Co-Occurring Disorders: Types and Treatment

Co-occurring disorders, sometimes called dual-diagnosis disorders are characterized by the presence of both mental health and substance use disorders and present unique challenges for individuals seeking treatment. The interaction between mental health and addiction can complicate recovery and necessitate a specialized approach to treatment. 

Co-occurring disorders are relatively common. Research suggests that approximately 8.5 million adults in the United States have co-occurring disorders (SAMHSA). If you or a loved one are experiencing co-occurring disorders, it’s best to speak with a specialist for the best possible treatment options.

What Are Co-Occurring Disorders (Dual Diagnosis)?

Dual diagnosis refers to the presence of both a substance use disorder (like drug addiction) and a mental health disorder (such as depression or anxiety) in an individual at the same time. These conditions can interact and complicate one another, making treatment more complex.

In simple terms, co-occurring disorders are like having two challenges at once. It’s not just the addiction you’re battling; it could also be things like anxiety, depression, or other mental health issues.

But the good news is, there’s help available that’s designed to tackle both at the same time. It’s about treating you as a whole person, not just one part of you. Understanding co-occurring disorders is a big step toward getting the right help and working towards recovery.

How common are co-occurring disorders among individuals with addiction issues?

Co-occurring disorders are relatively common among individuals with addiction issues. Studies have consistently shown a high prevalence of co-occurring mental health disorders among those struggling with substance use disorders. 

The exact prevalence rates can vary depending on the population studied and the specific disorders assessed. However, research suggests that approximately 40-60% of individuals with substance use disorders also have a co-occurring mental health disorder. (NCBI)

Why are co-occurring disorders significant in addiction treatment?

Co-occurring disorders are significant in addiction treatment because they necessitate the involvement of professionals trained to administer healing techniques for disorders like anxiety or depression and not just addiction. Treatment of co-occurring disorders requires different types of treatment and different types of professionals with the skills to administer those treatments which may include a psychiatrist, nurse practitioner and LCSW.

Treating addiction alone without addressing the co-occurring disorder or multiple disorders is less effective than treating addiction and mental health issues at the same time. Addressing co-occurring disorders in your treatment is like fixing both the engine and the brakes on that car at the same time or simultaneously. It’s about making sure you have the best chance to recover fully and lead a healthier life.

How do mental health and addiction influence each other?

Mental health and addiction are closely intertwined and have comorbidity between them. Mental health disorders can lead to substance use as a form of self-medication. Conversely, substance abuse can exacerbate or trigger mental health issues. This reciprocal relationship highlights the need for integrated treatment approaches.

Comorbidity between substance use disorders and mental illness is common. A full list of comorbidities as defined by NIDA in their 2021 study can be found below:

• Self-Medication: Sometimes, people turn to substances as a way to cope with their mental health challenges. You may find that drugs or alcohol temporarily alleviate symptoms such as anxiety, depression, or emotional pain. However, this relief is often short-lived and can lead to a cycle of dependence and addiction.
• Dual Vulnerability: Mental health issues can make you more vulnerable to developing a substance use disorder. Conditions like depression, anxiety, or post-traumatic stress disorder (PTSD) can create a sense of distress and make you more inclined to seek relief through substances. Unfortunately, this can lead to a dangerous cycle where substance use worsens your mental health symptoms.
• Chemical Imbalances: Substance abuse can disrupt the delicate balance of chemicals in your brain, affecting your mood, cognition, and overall mental well-being. This disruption can exacerbate existing mental health conditions or even trigger the onset of new ones. It becomes a vicious cycle where substance use worsens mental health and vice versa.
• Impaired Judgment: Both mental health issues and addiction can impair your judgment and decision-making abilities. This can make it harder to recognize the harmful consequences of substance abuse and seek appropriate help. It’s important to be aware of how these conditions can cloud your judgment and seek support from professionals who can provide objective guidance.
• Increased Risks: The presence of co-occurring mental health and substance use disorders can increase your risk for other problems. For example, it may lead to a higher likelihood of engaging in risky behaviors, such as unprotected sex or driving under the influence. These behaviors can have severe consequences for your physical and mental well-being.
• Treatment Challenges: Treating co-occurring disorders requires a comprehensive approach that addresses both mental health and addiction simultaneously. It’s crucial to find healthcare providers who specialize in dual diagnosis and can develop a treatment plan tailored to your specific needs. Treating one aspect while neglecting the other can hinder your progress and increase the risk of relapse.
• Genetics: Both substance use disorders and other mental illnesses are caused by overlapping factors such as genetic and epigenetic vulnerabilities

