of an anxiety disorder, drug use or withdrawal, or a blend of both.

This connection means that tackling one condition may not meet the needs of another, which is why there is a need to address both. Knowing both conditions enables professionals to create a more thorough mental health treatment plan. 

Risk Factors for Co-Occurring Disorders

There are some situations and experiences that may make co-occurring disorders more likely. But, a risk factor doesn’t automatically mean that someone will get these diseases.

Risk factors are: 

• A history of mental health and/or substance use disorders in the individual or family
• Adverse childhood experiences—trauma, abuse, or neglect
• Long-term stress or major life changes
• Access to alcohol or drugs at an early age
• Social isolation and/or restricted emotional support
• Previous issues related to emotional management.
• People with COPD often have a long history of untreated mental health symptoms.

Risk factors can be combined. For instance, a person that has suffered trauma and not enough social supports may encounter further difficulties when coping with anxiety or depression.

Understanding these can allow individuals and families to become more aware of issues at an earlier stage and access the right service. 

How Are Co-Occurring Disorders Diagnosed?

Co-occurring disorders are diagnosed by examining mental health symptoms and substance use. A trained mental health worker might inquire about an individual’s health and emotional past, drug use, and daily functioning.

An assessment could consist of: 

1. Mental health evaluation: Professional assessment of symptoms of depression, anxiety, PTSD, bipolar disorder etc.
2. Substance use assessment: Questions about type, frequency and amount of alcohol or drug use can determine if there may be substance abuse.
3. Medical history: Physical health, medications, past diagnoses, and withdrawals can be taken into account.
4. Symptom Review: A professional evaluation of the onset of symptoms and if they happen while the person is using substance or not.
5. Personal History: Family history, stressful events, relationships, etc. can help to complete the picture.

It can sometimes be hard to decide if symptoms are from a mental health condition, substance use or both. Further assessment may be required as required over time.

A proper diagnosis will help the professional determine appropriate treatment choices and reasonable care goals.

Looking for support with co-occurring disorders?

If you or a loved one is having mental health issues along with substance use, WellMind Therapy Center can assist you in understanding the mental health services and supports that are available.

Please contact (682) 432-1571 to discuss and take the next step towards professional support.

Treatment Options for Co-Occurring Disorders

Treatment for co-occurring disorders is usually geared more toward treating the two disorders together than each one as its own disorder. How a person is treated will vary by their symptoms, substance use history, health and support needs.

Treatments may involve: 

1. Individual counseling

Individual counseling will offer a confidential environment for discussing emotional issues, substance use, personal experiences and recovery objectives. One way a counselor can do this is through a technique called cognitive-behavioral therapy (CBT), which helps individuals identify harmful thought cycles and learn to manage them with more effective coping strategies. 

2. Medication management

Sometimes medications can be used to cope with some mental health issues, including depression, anxiety and bipolar disorder. A prescribing professional with appropriate skill and experience may make the decision about whether a medicine is suitable and be able to monitor the effect of a medicine. 

In some cases medication can be used in the treatment of a substance use disorder. The selection depends on the substance and individual’s needs. 

3. Integrated treatment

Integrated care combines care for mental health and substance use issues. Professionals can facilitate the coordination of counseling, medication management and recovery support to minimize holes in services. 

4. Group counseling and peer support

Group counseling provides an opportunity for individuals to share experiences, learn coping skills and gain support from others who have similar experiences. Peer support can also help to remove feelings of isolation and encourage. 

5. Family support

If appropriate, having family members involved can enhance communication and improve an individual’s support system. Family education is also an important way for families to grasp co-occurring disorders and how they can be supportive. 

6. Substance use recovery support

Relapse prevention planning, identification of triggers, healthy routines and community resources may be part of recovery support. For those with a physical dependency, it may also require medically supervised withdrawal treatment.

Treatment varies from person to person. The professional may be able to help identify appropriate services and if further levels of care are required. 

Benefits of Treating Co-Occurring Disorders Together

Combating mental health and substance use problems together can assist individuals in getting more coordinated support.

Potential benefits include: 

• More comprehensive understanding: Professionals may think about how both of these conditions influence the person’s thinking, feeling, and acting.
• Improved symptom management: Treating both conditions could help lessen factors that lead to continued distress.
• Better coping mechanisms: Counseling can assist folks discover other methods to manage challenging feelings, such as without the use of substances.
• Better functioning: With the right support, individuals can be supported to deal with relationships, the workplace, school and daily life.
• Coordinated services: It can help minimize the gap between mental health services and substance use recovery.
• Long term recovery planning: Individuals are able to identify warning signs, work with triggers and get assistance with challenges.

This can take some time and there can be setbacks. Regular reviews and modifications of the care plan can support individuals’ ability to respond to the changing needs. 

When to Seek Professional Help for Co-Occurring Disorders

If mental health symptoms and substance use are impacting relationships, responsibilities, physical health or quality of life, consider seeking professional help. 

An assessment may be helpful when you: 

• Frequently use alcohol or drugs to cope with stress or emotional pain.
• Experience chronic anxiety, depression, or mood swings with substance use.
• Have a hard time cutting down or stopping the use of substances.
• Have recurring work, school or home difficulties resulting from substance abuse or mental health issues.
• Attempted to resolve these issues without success on their own.

Don’t have to wait until symptoms are bad to seek assistance. With early assistance you can better understand what has happened and options available.

If someone is overdosing, has extreme withdrawal symptoms or is in immediate danger of hurting themselves, call for emergency medical assistance right away.

WellMind Therapy Center offers mental health services to those in need of mental health support for emotional and behavioral issues. Call the center (682) 432-1571 to find out more about the services offered and talk about the issue you are concerned with.

Frequently Asked Questions About Co-Occurring Disorders

1. How is dual diagnosis treated?

Generally, dual diagnosis is treated by treating both the mental health and substance use issues. Treatment can involve individual counselling, medication management, recovery support and regular assessments according to individual needs and requirements, behavioural therapies. 

2. What is a substance-related and addictive disorder?

Substance related and addictive disorders are defined as a problematic pattern of alcohol or drugs use that causes health, relationship or functional impairments. It could be through cravings, inability to stop, continued use despite harmful effects or withdrawal symptoms. 

3. What do co-occurring conditions mean?

Co-occurring conditions are two or more health conditions experienced by the same person. Also used in behavioral health, it typically refers to a mental health disorder that is present in conjunction with a substance use disorder, including depression and alcohol use disorder. 

4. Is anxiety a co-occurring disorder?

One of the disorders that might occur along with anxiety is a co-occurring disorder. Anxiety disorder and alcohol use disorder are a good example of two disorders that can occur together. Both are potentially assessable and may need support. 

5. Is depression a co-occurring disorder?

Depression can co-occur with other substance use disorders, such as alcohol and drug use disorders. If both are present, workers might consider an integrated care plan to treat depressive symptoms and substance abuse at the same time. 

Disclaimer

The information provided in this article is educational or informational only. It is not intended to replace professional medical advice, diagnosis or treatment. Co-occurring disorders are unique for each person. Seek professional medical advice and recommendations for individual assessment and care. If you are in an emergency, get immediate medical help. 

References

The following authoritative resources provide additional information about co-occurring disorders, their causes, diagnosis, and available support.

1. National Institute of Mental Health (NIMH): Finding Help for Co-Occurring Substance Use and Mental Disorders
2. Substance Abuse and Mental Health Services Administration (SAMHSA): Managing Life with Co-Occurring Disorders
3. National Institute on Drug Abuse (NIDA): Common Comorbidities with Substance Use Disorders