Co-Occurring Disorders

Co-occurring disorders exist in persons who have substance use disorder and mental illness disorder. The severity of each may vary but having these two disorders co-occurring presents challenges in the medical aspect of it may need more extended treatment periods.




The symptoms of co-occurring disorders include the individual signs for each condition plus another high potential for other problems like symptomatic relapses, hospital confinement, financial issues, social isolation, family conflicts, homelessness, physical and sexual victimization, and serious medical illnesses.


What are examples of co-occurring disorders?


According to the study by the National Institute of Mental Health, co-occurring disorders include mental health conditions like anxiety disorders, depressive disorders, ADHD, bipolar disorder, schizophrenia, and personality disorders.


What are the symptoms of substance use disorder?


Based on DSM-5, addiction will be the outcome of drug usage, mainly when used with alcohol, caffeine, cannabis, hallucinogens, inhalants, opioids, sedatives, stimulants, and tobacco. The addiction includes obsessive and excessive cravings, tolerance, and withdrawal symptoms.

For instance, alcohol use disorder is related to bipolar disorder, antisocial personality disorder, schizophrenia, and even anxiety and depression.


Other substance use disorders can co-occur with some psychiatric conditions. Preexisting disorders may also worsen with opium use disorder and depressive disorders.


What could be the causes?


The causes of mental health and substance use disorder can be genetic and environmental.


How common are co-occurring disorders?


National Institute on Drug Abuse imparted that people with mental health disorders are more prone to substance use disorder. Some individuals will have either a mental illness disorder or substance use disorder.


Which develops first: addiction or mental illness?


It can be both. People with pre-existing mental illness who resort to substances like alcohol or drugs to self-medicate their anxiety symptoms and depression or even PTSD may result in addiction. Others resort to the substances first, then the effects would lead to anxiety, depression, and other symptoms that may indicate mental illness. Both disorders can exist independently or co-occur due to either genetic or environmental reasons.


How do we treat them?


It is highly recommended by the Substance Abuse and Mental Health Services Administration (SAMHSA) to utilize the integrated treatment approach instead of treating the disorders separately. Integrated treatment is done by coordinating substance abuse and mental health interventions.


Integrated treatment programs include various forms of behavioral treatment, such as cognitive-behavioral or dialectical behavior therapy. These treatment aims to improve coping skills and reduce maladaptive ways of behaving. While the patient undergoes such therapies, they may be asked to take some medication. Clinicians and organizations may also collaborate to include sessions on handling issues like housing, health, and work.


Other programs can be given are psychoeducational classes to increase awareness of the symptoms and other facts about the disorders. While relapse-prevention education provides lessons on cues that lead to substance abuse to help the patients develop different alternative responses instead of resorting to substance use.


Dual-recovery groups found in treatment sites or offsite benefit patients on their recovery journey. Supportive forums allow them to join discussions to learn and share about their journey through psychiatric symptoms, medication, substance-related impulses, and coping strategies.

Integrated treatment can address co-occurring disorders, which can be more efficient as patients transition to detox and stabilization. Addiction specialists become trained in screening, spotting, and treating mental health conditions. Mental health specialists likewise become attuned to include points on substance use in their sessions with the patient.


Why is integrated treatment necessary?


Integrated treatment is seen to be more effective and practical. It can readily provide support for those who are recovering from addiction would experience relapses. While on the road to recovery, the patient is readily treated for mental health conditions that may occur in the process. This is crucial in attaining long-term success.

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