What are the risk factors for developing co-occurring disorders?

The common causes of developing mental health and addiction are listed below:

• Genetics: If your family has a history of mental health issues or addiction, you might be at a higher risk.
• Early Life Experiences: Traumatic events during childhood, like abuse or neglect, can increase the chances of both addiction and mental health problems later on.
• Brain Chemistry: Sometimes, the way your brain is wired can play a role. Imbalances in brain chemicals can make you vulnerable to both addiction and mental health disorders.
• Stress: High levels of stress, whether from work, relationships, or other factors, can make you more susceptible to these issues.
• Peer Pressure: The people you surround yourself with can influence your behavior. If your friends are into drugs, it can increase your risk.
• Drug Use: Ironically, the use of drugs or alcohol itself can be a risk factor. It can alter your brain chemistry and make mental health problems more likely.
• Not Seeking Help: Avoiding or not getting help for mental health issues early on can lead to self-medicating with drugs, increasing the risk of addiction.

What are The Different Types Of Co-Occurring Disorders?

Different types of mental health conditions are more commonly associated with addiction than others. The mental health conditions most commonly occur with addiction are listed below:

• Depression: Depression and addiction often go hand in hand. People may turn to drugs or alcohol to cope with the feelings of sadness and hopelessness that come with depression.
• Anxiety Disorders: Conditions like generalized anxiety disorder, social anxiety disorder, or panic disorder can make someone more susceptible to addiction as they may use substances to self-medicate and temporarily relieve anxiety.
• Post-Traumatic Stress Disorder (PTSD): Trauma survivors with PTSD may turn to substances to numb or escape from distressing memories and emotions.
• Bipolar Disorder: Individuals with bipolar disorder might be more prone to substance use during manic or depressive episodes as they seek to stabilize their mood or self-medicate.
• Borderline Personality Disorder (BPD): People with BPD may engage in impulsive behaviors, including substance abuse, to cope with intense emotions and instability in relationships.
• Attention-Deficit/Hyperactivity Disorder (ADHD): Individuals with ADHD may use substances to self-regulate their attention and mood.

Many different types of mental health conditions commonly occur with addiction. If addressed simultaneously, treatment outcomes are improved.

What Are The Different Types Of Treatment For Co-Occurring Disorders?

Co-occurring disorder treatment typically involves evidence-based treatment modalities and therapies aimed at providing comprehensive care to address both conditions concurrently. 

Traditional methods for co-occurring disorder treatment often include integrated treatment plans, medication-assisted treatment (MAT), psychotherapy, support groups, family therapy, relapse prevention strategies, lifestyle modifications, stress management techniques, education, and the establishment of structured routines. These approaches aim to promote recovery, manage symptoms, and improve the overall well-being of individuals facing the complex challenge of co-occurring disorders.

The treatment methods that can help you or someone with dual diagnosis are listed below:

