Co-Occurring Disorders: Symptoms, Diagnosis & Treatment

What Are Co-occurring Disorders: Symptoms, Diagnosis and Treatment

Human psychology can be a complex subject, as it tends to remain so unknown despite centuries of study and medical involvement. Many people who face addiction can get caught in a mental web surrounding psychology disorders that contribute to addictive and destroying behaviors. What comes first — mental health issues or addiction issues? While that’s hard to determine for sure, one thing is certain: many times, the two go hand-in-hand.

Psychologists have theorized several aspects of co-occurring disorders prevailing in humans which typically involves a substance-related addiction (drug or alcohol, in this case) at the same time as a mental illness. These co-occurring disorders can be identified in the form of depression or stress-related mental illnesses, schizophrenia, bipolar disorder, and many more.

Co-occurring disorders affect the cognitive function in a patient. Such patients are sometimes found to have an alarming level of drug or alcohol abuse. Along with drug abuse, people with co-occurring disorders most commonly suffer from certain mental health struggles such as post-traumatic stress disorder (PTSD), bipolar disorder, depression, or anxiety disorders.

co-occurring disorders


Many professionals are discovering co-occurring disorders actually add to the risk of opioid addiction. A study in the Journal of Clinical Psychology found:

Elevated levels of anxiety and depression have been reported in surveys of methadone-maintained patients with chronic pain, and one small study found high rates of Axis-I disorders among 40 patients with chronic pain referred from multidisciplinary pain clinics who also had either opioid abuse or dependence.

And in Behavior Research and Therapy we see the link between traumatic experiences, mental health and addiction:

In many clinical settings, there is a high comorbidity between substance use disorders, psychiatric disorders, and traumatic stress. Novel therapies are needed to address these co-occurring issues efficiently.

This article intends to shed some light into this particularly sensitive subject (co-occurring disorders) which can establish a false sense of shame in many individuals trying to overcome their addictions.

Co-occurring Disorders: Substance Abuse and Mental Health

It is commonly observed in patients with mental instability or a family history of psychological disorders to have a substance-related (drug or alcohol) addiction. This relation also holds true in the case of patients with substance use disorders exhibiting mental illness. Various studies have reported that patients (in such cases) have been diagnosed with either drug or alcohol abuse syndrome or its dependency. Of course, both can be alarming or fatal in nature.

The various situations which present these dual diagnosis syndromes often include a prescribed drug dependency and social anxiety, depression, and alcoholism, etc. The reliance on substances can add to or even complicate the treatment needed in learning to manage mental health disorders. In the same way, mental illness can pose new obstacles when it comes to a person in their treatment and recovery from drug addiction. This is why it’s so important for professionals in the drug and alcohol treatment industry to understand both addiction and mental health. 

co-occurring disorders

Treatment for Co-occurring Disorders

All co-occurring disorders include mental health issues. These mental disorders can be primarily classified into the following:

  • Bipolar disorder
  • Post-Traumatic Stress Disorder (PTSD)
  • Obsessive Compulsive Disorder (OCD)
  • Social anxiety
  • Depression
  • Schizoaffective disorder
  • Schizophrenia
  • Personality Disorders (i.e. Borderline, Narcissistic, and Antisocial Personality Disorders)
  • And more.

The most challenging situation arises when clinicians have to treat patients with substance abuse disorder. This requires the intervention of a substance abuse rehab. The patient needs comprehensive treatment procedures that can target both mental health issues and substance abuse at the same time, to the best of their well-being and recovery. Undergoing this can be extremely helpful compared to only treating one or the other. However, it can take time to find the best treatment methods for both, because each person and their co-occurring disorders can be so uniquely complex. 

