Serenity Blog Banner

Co-Occurring Disorders: Mental Health Disorders with Substance Use

If you have tried getting rid of your substance abuse but failed miserably, it may leave you with thoughts on why you failed and why is it impossible to make any progress. If this is something that resonates with you, you are probably suffering from a co-occurring disorder.

One of the most significant ways in which addiction treatment has improved came from the recognition that addiction rarely occurs in isolation. Rather, there is often one or more co-occurring disorder with addiction. This is a mental illness that may have caused the addiction or may have been caused by the addiction.

Lady Suffering from Co-Occurring Disorder

To be fair, most people suffering with a substance use disorder in the past could have told you this. They understood that their substance use did not come out of nowhere and that it wasn’t the only issue they had to solve. But for a long time, even the medical world did not take addiction seriously. They saw it as a lack of impulse control, rather than as a mental illness.

Nevertheless, the scenario has changed now; addiction is also taken very seriously by the medical world. With the appropriate treatment, diagnosing, treating, and recovering from addictions and mental illnesses have become easier. Let’s take a closer look at co-occurring disorders, their signs and symptoms, and the ways in which they impact our lives.

What are co-occurring disorders?

There are multiple definitions for the term, co-occurring disorders. For some, it means a person affected by 2 or more medical conditions. Others may define co-occurring disorders as the existence of 2 mental health disorders that are strongly correlated like anxiety and depression.

But here in this article, we will refer to the definition from the Substance Abuse and Mental Health Service Administration:

“the co-existence of a substance use disorder and a mental health disorder that cause functional impairment.”

A person suffering from a mental health disorder alongside a substance abuse addiction will find difficulting in coping with either until both receive adequate treatment.

How do co-occurring disorders work?

Substance abuse and a co-existing mental health disorder are both complex in their ways. But primarily, both of them are brain disorders that affect brain chemicals and how they impact each other. They affect mood, behavior and alter decision-making power.

The National Institute of Mental Health states that about half of the people suffering from substance addiction will also suffer from a mental health problem. Similarly, those suffering from a mental health disorder will also suffer from an addiction problem. They have a cyclical effect on each other.

It is alluring to know which one of the two co-occurring disorders occurs first and how to avoid it. However, there is rarely one that directly causes the other. Instead, a combination of genetic, environmental, psychological, and personal factors contribute to the development of both.

Symptoms of co-occurring disorders

A mental health professional will help you diagnose a mental health disorder or substance abuse disorder. Knowing the symptoms of co-occurring disorders will help you seek medical intervention early on. Here are some of the symptoms of co-occurring disorders:

  • Withdrawing from friends and family
  • Social withdrawal/ isolation
  • Abrupt changes in behavior
  • Unable to handle daily activities
  • Engaging in risky activities
  • Not paying attention to health and hygiene
  • Abusing substances while driving etc
  • Need substance to function properly
  • Painful withdrawal symptoms

Common types of co-occurring disorders

Generalized Anxiety Disorder:

Anyone who has struggled with anxiety will understand why it might lead to substance use. Anxiety makes it difficult to relax. Thoughts run through your head – and they are not pleasant thoughts. They tell you everything that could go wrong, along with the assertion that everything will go wrong. Many people with anxiety struggle to turn off or to sleep as well.

Substances provide a quick fix for the problem. Alcohol in particular is often used by people with generalized anxiety disorder to quiet their minds. The problem is that this solution quickly wears off, leading the person to use more and more of the substance. Eventually, they find themselves far more anxious than they were before, using the substance to try and get back to where they were.

Eating Disorders:

Eating disorders are often linked to addiction. Symptoms of eating disorders resemble symptoms of substance use disorders, including secrecy, warped perception, and bingeing. Many people battling eating disorders become addicted to diet pills and other substances that suppress their appetite. They may also use stimulants, whether to try to get the energy they are not getting from nutrition, to make them more active so as to lose weight, or to suppress their appetite.

Bipolar Disorder:

Bipolar disorder is linked to substance use due to symptoms of both mania and depression. When a person is depressed, they may turn to substances to try and feel better temporarily. Substances like alcohol ultimately lead to further depression, while stimulants have difficult comedowns.

When struggling with mania, they may use substances to try to calm themselves down. They may use alcohol or sleeping pills to get to sleep or just to relax. They may become dependent on substances to get through work or social situations.

