While mental health awareness has never been higher, there is still ground to cover, especially when you live with a substance use disorder and a mental health disorder(s). This combination is called a co-occurring disorder, and while it may seem intimidating at first, understanding and treating it is easier than it may first appear.
What Is A Co-Occurring Disorder?
The definition of a co-occurring disorder, according to the National Alliance on Mental Health (NAMI), is when someone is diagnosed with both a mental illness and a substance use disorder.
While the qualifications for diagnosing a mental illness vary, substance use disorders involve:
- Lack of / decreased self-control
- Behaving or performing worse around others
- Using substances like alcohol, tobacco, marijuana, stimulants, or opioids in a way that worsens overall health
- Levels of tolerance
- Severity of withdrawal
A substance use disorder can vary between abuse and dependence.
The Difference Between The Two
Abuse affects your ability to work, go to school, and have normal relationships with others. It can also create a medical condition or make one worse.
Dependence is more severe. It includes all the symptoms of abuse, but also results in an inability to control substance use.
Regardless of the severity, a substance use disorder plus a mental illness equals a co-occurring disorder.
How Many People Are Diagnosed With A Co-Occurring Disorder?
As of 2014, an estimated 7.9 million people were diagnosed with a co-occurring disorder. That’s 18% of the total number of adults diagnosed with a mental illness in America, or 3% of all Americans.
The demographics of who makes up that 3% varies based on the severity of the mental illness involved, but those between the ages of 26 and 49 are most at risk. Other at-risk groups include males, those of low socioeconomic status, veterans, and those with other medical problems.
Which Mental Illnesses And Disorders Are Most Common In Co-Occurring Disorders?
Some diagnoses are more common than others when it comes to co-occurring disorders.
The most common mental illnesses include:
- Bipolar disorder
- Obsessive-compulsive disorder (OCD)
- Panic disorder
- Generalized anxiety disorder (GAD)
- Post-traumatic stress disorder (PTSD) and complex post-traumatic stress disorder (C-PTSD)
- Eating disorders
- Attention deficit disorder (ADD)
- Conduct disorders
The most common substance use disorders focus on:
- Heroin / other opiates
- Methamphetamine / amphetamines
- Various prescription drugs
Common combinations include:
- Alcohol and bipolar disorder or schizophrenia
- Marijuana and schizophrenia
- Opioids and PTSD/C-PTSD
- Heroin and depression
It is also suggested that a substance use disorder involving cocaine can lead to anxiety disorders, even after use is discontinued.
How Are Co-Occurring Disorders Treated?
No matter what mental illness you might have, detoxification will be a part of integrated treatment. This is often the most difficult part of treatment, but during this time, inpatient rehabilitation is recommended. It provides you with constant care during withdrawal, potentially including medications to provide symptom relief.
After inpatient rehabilitation, transitioning to a group home or sober house can provide the same 24/7 support and care with greater freedom.
To treat the mental illness(es) involved, medications and therapy are recommended. Medications can combat the symptoms, allowing you to feel more like your “usual self,” while therapy provides a supportive environment to express your feelings, educate yourself about your illness, and learn new coping skills.
Support groups, both online and in person, can provide you with a sense of community that is often needed during recovery. Anyone involved in your treatment can help you find one that works for you.
What Are The Dangers Of Not Seeking Treatment?
Treatment for co-occurring disorders is not an easy undertaking, but going without is far worse. Choosing to ignore your diagnoses can result in a greater risk of:
- Arrest and incarceration.
- Symptoms getting worse over time.
- Loss of work and meaningful relationships.
- Severe medical conditions related to substance use.
- Hospitalization / ER visits.
- HIV / hepatitis / STDs.
- Suicide / death.
If you or a loved one is experiencing suicidal thoughts or tendencies, call the National Suicide Prevention Hotline at 1-800-273-8255.
There Is Hope
While a co-occurring disorder can seem challenging to face and treat, there are some things to remember:
- You are not alone in your diagnosis.
- There is a way to treat your illnesses.
- It can only get worse if you don’t seek help.
Recovery is possible and a new life is waiting for you. So what are you waiting for?
“Co-occurring Disorders.” Substance Abuse and Mental Health Services Administration. Published 8 March 2016. Accessed 27 June 2016. <http://www.samhsa.gov/disorders/co-occurring>.
“Dual Diagnosis.” NAMI.org. Accessed 27 June 2016. <https://www.nami.org/Learn-More/Mental-Health-Conditions/Related-Conditions/Dual-Diagnosis>.
“Mental and Substance Abuse Disorders.” Substance Abuse and Mental Health Services Administration. Published 8 March 2016. Accessed 27 June 2016. <http://www.samhsa.gov/disorders>.
“Substance Use Disorders.” Substance Abuse and Mental Health Services Administration. Published 27 October 2015. Accessed 27 June 2016. <http://www.samhsa.gov/disorders/substance-use>.