• Integrated Treatment: This approach focuses on treating both disorders together, recognizing that they often interact with each other. You’ll work with a team of professionals, including therapists and counselors, to create a tailored treatment plan.
• Medication-Assisted Treatment (MAT): If your co-occurring disorders involve substance abuse, MAT might be recommended. This involves using medications, like methadone or buprenorphine, to manage cravings and withdrawal symptoms while addressing the mental health aspect.
• Psychotherapy: Therapy, such as cognitive-behavioral therapy (CBT) or dialectical-behavior therapy (DBT), is vital. It helps you understand the connection between your mental health and substance use, develop coping strategies, and address underlying issues.
• Support Groups: Joining support groups can be incredibly beneficial. These groups provide a safe space to share experiences and learn from others who are also facing co-occurring disorders. Groups like Alcoholics Anonymous (AA) or Narcotics Anonymous (NA) can be valuable.
• Family Therapy: In many cases, involving family members in therapy can improve your support system. It helps loved ones understand your challenges and learn how to provide meaningful support.
• Relapse Prevention: Learning techniques to prevent relapse is crucial. You’ll work on identifying triggers and developing strategies to manage them effectively.
• Healthy Lifestyle: Incorporating a healthy lifestyle into your recovery plan can make a big difference. Regular exercise, a balanced diet, and adequate sleep can help stabilize mood and reduce cravings.
• Stress Management: Stress often contributes to both mental health and substance use issues. Techniques like mindfulness, meditation, and relaxation exercises can help you manage stress more effectively.
• Education: Educating yourself about both your mental health condition and substance use disorder is empowering. Understanding your challenges can lead to more informed decisions and better self-management.
• Routine and Structure: Establishing a daily routine can provide stability and reduce impulsivity. It’s an essential part of maintaining your recovery.

What are the limitations of treating co-occurring disorders separately?

Treating mental health and substance use issues separately can have some significant limitations for you or someone you know who’s dealing with these challenges. Here are a few key limitations to be aware of:

• Incomplete Understanding: When these issues are treated separately, it’s easier to miss the connection between them. Your mental health and substance use may be intertwined, and treating them separately might not address the root causes effectively.
• Risk of Relapse: If one issue is treated without considering the other, you might be more vulnerable to relapse. For example, if you’re receiving treatment for substance use but not addressing underlying mental health issues, you may turn to substances again as a way to cope with emotional distress.
• Less Effective Treatment: Treating these issues in isolation can result in less effective treatment outcomes. You might find it challenging to manage one condition while the other continues to impact your well-being.
• The strain on Support Systems: It can be confusing and frustrating for your support systems, such as family and friends, when they see you receiving separate treatments. They might not fully understand the interconnected nature of these issues, making it harder for them to provide meaningful support.
• Missed Opportunities: Integrated treatment approaches often offer a more holistic view of your health. By treating both issues together, you can explore how they relate and learn valuable coping strategies that address both aspects of your well-being.
• Longer Recovery: Treating these issues separately might extend your recovery process. An integrated approach can lead to more efficient progress and a quicker return to a healthier life.

While it’s possible to treat mental health and substance use issues separately, doing so may not address the underlying causes and can lead to less effective treatment outcomes. An integrated approach that considers both aspects of your health offers a more comprehensive and potentially more successful path to recovery.

How do traditional approaches fail to address the unique needs of individuals with multiple diagnoses?

It’s important to recognize that traditional treatment approaches may not always effectively address the unique needs of co-occurring disorders. Here’s why:

• Fragmented Treatment: Traditional approaches often separate mental health treatment and addiction treatment, treating them as separate issues. This fragmented approach can overlook the intricate interplay between mental health and addiction, missing the opportunity to address the underlying causes and potential triggers of both conditions.
• Misdiagnosis or Underdiagnosis: Co-occurring disorders can be complex and challenging to diagnose accurately. Traditional approaches may focus on treating one condition while overlooking the presence of the other. This can lead to misdiagnosis or underdiagnosis, resulting in inadequate treatment and limited progress.
• Limited Integration: Traditional treatment models may lack the integration of mental health and addiction services into a cohesive and coordinated approach. This can result in a lack of communication between treatment providers, leading to fragmented care and a lack of comprehensive support.
• Stigma and Shame: Co-occurring disorders often carry a significant stigma, both in society and within healthcare systems. This stigma can prevent individuals from seeking help or disclosing their struggles fully. Traditional approaches may not adequately address the shame and stigma associated with co-occurring disorders, potentially hindering progress and recovery.
• Relapse Risk: When co-occurring disorders are not addressed simultaneously, the risk of relapse increases. Treating one condition while neglecting the other can leave underlying issues unresolved, making it more challenging to sustain long-term recovery and overall well-being.
• Treatment Resistance: Concurrent disorders can be more resistant to treatment compared to single disorders. Traditional approaches that do not address both conditions together may not effectively target the complex underlying factors contributing to the dual diagnosis, resulting in limited treatment outcomes.

