Content reviewed by Christian Losch, LCSW, LCADC, CEO of Pinelands
Co-occurring disorders refer to the presence of both a substance use disorder and a mental health disorder. Mental health disorders can be a contributing factor to the development of substance use disorders. Risk factors for developing these disorders overlap, including environmental and genetic factors. Effective treatment for co-occurring disorders must address both conditions at the same time. Behavioral therapy is the most effective treatment. Popular methods include cognitive behavioral therapy (CBT), dialectical behavior therapy (DBT), contingency management (CM), motivational interviewing (MI) and commitment therapy (CT).
Although it is common to struggle with just one mental health or substance use condition, it is also possible to deal with more than one at the same time. Some people struggling with mental health issues may use substances for self-medication. Similarly, some individuals with a substance use disorder (SUD) may have an underlying mental health condition motivating their substance use behavior. More often than not, mental health and substance use disorders exacerbate the symptoms of one another. This dynamic introduces the nature of co-occurring conditions.
Co-occurring disorders are the presence of one mental health disorder and one substance use disorder at the same time. It is essential to understand that recovery from co-occurring disorders requires individualized treatment that simultaneously targets both conditions. Healing must address the severity of the individual’s experienced distress and focus on meeting target goals for both conditions together.
Mental health disorders can contribute to the development of SUDs and vice versa.
The National Institute of Mental Health (NIH) reports that nearly half of individuals who experience a substance use disorder will also experience a co-occurring mental health disorder, and vice versa, at some point in their lives. This figure highlights how common co-occurring conditions genuinely are. It also emphasizes the concerns associated with these conditions and how they develop.
Co-occurring disorders can include a SUD along with a mental health disorder, such as:
- Anxiety disorders
- Eating disorders
- Post-traumatic stress disorder (PTSD)
- Attention deficit hyperactivity disorder (ADHD)
- Bipolar disorder and other mood disorders
- Borderline personality disorder (BPD) and other personality disorders
While co-occurring disorders can develop simultaneously, one condition is more likely to develop before the other or due to the other. For example, mental health conditions such as depression or borderline personality disorder can cause severe emotional distress. In an attempt to self-medicate, a person may turn to alcohol or other drugs. While this may provide temporary relief from their mental health symptoms, they are still developing a substance dependency and not finding any long-term relief from their emotional distress. In this way, mental health conditions can contribute to the development of SUDs.
On the other hand, substance use disorders may form first. There are endless reasons why a person may choose to use substances, although there are dangerous consequences of using drugs even once. Over time, substance use changes brain structures and impairs brain functioning. This change and impairment can contribute to the development of mental health disorders.
Risk factors for developing SUDs and other mental health conditions overlap.
One of the most important things to understand about co-occurring conditions is that they develop from similar risk factors.
Risk factors for drug use, abuse and developing SUDs include, but are not limited to:
- Disorganized home environments
- Having relatives that struggle with substance abuse or other mental health conditions
- Inconsistent or ineffective parenting
- Lack of parental monitoring or proper nurturing
- Failure in academic performance
- Poor social skills
- Perceptions of positive drug-using behavior in life experiences through family, work, school or peer groups
Similarly, some risk factors for developing mental health conditions include:
- Having relatives that struggle with substance abuse or mental health disorders
- Unresolved trauma or other emotional distress, such as abuse or inability to cope with stressors
- Chemical imbalances in the brain
- Using alcohol or other drugs
- Childhood history of neglect or improper nurturing
- Poor social skills
- Chronic medical conditions
- Previous mental health conditions
Mental and substance use disorders can be genetic, meaning that inherited genes can be a critical risk factor. However, many environmental factors can increase a person’s vulnerability to developing either condition. When a person is trying to recover from co-occurring disorders, they must identify the underlying causes of their conditions to work to prevent relapse actively. As seen here, some of these causes may overlap.
Effective treatment for co-occurring disorders must treat both conditions simultaneously.
When considering treatment for co-occurring conditions, it is essential to consider treatment centers that specialize in treating them together. It is common for an individual entering treatment for a SUD to be later diagnosed with an underlying mental health condition. Even if you are only struggling with one condition, it is crucial to understand how effective programs for co-occurring disorders can be for long-term recovery.
While treatment for co-occurring disorders is similar to treating just a SUD or mental health condition independently, co-occurring disorder treatment programs focus on meeting the recovery goals of both conditions simultaneously. If a condition is left undiagnosed or untreated, it increases the chance of relapse for one or both conditions.
Behavioral therapy is the most effective route for treating co-occurring conditions. Behavioral therapy may or may not be offered in combination with medication, depending on the treatment facility. Some popular behavioral therapies for treating co-occurring disorders include:
- Cognitive-Behavioral Therapy (CBT)
- Dialectical Behavior Therapy (DBT)
- Contingency Management (CM)
- Motivational Interviewing (MI)
- Commitment Therapy (CT)
Pinelands Recovery Center of Medford is a premier drug and alcohol treatment center that offers treatment tailored specifically for those struggling with co-occurring conditions. We offer several different behavioral therapies to help individualize your treatment experience. We believe in you and your recovery, and we will do whatever we can to help you believe in yourself the same way. For more information, give Pinelands a call today at (877) 557-5372.