Co-Occurring Disorders With Substance Abuse

While every mental illness can present a threat during addiction, there are top co-occurring disorders with substance abuse. About 5.6 million people in the United States have co-occurring disorders according to a survey carried out in 2006.

 Another study in the ’90s showed that about 56 percent of people had a co-occurring disorder. SAMHSA predicts that things are even more serious now with a rise in mental health conditions.

While there is a chance for addiction to co-occur with substance, there are top co-occurring disorders with substance abuse. We shall explore them in this blog and perhaps understand why their dominance.

Table of Contents

What is a Co-occurring Disorder?

People with substance use disorders and mental health disorders are diagnosed as exhibiting co-occurring disorders. This condition is often known as dual diagnosis. The term –dual diagnosis is also used to describe the process of diagnosing and treating co-occurring disorders or dual disorders.

Simply put a co-occurring disorder is when someone that has a substance use disorder such as alcohol addiction is also diagnosed with a mental health disorder such as anxiety or depression. SAMHSA recommends that treatment addiction centers carry out a dual diagnosis to establish whether the patient has co-occurring disorders.

To get a better understanding, we can split co-occurring disorders into two components: a substance disorder and mental health disorder. Substance abuse is when substance use interferes with functioning at work, school, or in relationships. It is diagnosed when it causes a dangerous situation or worsens a medical condition.

· Substance use disorder

Substance dependence is more severe than substance abuse. In addition to the negative consequences, the person is not able to abstain from its use or control its use. 

In severe cases, it becomes physiological dependence so you need more of the substance to get the same effect (heightened tolerance) and you experience symptoms such as tremors and nausea when you discontinue its use (withdrawal effect).

· Mental health disorder

Mental health disorders, on the other hand, include mood disorders and anxiety and are caused by various issues such as age, trauma, substance use, or other chemical imbalances in the brain system.

 A high percentage of people with severe mental illness have a co-occurring substance use disorder according to the National Institute of Mental health.

Severe mental health disorders are defined by the length of episodes of illness. They include schizophrenia and schizoaffective disorder and come with symptoms such as hallucinations or delusions commonly called thought disorders.

Co-occurring diseases require special treatment for both mental or substance use disorders because ideally, it should combine both. However, with a successful dual diagnosis, it is still possible to help a patient through dual recovery with 100 percent success.

While any mental illness and substance use disorder can co-occur, some disorders are more likely to be diagnosed with substance use. We will look at the top co-occurring disorder with substance abuse.

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Mental health disorders co-occurring with substance abuse

1. Depression

Depression is a mood-related disorder just like dysthymia and bipolar disorder. It exhibits itself in ways such as weight loss or gain, low-self-esteem, blunted emotions, excessive sleeping, social withdrawal, agitation, poor grooming, slowed thought process and early morning awakenings.

There are various degrees of depression with dysthymia being the mildest. Major depression involves feeling sad, worthless, hopeless and helpless for a prolonged period of time. 

And no, it is not a bad day or a blue day. These feelings will be accompanied by persistent physical symptoms that rarely respond to treatment such as chronic pain, headaches, and digestive disorders.

2. Bipolar disorder

Bipolar disorder has been known to co-occur with substance use disorders. It causes extreme mood swings that could switch up from mania or extreme happiness, grandiosity, ecstasy or irritability or lessened need for sleep. Usually, the person sequences from one extreme state to another while going through few or no symptoms in between.

But bipolar is not just mood swings. It is the dramatic change in overall appearance, behavior, and levels of energy alongside the mood swings. These bipolar cycles come in the form of depression, mania, and a “mixed state.”

Other symptoms include an increase in goal-oriented activities, inflated self-esteem, more talkative and extreme involvement in pleasurable activities. Most people fall victim to substance use to help sustain these manic symptoms of bipolar disorder. This is why it is one of the most common co-occurring disorders.

3. Anxiety disorders

Anxiety is the flight or fight response to danger. It helps us respond to a perceived threat. We need it for survival. But when it is triggered unnecessarily, persists even after a threat is long gone, or causes you to restrict your life, it then becomes a disorder.

Anxiety disorders take many forms; post-traumatic stress disorder (PTSD), social anxiety, generalized anxiety disorder, panic disorder and obsessive-compulsive disorder (OCD).

When you examine the symptoms of all the categories of anxiety disorders, you realize that people are like to indulge in substance use to overcome them. Perhaps explaining why it is a top co-occurring disorder. Symptoms like confusion, muscle tension, excessive fear, avoiding people, impulses, recurring thoughts and restlessness.

4. Severe mental illness and co-occurring disorder

A severe mental illness is defined by the length of attack and the nature of the disability it causes. They produce psychotic symptoms such as schizoaffective disorder and schizophrenia. In severe forms, they will produce bipolar disorder and depression.

  • Schizophrenia is a thought disorder. It manifests in different psychotic, negative, cognitive and mood symptoms such as hallucinations, apathy, loss of interest or pleasure, delusions, false perceptions, mood shifts, anger, anxiety, and problems with attention and psychomotor speed.
  • Schizoaffective disorder is similar to schizophrenia, but it is usually long-term and with more severe symptoms. The victims will have severe depressive or manic symptoms. So the symptoms are more frequent and manifest for longer periods.

Severe mental illnesses also manifest in the form of thought disorders. These are disorders that affect perceptions and manifest in the form of delusions, hallucinations and abnormal behavior. The victims tend to manifest loss of contact with reality, and so they are sometimes known as psychotic disorders.

Dual Diagnosis Treatment

The best shot for co-occurring disorders is dual-diagnosis that is followed up with dual-treatment. It is always advisable to seek treatment from a facility that emphasizes on dual-diagnosis. It is effective and offers hope for a full recovery.




Our writers are experienced in everything related to addiction, mental health, rehab and recovery.

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