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It is not unusual for someone to need mental health and substance abuse counseling, as addiction and mental health conditions can occur side-by-side. When a person has both conditions, they benefit from co-occurring disorders treatment. Here, learn the facts about co-occurring disorders, including how common they are, how they develop, and how they are treated.
Co-occurring disorders exist when a person has both a mental health condition and a substance use disorder. According to the National Institute on Drug Abuse (NIDA), co-occurring disorders can interact with each other and make a person’s condition more severe. For example, addiction may be more severe and more difficult to treat among people who have a co-occurring mental health condition.
When people have co-occurring mental illness and addiction, they may also be said to have “comorbid conditions.” In some cases, one condition may develop after the other; in other instances, they may occur right at the same time.
When someone has co-occurring disorders, they will show symptoms of both mental illness and addiction. Sometimes, symptoms of the two can look similar, but keep in mind that each condition is a separate diagnosis.
While there are various mental health conditions, each of which has its own symptoms, the following general signs can point to a mental health condition:
On the other hand, someone who has a substance use disorder, which is the clinical term for an addiction, will show the following signs and symptoms:
When a person shows signs and symptoms of addiction, alongside common signs of mental illness, this can indicate the presence of co-occurring disorders.
There are some general signs and symptoms of mental illness, but as noted above, the various mental health conditions that co-occur with addiction each have their own diagnostic criteria. Below are some conditions that may co-occur with addiction.
Individuals with attention deficit hyperactivity disorder (ADHD) have difficulty remaining on task and staying organized, and they may show impulsive behaviors, such as fidgeting, speaking out of turn, or having trouble remaining seated. Genetic factors have been found to increase the risk of substance abuse in individuals with ADHD.
People with anxiety disorders don’t just have a normal level of anxiety about stressful events. Their worry and fear is excessive and begins to interfere with daily life. Among the anxiety disorders are generalized anxiety disorder, which involves exaggerated worries about daily life, and social anxiety disorder, in which people have intense fear surrounding social situations, such as interacting with other people or participating in group discussions at work or school. A person who has anxiety may use substances in order to cope with their worries and fears.
Mood disorders include depression, which is associated with symptoms like persistent feelings of sadness, difficulty concentrating, changes in sleeping and eating habits, and loss of interest in usual activities. Bipolar disorder, in which a person swings between periods of depression and periods of mania (extremely elevated mood) is also considered a mood disorder. People may self-medicate low moods with drugs or alcohol.
Individuals who live with personality disorders have patterns of thinking and behaving that vary from what is expected, and these patterns cause significant difficulties with functioning in everyday life. For instance, people with borderline personality disorder experience intense emotions and unstable relationships, whereas those with histrionic personality disorder require constant attention and feel distressed when they are not the center of attention. Substance abuse can become a method of coping with the distress that comes with personality disorders.
People who live with eating disorders are hyper fixated on food and weight, to the extent that they have difficulty functioning in other areas of life. They may have anorexia nervosa, which involves an intense fear of gaining weight and results in extreme food restriction, or bulimia nervosa, which is characterized by cycles of binging and purging or another eating disorder. For individuals with eating disorders, substance abuse can be a way to control weight or avoid taking in calories.
Post-traumatic stress disorder (PTSD) occurs when someone has witnessed a traumatic event, and then experiences troubling symptoms, like difficulty sleeping, flashbacks of the trauma, and attempts to avoid anything associated with the traumatic memory. Drugs and alcohol may allow people to “numb” their emotions and avoid the flashbacks that occur with PTSD.
Psychotic disorders, including schizophrenia, result in unusual patterns of thinking and behaving, and a person is likely to experience hallucinations and delusions with this mental health condition. Studies have suggested that genetic risk factors can also make individuals with schizophrenia more vulnerable to developing addictions.
There is no single factor that leads to the development of a co-occurring disorder, but several factors can increase the risk of having both a mental health condition and an addiction. They include the following:
It is often difficult to determine whether a mental health condition or a substance use disorder came first. In some cases, shared genetic risk factors may lead a person to develop both conditions at about the same time. On the other hand, some people may develop symptoms of a mental health condition, and then begin using substances to self-medicate. Finally, it is also possible for brain changes from substance abuse to lead to the development of a mental health condition.
Co-occurring disorders are extremely common. According to NIDA, about half of people with mental health disorders will develop substance use disorders at some point during their lives, and vice versa.
Recent research has also revealed the following statistics:
When a person has co-occurring disorders, it is important that they receive treatment for both conditions. If the mental illness is treated but the substance use disorder is not, a person may continue to use drugs, causing a worsening of mental health symptoms. Similarly, if a person receives treatment for the addiction but not the mental health condition, they may return to using drugs to self-medicate the mental illness.
Mental health counseling can be utilized to treat co-occurring disorders. Several forms of therapy, including cognitive behavioral therapy and dialectical behavioral therapy, are effective for treating both mental illnesses and addictions. In counseling sessions, you can learn to uncover negative patterns of thinking that are contributing to both mental illness and addiction, and learn healthy coping skills.
In addition to mental health counseling, substance abuse treatment may involve taking medications, as needed, to help reduce cravings and withdrawal symptoms. Treatment for substance use may also include participation in support groups or group counseling sessions. The specific length of time spent in substance abuse treatment will vary for each person, but experts recommend that treatment last at least three months to ensure the best outcomes.
If you’re seeking dual diagnosis treatment in the Denver area, Denver Mental Health Counseling is here to help. In addition to offering individual therapy and group therapy, we provide both outpatient and intensive outpatient services as well as medication-assisted treatment (MAT) when appropriate. Contact us today to start your treatment.
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National Alliance on Mental Illness. “Warning Signs and Symptoms.” Accessed April 2, 2022.
National Institute on Drug Abuse. “The Science of Drug Use and Addiction: The Basics.” July 2, 2018. Accessed April 2, 2022.
National Alliance on Mental Illness. “Mental Health Conditions.” Accessed April 2, 2022.
Wimberley, Theresa, et al. “Genetic liability to ADHD and substance […]dividuals with ADHD.” Addiction, July 2020. Accessed April 2, 2022.
American Psychiatric Association. “What are Personality Disorders?” November 2018. Accessed April 2, 2022.
Khokhar, Jibran Y.; Dwiel, Lucas L.; Henricks, Angela M.; Doucette, W.T.; Green, Alan I. “The link between schizophrenia and subst[…]unifying hypothesis.” Schizophrenia Research, April 2018. Accessed April 2, 2022.
Indiana University Center for Health Policy. “Mental Health, Substance Misuse, and Sui[…]d Protective Factors.” June 2018. Accessed April 2, 2022.
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National Institute on Drug Abuse. “Common Comorbidities with Substance U[…]ders Research Report.” April 13, 2021. Accessed April 2, 2022.
Substance Abuse and Mental Health Services Administration. “Medication-Assisted Treatment (MAT).” January 10, 2022. Accessed April 2, 2022.
National Institute on Drug Abuse. “Principles of Drug Addiction Treatment: […] (Third Edition).” September 18, 2020. Accessed April 2, 2022.
Denver Mental Health Counseling by The Recovery Village aims to improve the quality of life for people struggling with substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare providers.
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