What Are Co-Occurring Disorders?

It’s not uncommon for people to experience a mental health disorder along with substance abuse; psychologists call this a “co-occurring disorder.” Typically, the mental health disorder triggers substance abuse, especially if the first condition is undiagnosed and untreated. However, substance abuse can also cause mental health disorders.

For many people, only one disorder or the other is treated. Treating both disorders simultaneously is crucial for healing. To live a more healthy life, it’s essential to get a proper diagnosis so each condition can be appropriately treated.

What Are the Symptoms of Co-Occurring Disorders?

Symptoms of a mental health disorder tend to overlap with symptoms of substance abuse. In both cases, these symptoms can include:

  • Social isolation
  • Difficulty concentrating at work or school
  • Strained relationships
  • Agitation or prolonged sadness
  • Anxiety

Left untreated, the most severe signs of co-occurring disorders could include hospitalization, financial strain, homelessness, and other serious medical conditions.

What Are the Causes of Co-Occurring Disorders?

There is no official consensus among psychologists on what causes mental health disorders, but multiple factors can contribute to their development. Some people may have a higher risk due to their genetics or environment. The distressing symptoms of mental health disorders can cause an individual to self-medicate with drugs or alcohol, ultimately leading to addiction. However, it is also possible to develop mental health disorders due to prolonged abuse of substances.

How Common Are Co-Occurring Disorders?

People with mental health disorders are more likely to experience addiction than those with no diagnosis. According to the Substance Abuse and Mental Health Services Administration’s (SAMHSA) 2018 National Survey on Drug Use and Health, approximately 9.2 million adults in the United States have a co-occurring disorder.

Common Signs of Co-Occurring Disorders

There are many combinations of co-occurring disorders, meaning each person will exhibit different signs when they are struggling. However, common signs of co-occurring disorders include:

  • Sudden changes in behavior
  • Social isolation
  • Loss of control over how much substances are used
  • Risky behavior (driving under the influence, unprotected sex, etc.)
  • Problems with concentration
  • Suicidal ideation

The Most Common Co-Occurring Disorders

Substance abuse can occur with several different mental health disorders. The following disorders are the most commonly associated with drug or alcohol abuse.


People with depression may find it difficult to experience joy or pleasure, even during activities they normally enjoy. Alcohol or drugs can help recreate those feelings, albeit temporarily. However, once the elation wears off, the person with depression may feel the need to use again – perhaps at a higher dose to make the good feelings stronger, resulting in a worsened crash later. This can lead to a vicious cycle of dependence.


Substance abuse can offer temporary relief to the stress and burdens associated with prolonged anxious thoughts or feelings. For example, someone suffering from an anxiety disorder may feel compelled to drink in social situations to function as their “best self.” In reality, the anxiety relief from alcohol is temporary and can worsen anxiety symptoms when it wears off. Anxiety will worsen over time as the dependence on alcohol increases, making one vulnerable to developing an addiction.

Bipolar Disorder

The imbalance of chemicals in the brain caused by bipolar disorder can cause extreme feelings of sadness or anger, otherwise known as “mania” or “hypomania.” Substance abuse can temporarily relieve these symptoms at the expense of making brain activity more irregular. According to DualDiagnosis’ article “Co-Occurring Disorders: The Most Popular,” bipolar disorder is associated with substance abuse more often than other mental health disorders.

Post-Traumatic Stress Disorder

Post-traumatic stress disorder (PTSD) isn’t just a diagnosis for war veterans; anyone who has experienced something traumatic can develop this mental health disorder. This may include survivors of severe storms or accidents, sexual assault, domestic violence, or other forms of abuse. It’s not uncommon for people living with PTSD to turn to drugs or alcohol as a means of escaping memories or flashbacks of the traumatic event.

Borderline Personality Disorder

Borderline personality disorder (BPD) is characterized by extreme restlessness and mood swings, along with unpredictable behaviors and difficulties forming relationships or connecting to the surrounding environment. People with BPD (roughly 1.6% of Americans) may use drugs or alcohol to help them adapt to their surroundings. Because the relief is short, the substance abuse likely aggravates the already existing symptoms of BPD.

How Are Co-Occurring Disorders Treated?

Co-occurring disorders are best treated by a team of professionals who understand both mental health disorders and substance abuse. This may involve an integrated approach with more than one treatment option so that both conditions can be treated together. Integrated treatment may involve cognitive-behavioral therapy (CBT) that helps patients develop healthier thought patterns and coping mechanisms for their mental health struggles. Many therapies can also be used alongside medication for the best treatment outcomes. Depending on the severity of the substance abuse, treatment at an overnight facility may be recommended.

At Crownview Co-Occurring Institute, we understand the struggle of dealing with mental health disorders and substance abuse. The hardest part can be admitting that you have a problem; the next hardest step is reaching out for help. If that’s where you are, we commend you for taking this critical step. When you’re ready, our facility offers various treatment options for both disorders: the underlying mental health disorder and substance abuse. Depending on your diagnosis, we may recommend cognitive-behavioral therapy (CBT), medication, outpatient treatment, or a combination of these options. Our knowledgeable, compassionate staff will work with you at your pace to provide the best care possible so that you can live a healthy and productive life. To learn more about our treatment options and how we can help you, reach out to Crownview Co-Occurring Institute today by calling (760) 477-4754.