Integrated and holistic treatment models that offer comprehensive care addressing both mental health and addiction simultaneously can provide a more effective and tailored approach to your recovery journey. Remember, you deserve holistic support that recognizes the interconnected nature of your challenges and empowers you to achieve lasting well-being.

How Does Integrated Treatment For Dual Diagnosis Work?

The integrated approach, also known as integrated treatment or dual diagnosis treatment, is a comprehensive and coordinated method of addressing co-occurring disorders. It recognizes that mental health and addiction are interconnected and aims to provide simultaneous treatment for both conditions. Here are some key aspects of the integrated approach:

• Holistic Assessment: Integrated treatment begins with a thorough assessment that considers both mental health and substance use aspects. This assessment helps identify the specific disorders present, their severity, and how they interact with each other. It also takes into account other important factors such as medical history, social support, and personal circumstances.
• Concurrent Treatment: In an integrated approach, mental health and addiction treatment occur simultaneously rather than as separate interventions. This means that a comprehensive treatment plan is developed to address both conditions together. Treatment modalities may include individual therapy, group therapy, medication management, psychoeducation, and relapse prevention strategies.
• Coordinated Care: Integrated treatment involves collaboration and communication among healthcare providers from different disciplines. This ensures that mental health professionals and addiction specialists work together as a team to provide cohesive and coordinated care. They share information, coordinate treatment strategies, and adjust interventions based on your progress and evolving needs.
• Targeting Underlying Issues: Integrated treatment recognizes that substance use and mental health disorders often have shared underlying factors. These may include trauma, unresolved emotional issues, self-esteem problems, or dysfunctional coping mechanisms. The treatment focuses on addressing these underlying issues to promote long-term recovery and overall well-being.
• Relapse Prevention: Integrated treatment emphasizes relapse prevention strategies tailored to your specific needs. It recognizes that managing both mental health and addiction is an ongoing process and provides tools and coping skills to effectively navigate triggers, cravings, and high-risk situations. Relapse prevention plans may include ongoing therapy, support groups, lifestyle changes, and healthy coping mechanisms.
• Supportive Environment: Integrated treatment often takes place within supportive environments such as specialized dual diagnosis treatment centers or programs. These environments foster a sense of safety, understanding, and empathy. They provide a space where you can openly discuss your challenges, ask questions, and receive support from peers who are also navigating similar experiences.

Is dual diagnosis treatment effective?

The effectiveness of dual diagnosis treatment is significantly enhanced by a holistic approach. This involves coordinated and simultaneous treatment of both mental health and substance use disorders. Key elements of an effective dual diagnosis treatment include:

1. Holistic Assessment: A thorough evaluation of both mental health and substance use issues.
2. Concurrent Treatment: Simultaneous management of co-occurring conditions.
3. Coordinated Care: Ensuring all aspects of treatment work together harmoniously.
4. Targeting Underlying Issues: Addressing root causes and not just symptoms.
5. Relapse Prevention Strategies: Essential for sustaining long-term recovery.
6. Supportive Environments: Creating a setting conducive to healing and recovery.

Traditional treatment methods that overlook the interconnected nature of dual diagnosis often result in fragmented care and limited success. Seeking specialized assistance from healthcare providers with expertise in dual diagnosis is critical to obtaining comprehensive support tailored to co-occurring disorders.

Where Can I Find Dual Diagnosis Treatment Near Me?

Valley Spring Recovery Center (VSRC) offers comprehensive dual diagnosis treatment in New Jersey. Contact us today to get help immediately.