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The Most Common Co-Occurring Disorders with Substance Abuse

co-occurring substance use disorder treatment

About half of people who battle a substance use disorder in their lifetime will also experience a mental illness. The same can be said vice versa. When a substance use disorder and mental health disorder occur simultaneously, they are called co-occurring disorders.

Co-occurring disorders are very common. In 2018 alone, more than 9 million adults in the United States experienced a co-occurring substance use and mental health disorder. This figure does not include adolescents, who (due to their stage of brain development) are at increased risk for co-occurring disorders. An estimated 60 percent of adolescents in drug treatment today meet the diagnostic criteria for another, co-occurring mental illness.

You may be asking, “What are the most common co-occurring disorders with substance use?” If you have a loved one battling a substance addiction, you may be especially concerned about what other potential issues could also be in sight.

According to the National Institute on Drug Abuse (NIDA), people diagnosed with substance use disorders are twice as likely to suffer also from a mood or anxiety disorder than the general population. The same goes vice versa. Similarly, those diagnosed with an antisocial condition, such as antisocial personality or conduct disorder, are twice as likely to become addicted to drugs.

While the “most common” co-occurring disorders will vary between men and women, the following seven mental health conditions often coincide with drug abuse.

  1. Depression

According to the Journal of Clinical Psychiatry, more than one-third of Americans who struggle with substance abuse also suffer from depression. In addition, depression is three times more likely to develop in people with substance dependence, than the general population.

Depression is a disorder that’s marked by feelings of sadness, hopelessness, dejection and isolation. People battling depression often develop addictive disorders to try and cope with (or escape from) the symptoms listed above. They may try to “drown their sorrows” with alcohol, or get high to escape their negative thoughts and pain. This self-medication is exactly what contributes to the cycle of co-occurring disorders – a person uses drugs to feel better temporarily, but over time, the drugs actually exacerbate the symptoms of the mental illness.

  1. Anxiety Disorder

While there are many types of anxiety disorders, generalized anxiety disorder (GAD) is perhaps the most common with substance abuse. According to recent research, adults with GAD are highly likely to self-medicate their anxious symptoms with drugs and alcohol.

Anxiety disorder symptoms can vary by person and their stressors. In general, it is characterized by persistent and excessive worry and concern. These worries could be about health, money, work, relationships, or other issues. It can cause physical symptoms, like headaches and nausea, in addition to taking a major emotional toll. Approximately 40 million Americans struggle with an anxiety disorder today, with women being 2x more likely to have one than men.  

  1. Post-Traumatic Stress Disorder

Post-traumatic stress disorder (PTSD) is an anxiety disorder that stems specifically from trauma. For example, war veterans often experience PTSD after violent experiences. Women are also very likely to develop PTSD after being physically or sexually abused. This is just the beginning. PTSD can develop following any traumatic or life-threatening event, and cause an array of difficult symptoms in sufferers: difficulty sleeping, painful flashbacks, reactivity, distorted thoughts, and more.

Why does PTSD often co-occur with substance abuse? Those carrying the burden of trauma may not know how to cope. With daily struggles and difficult memories, they may turn to drugs or alcohol for some temporary relief. 

More than half and up to two-thirds of people who battle post-traumatic stress disorder also battle substance addiction. The reverse is true, as well. And according to the journal of Clinical Psychology, those who suffer from PTSD are two to four times more likely to develop a substance use disorder.

  1. Bipolar Disorder

Bipolar disorder, as defined by the NIDA, is a chronic mood disorder in which a person experiences unusual mood instability (mania or hypomania) as well as alternating episodes of depression and mania. Those with bipolar disorder also may experience sharp changes in energy and activity levels.

Research shows that 30 percent to more than 50 percent of people with bipolar disorder will develop a substance use disorder at some point during their lives. This may be due to an increased likelihood to self-medicate with drugs, or an underlying susceptibility to both disorders (both of which are chronic disorders in the brain).

  1. Personality Disorders

According to the Diagnostic and Statistical Manual for Mental Disorders (DSM-5), there are 10 types of personality disorders. These include antisocial personality disorder, borderline personality disorder, paranoid personality disorder, obsessive-compulsive personality disorder, and more. Each of these disorders will affect a person differently, including their ability (or willingness) to interact with others.

Very often, personality disorders are associated with compulsive behaviors—so it makes sense that substance abuse often co-occurs. Substance use disorders are also characterized with a compulsive need to use drugs or drink alcohol, despite the other consequences. It inhibits a person’s ability to rationalize decisions and think about their actions and some personality disorders can do the same. Research has found that between 65 to 90 percent of patients being treated for substance abuse have at least one co-occurring personality disorder. 

  1. Schizophrenia

Schizophrenia is the most common type of psychotic disorder, and is characterized by long-term symptoms of psychosis such as hallucinations, delusional thinking, and disorganized actions and behaviors. Often, schizophrenia disrupts a person’s ability to manage relationships, and attend work, school, and social functions. Schizophrenia can develop at any point in a person’s life, but it most often surfaces during the teenage or young adult years (between 16 and 25 years old).

While research is still being done, studies suggest that certain psychoactive drugs (such as methamphetamines) and psychotropic drugs can increase a person’s vulnerability to schizophrenia. Teenagers who use these drugs are also at increased risk for developing psychotic disorders like schizophrenia, as their brain is still in development. Marijuana use has also been linked to schizophrenia in teens. Specifically, teenagers who use marijuana daily are about three times more likely to develop schizophrenia down the road.

  1. Eating Disorders

From anorexia to bulimia, there are many types of eating disorders. And they are affecting about 20 million women and 10 million men in the United States today. Eating disorders are generally characterized by unhealthy eating habits (such as binge eating, or lack of eating), but can also be very hard to detect. Anyone, of any age and body type, is at risk of an eating disorder. This is particularly true for teenagers, who are often concerned with body image and fitting in.

On top of the detrimental physical effects of eating disorders, many may not realize that eating disorders and substance abuse often co-occur. Studies show that 50 percent of people with eating disorders today also abuse drugs or alcohol. Those afflicted are five times likelier to abuse substances than the general population. Individuals who abuse alcohol or illicit drugs, similarly, are up to 11 times likelier to have eating disorders.

If your loved one is battling an eating disorder, and you have concerns of substance abuse, it is important to seek integrated substance use and eating disorder treatment.

In fact, if your loved one is suffering any co-occurring mental health and substance use disorder, it is important to find an integrated program that is equipped to treat both issues. When it comes to co-occurring disorders (i.e. dual diagnosis), not all treatment centers are created equal. Look for a program that is experienced in dual diagnosis cases, and that can offer a holistic and integrated approach to your loved one’s treatment plan. This will provide the best chance of success at their recovery.

To learn about Turnbridge’s professional treatment for these common co-occurring disorders, please do not hesitate to reach out. Call 877-581-1793 to learn about our dual diagnosis programs for young men and women.