Role of Cognitive Behavioural Therapy in Co-occurring Disorder Treatment

More than a prescribed medicine, a patient with a co-occurring disorder might react best to cognitive behavioral therapy. It helps the patient deal with psychosocial anxiety issues, promotes mental health and stability as well as prevents relapse by eliminating a drug-based dependency. Clinicians and psychologists theorize cognitive behavioral therapies for patients with such disorders as the complete dependency on a substance and its abuse tends to compromise their mental health. This further impacts social and psychosomatic (“mind/body”) interactions. More often than not, therapists must play a large role in dealing with life-threatening behavior found in co-occurring disorders.

The effects of co-occurring disorders can cascade into all personal areas of the patient’s life. These include financial troubles, family problems, the stress of hospitalizations, sexual or physical abuse, and other medical complications. Many or all of these stories can come up in treatment and must be dealt with in a safe, supportive environment. Especially because more often than not, such issues left undealt with can contribute to addiction and mental health.


dual diagnosis addiction recovery


Integrated Treatment Programs

One of the most preferred and effective treatment programs for patients exhibiting a dual diagnosis disorder is the ‘integrated treatment plan’.  This program incorporates both psychotherapeutic and occupational therapy to reverse the co-occurring disorder in a patient. This particular program has, regularly, been recommended by The Substance Abuse and Mental Health Services Administration (SAMHSA), USA as well as the American Psychiatric Association to treat such patients.

This interdisciplinary squad consists of psychotherapists, social workers, case managers, clinical counselors, etc.

Integrated Treatment Programs includes activities that help patients to:

  • Explore life while they fight drug abuse and mental health.
  • Recover using holistic treatment methodologies.
  • Identify solutions to their family problems as well as employment support services.
  • Receive a goal-oriented approach to the recovery program.
  • Individualized treatment plans with the patient’s best interest in mind (no “one size fits all”).

Patients displaying Alcohol Use Disorder (AUD) in comorbid conditions are, usually, recommended a Selective Serotonin Reuptake Inhibitor (SSRI) antidepressants during the cognitive behavioral therapy (CBT) program. The duration of the program may last up to 24 weeks provided the patient does not opt-out of it. In other treatment procedures, like the Interpersonal and Social Rhythm Therapy (IPSRT), patients with greater will-power and a positive mindset to cooperate with the team have a better recovery ratio than others.

Treatment Programs Offered by Treatment Centers

addiction treatment for dual diagnosis

There are several treatment centers specializing in co-occurring disorders or dual diagnosis. The medical team in such centers accelerate the management of mental illness in patients by engaging them in various assessment procedures (both medical and psychiatric processes are involved).

In many cases, the patient attending the rehab session avoids opening up to the medical attendant at first. To offer treatments to patients and address their core underlying issues, the medical staff conducts several bio-psycho examinations for the attendees. These assessments are crucial to obtain extraneous information about patients with bipolar disorders, drugs or alcohol-dependence, anxiety, depression, psychosis, panic attacks, and several other mental or intellectual disabilities.

Several drug and alcohol addiction treatment hubs enroll people with co-occurring disorders in a comprehensive treatment program. These programs may include alcohol rehab plan, outpatient therapy, drug rehab arrangement, etc. These treatment plans explicitly consist of nutrition and addiction programs. Since the mental capacity and emotional quotient (EQ) is related to a person’s surrounding environment (e.g., family, religious beliefs, past traumas, peer groups, etc.), the treatment centers chart out a family program for the patients’ overall well-being.


What to Do if You or a Family Member Has a Co-occurring Disorder

All in all, to fight the onset of behavioral challenges in a patient with a co-occurring disorder, one must resort to the psychotherapeutic solutions instead of a big box of medications. An integrated treatment approach has been successful in addressing several critical substance cases of abuse and mental health disorders. Find an ethical treatment center with staff who specialized in co-occurring disorders near you to start treatment sooner rather than later!

At Opus Health, we are familiar with co-occurring disorders and many of our patients in recovery discover how to manage their symptoms. Through willing to stay sober, remaining in the community, and taking a path to a better life, our patients have found how to return to jobs, build families, and overcome disorders as best they can with the help of caring professionals.

If you or a loved one needs help, call us at 949-625-4019.

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