Co-Occurring Disorders: Addiction & Mental Health

People who have substance use disorders (SUD) also often have mental health disorders, and vice versa. This is known as a co-occurring disorder, or dual diagnosis. If you’re wondering how common co-occurring disorders are, you should know that approximately half of people who have one disorder will also have the other at some point in their lives.1 According to the 2020 National Survey on Drug Use and Health, an estimated 6.7 percent of people ages 18 and older had a co-occurring disorder in 2020.2

This article will help you understand what co-occurring disorders are, their signs, symptoms, and causes, and how to treat co-occurring disorders. If you suspect or know that you have a co-occurring disorder, or you know someone who might, there is help available so you can feel better and reclaim control of your life.
Co-Occurring Disorders

What Are Co-Occurring Disorders?

Co-occurring disorders, or dual diagnosis, means that a person has a mental health condition and a SUD the same time.1,3 People can experience many types of mental health disorders and substance use disorders simultaneously. This can include:


How Are Co-Occurring Disorders Diagnosed?

Person in scrubs with arms folded in front of body holding stethoscope

Diagnosing co-occurring disorders can sometimes be challenging, as symptoms of SUDs and mental health conditions often overlap.1 It’s important to receive a proper diagnosis for both disorders from a qualified healthcare provider so that you can receive appropriate treatment for each disorder.1

Only a doctor or another licensed mental health professional can diagnose co-occurring disorders. They will use criteria from the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-5) to assess for the presence of a mental health disorder as well as substance use disorder (SUD).4 The DSM-5 includes specific time frames and behavioral, psychosocial, and emotional criteria to assist with making an accurate diagnosis.5

An evaluation might consist of using a wide range of comprehensive assessment tools to screen for psychiatric illness and addiction.6 However, diagnosing a co-occurring disorder can be difficult and symptoms can overlap. People who enter a treatment facility for SUD may receive observation after they’ve been abstinent from drugs or alcohol for a certain period; this can help to establish whether they are also experiencing a mental illness that is not substance-induced.6

Signs & Symptoms of Co-Occurring Disorders

Symptoms of co-occurring disorders include symptoms of both a mental health disorder and a SUD.3 Every mental health disorder has its own unique set of diagnostic criteria and symptoms, which is why proper diagnosis is important. The specific symptoms of the mental health disorders listed above can vary widely.3

However, some of the potential signs of a mental illness can include:5

  • Mood changes.
  • Excessive fear or worrying.
  • Confusion or problems thinking.
  • Withdrawal from friends or family.
  • Changes in sleep or appetite.
  • Frequent irritability or anger.
  • Problems interacting with others.
  • Problems perceiving reality, such as believing things that aren’t true (delusions) or seeing things that aren’t there (hallucinations).
  • Unexplained physical aches and pains.
  • Suicidal thoughts or actions.

In addition to mental health symptoms, the signs of co-occurring disorders also involve symptoms of SUD, which include a wide range of physical, behavioral, and emotional changes, such as:7

  • Having a desire to want to limit or stop substance misuse but being unable to do so.
  • Consuming the substance in larger amounts or for longer periods of time than intended.
  • Experiencing cravings for continued use.
  • Spending a great deal of time obtaining, using, or recovering from substance use.
  • Continuing to use despite the harm it causes in relationships.
  • Continuing to use despite putting oneself in danger when doing so.
  • Needing to consume more of the substance to achieve the desired effects.
  • Experiencing withdrawal symptoms when unable to use.

What Causes Co-Occurring Disorders?

Scientists know that there is a relationship between co-occurring disorders, but this does not mean that one disorder causes the other.1 Plus, it is also not always easy to determine which disorder occurred first.1

There are certain risk factors that can increase a person’s chance of developing a co-occurring disorder. This can include:1

  • Genetics. Having a family member who had or has a mental health condition or addiction can increase the likelihood that you might develop one or both conditions as well.
  • Environmental influences. This can include factors such as exposure to stress or trauma, which can increase your risk of both substance use disorders (SUD) and mental health disorders.
  • Having a mental health condition. Studies have shown that people with a mental health disorder may use drugs or alcohol as a way of self-medicating their symptoms, but this often tends to make their symptoms worse and can lead to the development of SUD.
  • Having SUD. Substance misuse can cause brain changes that can make it more likely for a person to develop a mental health disorder.

How to Treat Co-Occurring Disorders

cropped image of a group therapy sessions

Co-occurring disorders should generally be treated together, an approach known as integrated treatment.1 This means that you receive simultaneous treatment for the addiction and the mental health condition.3 Treatment for co-occurring disorders often involves medication, counseling, and behavioral therapies, depending on the specific substance you use and your mental health diagnosis.1

At Sunrise House, we offer specialized, evidence-based co-occurring disorder treatment that can take place at different levels of addiction treatment. Our inpatient rehab in New Jersey provides a comprehensive continuum of care that includes medical detox, residential rehab, and aftercare. You’ll receive a thorough medical and psychosocial evaluation with our clinical staff to help determine the appropriate placement for your needs.

During treatment, you may receive specific medications, such as medications that are used to treat opioid, alcohol, or nicotine addiction, as well as medications to help reduce the symptoms of mental health disorders.1

In addition, you may participate in different types of therapy in group or individual formats. This can include behavioral therapies such as cognitive-behavioral therapy (CBT), which helps you make changes to unhelpful thoughts or behaviors. You will receive individual therapy to help you work on specific issues, and you can also participate in groups that are specifically geared to unique needs, like LGBTQ+ groups or gender-specific groups. You can also benefit from 12-Step mutual support groups, like Alcoholics Anonymous (AA).

If you are struggling with a co-occurring disorder, or you’re interested in helping a loved one with addiction and a mental health condition, you should know that help is available. You can start the treatment admissions process today. You can also learn more about ways to pay for rehab or using insurance to pay for rehab, and you can easily with us online.

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