Common Co-Occurring Disorders and How to Treat Them

When someone struggles with both addiction and mental health disorders, they have co-occurring disorders. According to the Substance Abuse and Mental Health Services Administration (SAMHSA) 2020 National Survey on Drug Use and Health, 17 million people in the United States have co-occurring mental health and substance use disorders.

Read on to learn more about mental health disorders, what co-occurring disorders are, and how to get help form mental health and substance use disorders.

Common Mental Health Disorders

There are several mental health disorders that commonly co-occur with addiction. These include:

• Depression.
• Post-traumatic stress disorder (PTSD).
• Generalized anxiety disorder.
• Obsessive compulsive disorder (OCD).
• Bipolar disorder.
• Schizophrenia.
• Attention-deficit hyperactivity disorder (ADHD).

Depression

This mental health issue is typically described as a “blue” mood that lasts for weeks or months without ceasing. People who have depression may work hard to hide the issue, but there are breakthrough signs and symptoms that include:

• Loss of interest in hobbies and activities that once brought pleasure.
• Apathy.
• Inability to express emotion.
• Low energy.
• Slow reaction times.
• Frequent mention of physical pain, or multiple visits to the doctor for pain.
• Sleep changes; insomnia or sleeping too much.
• Changes in appetite.
• Feelings of worthlessness or hopelessness.
• Irritability.
• Restlessness.
• Suicidal thoughts or ideation.

Post-Traumatic Stress Disorder (PTSD)

This mental health disorder may arise after an event in which a person was the victim of or witness to a traumatic occurrence. War experiences, terrorist attacks, physical violence, rape, motor vehicle accidents, or natural disasters could trigger the onset of PTSD. Symptoms can include:

• Flashbacks, or re-experiencing the event in other ways such as through nightmares or frightening thoughts.
• Being easily startled.
• Feeling on edge.
• Outbursts of anger.
• Avoidance of things that remind the person of the trigger event.
• Insomnia.
• Feelings of guilt or blame.
• Inability to remember key parts of the traumatic event.

Generalized Anxiety Disorder

Most people will experience bouts of anxiety at some point in their lives. For those with generalized anxiety disorder, symptoms are persistent and can make a healthy and fulfilling life very difficult to maintain. According to the National Institute of Mental Health (NIMH), common symptoms of an anxiety disorder include:

• An inability to relax.
• Difficulty concentrating or focusing.
• Frequent or chronic headaches.
• Fatigue.
• Muscle tension, stomach aches, or unexplained physical pain.
• Irritability.
• Excessive worry.

Obsessive Compulsive Disorder

According to the Anxiety and Depression Association of America, this mental health disorder presents with obsessions — intrusive and persistent thoughts that do not go away, despite efforts to ignore them — and compulsions, which are actions or rituals used to manage the anxiety from obsessive thoughts.

People with obsessive-compulsive disorder may be preoccupied or overly concerned with:

• Cleanliness.
• Order or symmetry.
• Safety of loved ones.
• Specific objects that seem worthless or unimportant to others.

Obsessions are overwhelming and difficult to ignore for someone with OCD. Worries and concerns may intrude on everyday life to such a degree that the person finds it difficult to accomplish day-to-day tasks. In an effort to eliminiate or resolve these obsessive thoughts, people with OCD may:

• Wash up or clean aggressively and repetitively.
• Check and recheck doors, windows, ovens, or other household items.
• Repeat behaviors, such as saying a phrase or walking through a door.
• Create rituals, such as counting items, walking in a specific way, or using an exact phrase.

For someone with OCD, these compulsive tasks can take up hours of every day. They do not bring the person any kind of pleasure.

Bipolar Disorder

Bipolar disorder has a range of symptoms that are categorized broadly as depressive, manic, and hypomanic. How a person’s symptoms present will determine which type of bipolar disorder a person has, and each type can work a little differently from person to person. Because this disorder has many variables, it is difficult to outline what specific symptoms will look like in every person. In general, bipolar symptoms include:

• Episodes of mania. Feelings of increased importance and grandeur. Symptoms may also include a decreased need for sleep, increased energy, rapid speech, and risk-taking behaviors.
• Episodes of depression. Feelings of sadness or loss. Sleep disturbances; sleeping too much or too little. Increased expressions of worthlessness or hopelessness, and reduced energy.
• Episodes of hypomania. These are close to manic episodes but are generally less severe. Individuals experiencing hypomanic symptoms may not be aware they are in a hypomania phase, but those around them may notice changes in behavior.

Additionally, bipolar symptoms may include cycling between episodes of mania and depression or staying depressed for long periods with no episodes of mania at all.

Schizophrenia

This mental health disorder affects the way a person feels, acts, or things. For people with schizophrenia, it can be difficult to distinguish between what is real and what isn’t. Symptoms of this disorder can include:

• Hearing sounds others cannot (auditory hallucinations).
• Seeing things that are invisible to others (visual hallucinations).
• Talking to people others cannot see.
• Compulsions to do things that seem unusual to others.
• Experiencing deep mood shifts.
• Speaking unintelligibly.

