Co-occurring disorder is a medical term that describes a condition in which a person suffers from addiction as well as a mental health disorder such as anxiety or depression. Co-occurring disorders are common among people who engage in substance abuse, and treatment requires comprehensive care to address both conditions fully.

Often, one condition adversely impacts the other – for example, someone with depression may engage in substance use to self-medicate. Or, someone who uses drugs or alcohol may experience a worsening of their mental health symptoms.

There is no one scientific explanation for why mental health disorders and addiction occur together so often, but most experts believe a combination of biological, developmental, and environmental factors come together in a way that seems to contribute to both conditions.

And unfortunately, people who suffer from both a mental health condition and substance use disorder frequently exhibit symptoms that are more severe and resistant to treatment when compared to those who experience only one condition.

Assessment of Co-Occurring Disorders

During a clinical evaluation for a dual diagnosis, health providers collect information and consider many factors, such as the following:

Does the patient…

…meet the criteria for one or more psychiatric conditions?

…have a personal history of substance abuse that has adversely affected their health, relationships, work, etc.?

…appear to be a danger to themselves or others?

…have a reliable support system and resources available?

…exhibit motivation to participate in rehab and ultimately, recover?

Signs and Symptoms of Related Conditions

Mental health conditions and substance use disorders often occur together, but the symptoms can usually be differentiated. Common signs and symptoms of mental health conditions include, but are not limited to the following:

  • Feelings of hopelessness, helplessness, worthlessness, guilt, fear, etc.
  • Loss of interest in daily activities.
  • Change in appetite, weight, or sleep patterns.
  • Lack of energy, fatigue.
  • Racing, intrusive thoughts and trouble concentrating.
  • Increased irritability.
  • Risky, impulsive behavior.
  • Suicidal or homicidal thoughts.

Signs, symptoms, and behaviors associated with substance use disorders include, but are not limited to the following:

  • Inability to control substance use.
  • Cravings for drugs or alcohol.
  • Developing tolerance, meaning more use of the substance is needed to achieve the same effect.
  • Withdrawal symptoms manifest when the user tries to quit or cut back.
  • Life is revolving around substance use and time spent acquiring, using, and recovering.
  • Difficulty meeting critical obligations at the expense of school, work, relationships, etc.

Treatment for Co-Occurring Disorders

Living with a mental health condition in conjunction with a substance abuse disorder can be incredibly challenging – but through engagement in intensive treatment, such as behavioral interventions, however, recovery is indeed possible.

Behavioral therapies typically consist of the following approaches:

  • Cognitive-behavioral therapy, which aims to mitigate problematic beliefs, feelings, and practices and replace them with healthier, more constructive thoughts and patterns of behavior.
  • Dialectic behavioral therapy, which has the objective of reducing self-harming behaviors.
  • Integrated group therapy, which relies partially on peer support and addresses the symptoms of both mental health conditions and substance abuse at once.


Treating a patient with a co-occurring disorder often involves with the use of medication in addition to psychotherapy, depending on the mental health condition and the substance use disorder.

For example, mood stabilizers such as anti-depressants are often used for depression or anxiety, as is opioid replacement therapy for persons who are addicted to prescription painkillers or heroin.

Inpatient Co-Occurring Disorder Treatment

Depending on the severity of the mental illness or addiction, a person may benefit from inpatient treatment – moreover, residential rehab or a partial hospitalization program.

Due to the complex nature of a co-occurring disorders, many people with this diagnosis will need additional services and continual, long-term support from a variety of health providers, such as general practitioners, therapists, and psychiatrists.

Residential rehab programs are more intensive because clients may receive the following services:

  • Regular, ongoing education and mental health conditions, substance abuse, and addiction
  • Daily therapy sessions
  • Daily support group attendance
  • Immersion in a community of peers with similar experiences

Intensive Outpatient (IOP) Co-Occurring Disorder Treatment

Outpatient treatment, on the other hand, is more flexible than residential treatment.  People who choose outpatient treatment have often completed an inpatient treatment program or need more freedom to attend to work, school, or family responsibilities. They visit the center several times per week but primarily reside at a private residence or partnered supportive housing.

Participants may receive a variety of services during intensive outpatient treatment, including:

  • Medication management
  • Transportation
  • Involvement in peer support groups or 12-step programs
  • Individual and family therapies
  • Support for independent living

If you or someone you love is suffering from addiction and a mental health condition, please contact us as soon as possible for a free consultation.

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