Addiction Treatment
Addiction Treatment

Treatment for Co-Occurring Disorders

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Medically reviewed: 06/04/2018
Last updated: 07/12/2019
Author: Addictions.com Medical Review

Reading Time: 4 minutes

It’s estimated that 7.9 million Americans with substance abuse disorders also face co-occurring mental health disorders that have just as much a need for specialized treatment as their addictions.

Individuals with mental health disorders are more at risk for developing addictions than the general population. Anyone diagnosed with a co-occurring disorder needs to receive targeted treatment for their specific and unique needs in both addiction and mental health to ensure a successful recovery.

Types of Co-Occurring Disorders

Below is an overview of the most common types of co-occurring disorders:

  • ADHD: A pattern of attention irregularities or hyperactivity-impulsivity that interferes with development or functioning and is not caused by another mood disorder.
  • Anxiety: Consistently experiencing intense and excessive worry, apprehension, nervousness, and fear. This can be aimed at specific things, such as social situations, or be a generalized feeling of dread that is not related to anything specific. Some individuals with anxiety experience panic attacks.
  • Borderline Personality Disorder: A mental disorder characterized by a pattern of problematic and changing behavior, moods, and self-perception that leads to frequent impulsive actions and relationship conflicts. These individuals can suffer intense bouts of anxiety, depression, and anger that can be brief or last for days.
  • Bipolar Disorder: Once known as manic-depression, this brain disorder leads to unpredictable shifts in energy, mood, and levels of activity and functioning that range from very energized manic episodes to very low depressive episodes.
  • Behavioral Addictions: Some people with substance use disorders also suffer from addictions to behaviors like gamblinggamingsexcomputersshopping, or smartphones. These addictions can cause many of the same kinds of intense cravings, personality changes, and negative consequences as chemical addictions.
  • Depression: A persistent low or negative mood that interferes with how a person thinks, acts, and functions in the activities of daily living Individuals with severe depression may have difficulty finding the energy and motivation to complete simple tasks such as showering or dressing to leave the house.
  • Eating Disorders: An unhealthy pattern of disordered eating habits and perceptions. Individuals often have distorted body images and may binge and purge, or starve themselves. Alternatively, they may have an eating disorder that substitutes for a need they cannot otherwise address, such as depression, loneliness, anger, etc.
  • OCD: Obsessive-Compulsive Disorder causes reoccurring, uncontrollable obsessions, intrusive thoughts, and behaviors that an individual is compelled to repeat over and over.
  • PTSD: A state of heightened reactivity after a shocking, threatening, or frightening event (experienced directly or indirectly) that results in feelings of fear, stress, panic, and even a realistic mental recreation of the actual event when the individual is not endangered.
  • Schizophrenia: A disabling, severe, chronic mental disorder in which individuals detach from reality, and which can be very disabling.
  • Sleep Disorders: Problems that interfere with getting sufficient or good quality sleep, such as insomnia, night terrors, sleep apnea and other sleep/wake disruptions, REM and non-REM disorders, narcolepsy, hypoventilation, circadian disorders, sleep-walking, and other parasomnias.

Self-Medicating For Co-Occurring Disorders

The range of disruptive and painful symptoms that are caused by mental health disorders are difficult to bear, and many individuals are intensely relieved when they discover that using drugs or drinking can make them feel “normal,” so that it is easier to function in ways they found challenging before. They may then slip into a pattern of self-medicating that not only puts them in danger of addiction but also makes it difficult for them to be correctly diagnosed and treated for their mental health problems.

As the individual develops a tolerance and needs increasing amounts of drugs or alcohol to control symptoms, they get caught in a downward spiral where substance use exacerbates the mental health issues and vice versa. Ultimately, this leads to a situation far worse than the original issue, as the individual now faces a potentiated dual diagnosis—that is, their original problem and the co-occurring substance use disorder have become more than the mere addition of the parts.

How to Treat Co-Occurring Disorders

Some people with co-occurring disorders (also known as dual diagnosis) only develop a mental health issue after they become addicted to a substance. Chronic substance use alters brain chemistry in ways that can easily create a new psychological problem or trigger one that has not yet developed, such as the association between adolescent cannabis use and schizophrenia. In these cases, people will sometimes assume that they only need treatment for their substance use disorder because they believe that their depression, panic attacks, or other new mental health issues will disappear after detox. While this can happen, more likely it will not.

Individuals with co-occurring substance use and mental health disorders need specialized treatment—not just for their addiction, but for their mental health issues, as well as the interplay between the two. Just as substance use disorders may require different treatment approaches depending on the individual’s history and the specific substance/s used, different mental health disorders require targeted, individualized forms of treatment.

To accurately diagnose and treat co-occurring disorders, an individual must first fully detox from substance use. As detoxing can often lead to an initial worsening of mental health symptoms due to the inevitable challenges of trying to cope with the stress of withdrawal, or may even lead to the development of new symptoms, inpatient rehab programs are the usually best option for dual diagnosis treatment.

Dual Treatment for Better Outcomes

Addiction and mental health are intimately connected, with one potentiating the other. It’s estimated that as many as six out of 10 people who are suffering from addiction also have a mental health disorder, yet most are not receiving treatment for either problem.

To get the best treatment possible for co-occurring disorders, individuals in recovery need to receive therapies for both the addiction and mental health disorders at the same time. An integrated treatment approach allows both problems to be stabilized simultaneously, allowing for a more thorough recovery with a much lower risk of relapse and a much brighter future.