Every good rehab will help identify and treat co-occurring disorders. Because addiction rarely occurs in isolation, you should avoid institutions that try to treat it on its own.

Attention Deficit Hyperactivity Disorder:

Attention Deficit Hyperactivity Disorder(ADHD) is often found in adolescents and young adults. The inability to focus, impulsiveness, and hyperactive behavior are all characteristics of this disorder. In most cases, people suffering from ADHD are prescribed medications including stimulants. Young adults will often begin abusing their prescriptions and also rely heavily on alcohol and other drugs to feel better.


Schizophrenia causes a person to experience hallucinations, psychosis, delusions, and disorganized thinking. This is a severe mental health condition where patients are unable to differentiate between reality and illusions. Commonly, these patients often turn to drugs and alcohol to cope with these experiences.

Clinical Depression:

The World Health Organization says that there are about 5% of people globally suffer from general depression also known as clinical depression.

Depression is anecdotally considered to coexist with Substance Use Disorders (SUD). However, there are no consistent patterns of comorbidity between depression and SUDs. It is simply an indication that depression is a highly complex disorder that can be caused by several reasons.

It is a widely known fact that drug and alcohol use is strongly correlated with intense feelings of depression. Studies suggest that alcohol use develops and worsens depression. Studies also examine the role of detox in reducing the severity of depression.

Post-Traumatic Stress Disorder:

Post-Traumatic Stress Disorder (PTSD) was once considered to be a disorder only experienced by army veterans who had been in combat and experienced traumatic deaths.

Our understanding of PTSD has grown significantly over the past few years and expanded our knowledge about it. It can happen to anyone who has experienced a highly traumatic event. The reasons can be varied but all of them can be linked back to a physical or mental trauma. This could be violence, physical, mental abuse, and sexual abuse can all lead to the development of PTSD.

PTSD causes the patient to have unwanted flashbacks and memories that make them relive the traumatic event. Patients often lean towards drugs and alcohol to stop these flashbacks.

How Co-Occurring Disorders Impact Addiction

The existence of two disorders at the same time can have a significant impact on addiction. These are:

More vulnerable to addiction:

People with existing mental health disorders are more vulnerable to developing some form of addiction. This will arise from the need to let go of their emotional baggage. They will use drugs and alcohol as a method of self-healing, curbing distress, and coping with emotions.

Diagnosis and treatment become difficult:

It becomes difficult to diagnose and treat a patient with co-occurring disorders since there are overlapping symptoms. A mental health disorder can mask the diagnosis of addiction and vice versa. This can result in wrong diagnosis or delayed treatment.

Increased risk of relapse:

Individuals with co-occurring disorders are at an increased risk of relapse even after complete treatment. The interplay between mental health disorders and substance abuse disorders will result in an endless cycle of self-destructive behaviors resulting in maintaining sobriety.

Self-treatment behavior:

Patients with co-occurring disorders may begin using medication or drugs as a means of self-treatment to alleviate emotional pain. This often creates another addiction cycle that is difficult to break free from.

Impaired decision making:

Co-occurring disorders will lead to impaired judgment and decision-making. This will cause poor decision-making in cases related to substance use.

Difficulties in recovery:

A comprehensive and integrated treatment approach is required for the treatment of co-occurring disorders. Any lapse will cause the underlying mental health disorder to act as a trigger for relapse.


It is vital to understand the complexities associated with co-occurring disorders. Healthcare providers conduct thorough assessments and make customized plans that target both, mental health disorders and substance use disorders. Behavioral therapies, counseling, medication, support groups, etc. are key components in a co-occurring disorder treatment. Today, any rehab that does not take a co-occurring or dual diagnosis approach should be avoided.

The aim is to understand the complexity and address all aspects of the person’s well-being. Serenity Malibu’s health experts are experienced in treating co-occurring disorders. Since this disorder affects people differently, the treatment must also be individualized. Our customized treatment program gives our patients long-term recovery and effective results.

Are you or anyone in your circle in need of treatment for co-occurring disorders? Don’t hesitate, contact Serenity Malibu right away! Your long-term recovery will be guided by our expert staff.

Licensed by the State Department of Health Care Services | Program ID Number: 190655AP | Program Expiration Date : 4/30/2025
Copyright © 2022 Serenity Malibu, All rights reserved. | Privacy Policy | Accessibility Statement