What are Co-occurring Disorders?
Some people suffer from a psychiatric or mental health disorder along with substance use of alcohol or other drugs. Or, a person may have had a substance use disorder at one time in his or her life (for example, alcohol use in college), but may currently suffer from only one disorder (such as major depression).
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More than ten million people in the United States suffer from a substance use disorder along with one or more mental health disorders.
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This combination of health disorders is often referred to as a dual diagnosis, dual disorders, or co-occurring disorders. Co-occurring disorders are common in the general population and are even more prevalent among persons seeking treatment in the medical, mental health, or addiction treatment settings.
More than ten million people in the United States suffer from a substance use disorder along with one or more mental health disorders. Of the people with a substance use disorder, about 60 percent to 70 percent have or had a mental health disorder. Of the people with a mental health disorder, 25 percent to 50 percent have or had a substance use disorder.
So, co-occurring disorders are common, but not everyone with a substance use or mental health disorder has one. People with substance use disorders may have emotional problems such as depression, anxiety, or post-traumatic stress symptoms, but their emotions are normal responses to life events. Some people with mental health disorders may drink alcohol or use drugs. But if their use is not problematic, they do not have co-occurring disorders.
Common problems
Co-occurring disorders can cause a wide variety of problems, depending on the specific substance use and mental health disorders people have.
Common problems relating to co-occurring disorders include
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use of alcohol or other drugs to reduce the difficulty or pain associated with mental health problems, which may work in the short term but usually backfires in the long run
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a mental health disorder that is worsening because of alcohol or drug use
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a substance use disorder that is worsening because of mental health problems
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difficulty getting treatment for both disorders, or difficulty benefiting from treatment
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difficulty finding supportive people who understand both disorders
Causes of co-occurring disorders
There appear to be common genetic risk factors for substance use and certain mental health disorders, but genes alone cannot explain all cases of co-occurring disorders. Other factors include:
In fact, stressful experiences may trigger genetic factors that contribute to co-occurring disorders.
It is not known why people become addicted to a certain substance and not another. Some research indicates that access and exposure to substances may be the most important reason. That is, the substances people have access to determine the type of substance use disorder they are likely to develop.
People with a mental health disorder may be more biologically sensitive to the effects of substances. They may also use substances to cope with symptoms or facilitate social connections. In general, people who have a mental health disorder are at much greater risk of also having a substance use disorder. People who have a substance use disorder are also at much greater risk of developing a mental health disorder.
| Common mental illnesses in those with co-occurring disorders
Some of the most common mental health disorders found in chemically dependent people are:
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Mood disorders
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Major depression
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Dysthymia
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Bipolar disorder
Thought disorders (also considered to be severe mental illness)
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Schizophrenia
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Schizoaffective disorder
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Anxiety disorders
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Post-traumatic stress disorder
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Panic disorder
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Social anxiety
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Generalized anxiety disorder
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Obsessive-compulsive disorder
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The symptoms of co-occurring disorders vary somewhat, but some typical symptoms do exist. Some symptoms of substance use are similar to the symptoms of mental health disorders, which makes diagnosing co-occurring disorders more challenging. Substance use can both mimic (look like) and mask (cover up) a mental health disorder.
Effective treatment
Effective treatment for co-occurring disorders has been developed only recently. In the past, treatment professionals failed to understand that treating one disorder would not cause the other disorder to automatically improve. Both disorders need to be treated at the same time, which is called integrated treatment.
Integrated treatment can stabilize the symptoms of co-occurring disorders and provide the foundation for lasting recovery from substance use and psychiatric disorders.
A variety of options are available for treating co-occurring disorders. These include finding support, engaging in therapy, and taking appropriate prescription medication.