Attention-Deficit Hyperactivity Disorder (ADHD)

This disorder is often associated with young children, but ADHD is not limited to young people. Adults are often diagnosed with ADHD. Many ADHD symptoms are more noticeable at work or other in circumstances that require periods of focus, organization, or retention of complex instructions. This means that adults with ADHD often have difficulty keeping jobs or performing well in the positions they can keep. Symptoms of ADHD in adults can include:

• Difficulties with organization.
• Persistent procrastination and difficulty meeting deadlines.
• Inability to complete projects.
• Impulsivity.
• Persistent boredom.
• Inability to follow directions or track a complicated discussion.
• Disorganized thoughts.
• Overworking.
• Overeating.
• Impatience.
• Low self-esteem.
• Fidgeting.
• Carelessness.

What is a Substance Use Disorder?

A substance use disorder (also referred to as addiction) is a chronic but treatable condition that affects a person’s brain and behavior. It can have far-reaching consequences on every part of their life. When an individual has a substance use disorder, they often have difficulty controlling their ability to stop or slow down their use of drugs or alcohol despite harmful consequences to their physical and mental health, quality of life, and relationships.

Signs of Addiction

The Diagnostic and Statistical Manual of Mental Disorders (5^th ed) lists specific criteria that can indicate the presence of a substance use disorder. These include:

• Continued use of substances despite problems with social or interpersonal relationships resulting from substance use.
• Using drugs or alcohol in hazardous situations, such as while driving a car.
• Neglecting major responsibilities at home, school, or work to use substances.
• Experiencing unpleasant effects when use of drugs or alcohol is reduced or stopped (withdrawal).
• Needing to use increasing amount of a substance in order to achieve the same effects (tolerance).
• Using larger amounts of a substance for longer periods or time than intended.
• Attempting to cut back or stop use of drugs or alcohol, but finding yourself unable to do so.
• Spending a great deal of time getting or using drugs or alcohol, or recovering from their effects.
• Craving substances.
• Giving up activities that were once enjoyed to use drugs or alcohol.
• Experiencing physical or psychological problems as a result of the use of substances, and continuing to use despite the problems experiences.

What is a Dual Diagnosis?

Dual diagnosis and co-occurring disorders are different terms for the same thing. When someone has a “dual diagnosis,” they have two or more co-occurring mental health and substance use disorders. Because someone can have more than two simultaneous conditions, co-occurring disorders more accurately describes their diagnosis.

How to Help a Loved One with Co-Occurring Disorders

It’s natural to want to help a loved one who is struggling with co-occurring disorders. Some helpful tips for getting your friend or family member they help they need include:

1. Educate yourself about substance use and mental health disorders.
2. Speak to your doctor or a mental health provider for advice about treatment options.
3. Talk to your loved one. Try to choose a time when they are not using or under the influence of substances. Remember to avoid judgment and language that is stigmatizing, such as “addict” or “drunk.”
4. Be empathetic and remain open to what your loved one has to say.
5. Schedule an appointment with a doctor or prepare a plan for admission into treatment.
6. Offer to bring your loved one to their appointment or to treatment.
7. Set boundaries and stick to them.

Our guide for families offers more insight into helping a loved one with co-occurring disorders,

How to Treat Co-Occurring Disorders

Symptoms of mental health disorders can be made worse by continued substance use, and a lack of treatment for a mental health disorder may worsen substance use problems. Because co-occurring disorders can be complex and closely intertwined, professional treatment is often necessary to address the effects of both the behavioral health issue and addiction. If just the substance use disorder is treated without addressing the underlying mental health concerns, treatment may not be successful long-term. In general, it’s recommended that people struggling with a dual diagnosis undergo an integrated treatment program that treats co-occurring disorders simultaneously.

When a person goes to an integrated treatment program at an inpatient rehab in New Jersey, they will receive both therapeutic and medical interventions concurrently as part of a care plan that is specifically tailored to their needs and treatment goals. This integrated approach uses proven therapies and can include the use of FDA-approved medications as necessary. Further, it allows the team of doctors, nurses, and addiction specialists to monitor the effectiveness of treatment and make adjustments as needed.

Common Therapies for Co-Occurring Disorders

There are several effective therapies used for co-occurring disorders which use a combination of evidence-based therapies (e.g., cognitive-behavioral therapy, relapse prevention training), medications, and alternative therapies such as mindfulness.

Therapy can be conducted in individual or group settings, or a combination of both.

Medications Used in Dual Diagnosis Treatment

Depending on the type of substance or substances a person was using, dual diagnosis treatment can include the use of certain medications to help manage withdrawal symptoms, reduce cravings for drugs or alcohol, and make the transition from use to recovery more comfortable. In some cases, to help manage mental health symptoms anti-depressants or other psychiatric medications may be prescribed.

Finding the Right Treatment Center for Co-Occurring Disorder Treatment

Choosing the right treatment center for yourself or a loved one is an important part of the recovery process. Some things to look for in inpatient or outpatient drug and alcohol rehab in New Jersey are:

• What kinds of levels of addiction treatment and program options do they offer?
• What are their facility licensing and accreditations?
• What are their staff qualifications?
• Do they offer amenities and features that you’re looking for?
• Do they provide information about what to expect in inpatient rehab?
• Do they offer aftercare planning and continued support after you leave treatment?

How to Pay for Rehab

One of the biggest concerns that many people have is about handling the cost of rehab. Many rehabs, including our drug and alcohol addiction treatment center in New Jersey, offer a variety of options to help you get the treatment you need.

Find out if your insurance will cover part or all of rehab by filling out our You may also wish to contact our friendly and helpful admissions navigators at to find out more about Sunrise House, using insurance to pay for rehab, or to start the admissions process. Recovery is possible. We’re here to help.