If you happen to struggle with both a substance use disorder (SUD) and a co-occurring mental health condition, you are not alone. According to the National Alliance on Mental Illness, about 9.5 million Americans were affected by co-occurring disorders in 2019.
Co-occurring disorders come in a multitude of combinations, like alcohol use disorder coexisting with depression, as an example. Regardless of the specific coupling of disorders, the treatment protocol requires that both co-occurring disorders be treated simultaneously for the best recovery outcome.
Once in recovery, the focus shifts toward maintaining sobriety in the presence of a coexisting mental health challenge. Fortunately, there are outpatient mental health services, including psychotherapy and support groups, to assist your recovery efforts following treatment.
What are Co-Occurring Disorders?
The term “co-occurring disorders” refers to when an individual presents both a substance use disorder and a mental health disorder simultaneously. The condition is referred to as a dual diagnosis. There are two scenarios in which a dual diagnosis can develop:
- The mental health disorder emerges first. When someone struggles with a mental health disorder, such as depression, anxiety disorder, or bipolar disorder, they may use a substance to self-medicate the unpleasant emotional state they are experiencing. Over time, tolerance to the substance increases and then consumption increases, which then evolves into a secondary SUD.
- The SUD emerges first. Someone who becomes dependent on a substance may eventually experience any number of negative consequences directly related to the SUD. As these consequences take their toll, the individual may begin to develop symptoms of depression or anxiety in response to the added stress and damage the SUD has caused.
Regardless of the order that the two disorders occurred, the outcome is the same: untreated substance use will worsen the symptoms of the mental health disorder, and untreated mental health disorders worsen the SUD. The disorders basically stoke the adverse effects of the other.
Signs of Co-Occurring Disorders
The symptoms of a dual diagnosis will vary according to the specific combination of disorders involved. This means that the symptoms of alcohol use disorder and a co-occurring anxiety disorder will look different from cocaine addiction and co-occurring depression.
There are, however, some general signs that a co-occurring disorder may be present. These include symptoms of both substance use and mental health disturbance:
Signs of substance use:
- Unable to limit use of the substance or to stop using the substance
- Obsessing about acquiring and using the substance
- Increased substance consumption due to increasing tolerance
- Lying about substance use, hide the substance, steal money for the substance
- Obtaining the substance illicitly through doctor shopping, stealing, or on the street
- Experiencing withdrawal symptoms when substance not available
- Neglecting responsibilities or obligations
- Suffering work or academic performance
- Experiencing erratic mood swings
Signs of mental health disorder:
- Experiencing changes in eating habits
- Experiencing changes in sleep habits
- Suffering from sleep disturbances and/or nightmares
- Experiencing sexual dysfunction
- Displaying excessive or irrational worries or fears
- A lowered mood, persistent sadness, feelings of hopelessness
- Exhibiting angry outbursts, irritability, agitation
- Loss of interest in usual activities
- Disregarding personal hygiene
- Isolation from friends and family, or avoiding social events
A cluster of symptoms from both categories would indicate a dual diagnosis is present.
Managing a Co-Occurring Mental Health Issue in Recovery
While a dual diagnosis involves unique challenges that affect treatment and recovery, the co-occurring disorders can be managed. Initially, while in treatment, the focus will be to stabilize the symptoms related to the mental health issue. Treatment will include psychotherapy that addresses both of the disorders, and will teach coping skills for managing stress better.
In recovery, managing the co-occurring disorder will involve regular therapy sessions, support groups, holistic activities, and possibly medication for controlling the symptoms. When combining these actions with other continuing care efforts that support recovery, you should be able to enjoy a productive and fulfilling life.
Ashley Addiction Treatment, formerly Father Martin’s Ashley, is a nationally recognized nonprofit leader in integrated, evidence-based treatment for substance use disorders and is accredited by The Joint Commission. We offer both inpatient and outpatient programs, holistic addiction treatment, drug detox, relapse prevention plans, family wellness programs and a variety of other services tailored to each patient’s needs. Our driving principle — “everything for recovery” — reinforces our mission to heal each individual with respect and dignity, and reflects on our ongoing commitment to meet new challenges. For information about our comprehensive programs, please call (866) 313-6307.