Co-Occurring Disorders and Substance Abuse
[vc_row][vc_column][vc_column_text]Living with a mental health condition can put individuals at a higher risk of developing a drug and alcohol addiction.

Often, individuals who need drug and alcohol addiction treatment are diagnosed with common co-occurring disorders. According to the Substance Abuse and Mental Health Services Administration (SAMHSA) 2019 National Survey on Drug Use and Health, nearly 50% of individuals with a severe mental illness reported engaging in drug or alcohol abuse.

Furthermore, the National Institute on Drug Abuse (NIDA) reported that individuals diagnosed with substance use disorders (SUD) are twice as likely to suffer from a mental health disorder than those who do not have SUD. Similarly, individuals diagnosed with an antisocial condition, such as antisocial personality or conduct disorder, are twice as likely to become addicted to drugs.

Common Co-Occurring Disorders

Co-occurring disorders vary depending on the person. While many emotional issues can substantially impact a person’s addiction problems, including anger issues, low self-esteem, guilt, and grief, these issues are generally considered symptoms instead of disorders. Below are some of the most common mental health disorders associated with SUD.

Generalized Anxiety Disorder

Generalized anxiety disorder (GAD) is perhaps the most common mental health disorder to occur alongside substance abuse. According to recent research, adults with GAD are incredibly likely to self-medicate their anxiety symptoms with drugs and alcohol.

GAD is diagnosed in individuals who experience recurring, frequent anxiety and symptoms such as sleep disturbances, restlessness, headaches, nausea, and functional impairment.

GAD is characterized by persistent and disproportionate worry or concern. These concerns could be about health, money, work, and relationships. Symptoms of GAD can vary depending on the individual and their triggers.


Depression is three times more likely to develop in people with substance dependence than in general.

Individuals struggling with depression often develop SUD as they try and cope with the symptoms of sadness, hopelessness, melancholy, and isolation. They may try to “drown their sorrows” with alcohol or get high to avoid their negative thoughts and pain. Ironically, this self-medication is what contributes to the cycle of co-occurring disorders.

The substance becomes a coping mechanism to feel better temporarily, but in reality, the drugs and alcohol exacerbate depressive symptoms.

Post-Traumatic Stress Disorder

Post-traumatic stress disorder (PTSD) develops after a person experiences events that cause intense stress and, in some cases, are life-threatening. Usually, individuals with PTSD experience flashbacks, night terrors, sleep disturbance, difficulty concentrating, feelings of detachment, and irritability.

Nearly half of individuals who battle post-traumatic stress disorder also struggle with alcohol or drug addiction. According to the Journal of Clinical Psychology, individuals with PTSD are two to four times more likely to develop a substance use disorder.

People living with PTSD carrying the burden of trauma sometimes do not know how to cope or have little to no support system. They turn to drugs or alcohol for temporary relief from daily struggles and difficult memories.

Bipolar Disorder

Bipolar disorder is a chronic mood disorder where an individual experiences unusual mood instability and irregular episodes of depression and mania. People with bipolar disorder also may experience sudden changes in energy and activity levels.

Individuals with bipolar disorder are susceptible to drug and alcohol addiction. Research has shown that SUDs are particularly common in bipolar disorders. The lifetime occurrence of SUDs is at least 40% in bipolar I clients, more than likely due to an increased probability to self-medicate with alcohol or drugs.


Schizophrenia is a severe mental health condition that impacts how people think, feel, and behave. It is characterized by long-term hallucinations, delusional thinking, and disorganized thinking.

Many individuals become unable to distinguish between reality and fantasy, and it’s not unusual for those living with this disorder to turn to drugs or alcohol to cope with these experiences. Research has shown clients with schizophrenia are vulnerable to SUD, where one study revealed that 47% of clients with schizophrenia suffered from alcohol or drug abuse.

Personality Disorders

Personality disorders such as obsessive-compulsive disorder and borderline personality disorder can affect how individuals interact with others.

Personality disorders are associated with compulsive behaviors. Similarly, SUDs are also characterized by an obsessive need to use drugs or drink alcohol, despite the consequences.

Research has revealed an overall prevalence of personality disorders to range from 10% to 14.8% in general populations, compared to 34.8% to 73% in clients treated for SUD.

Eating Disorders

Eating disorders (ED) occur often in SUD clients, with the highest reported rates of co-occurrence in individuals with bulimia nervosa and alcohol use disorders.

The National Center on Addiction and Substance Abuse projected that 50% of women with ED abuse substances. Binge eating has also been more likely to occur in people with SUD than those without SUD.

Treatment for Co-Occurring Disorders

There are many different treatment methods when treating co-occurring disorders and SUD. Behavioral therapies, such as motivational enhancement therapy, cognitive behavioral therapy, contingency management, and 12-Step facilitation, are customary of care for individuals with co-occurring disorders and SUD.

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