Co-Occurring Disorders: Addiction and Mental Health 

Mental Health 

Addiction and other mental illnesses often occur together. In fact, some studies on co-occurring disorders say that half of the people with substance use disorders also have other mental illnesses such as anxiety or depression. Likewise, many of those same studies show that the reverse is true, too. Up to half of the people with mental illnesses will also deal with substance abuse. 

When this happens, it’s called a dual diagnosis or co-occurring disorder. Often, when somebody deals with drug or alcohol abuse, their treatment will need to address a co-occurring disorder, too. 

Common Co-Occurring Disorders 

Some mental health conditions are more common in people with substance use disorders. Those conditions include: 

  • anxiety disorders (generalized anxiety, panic disorder, OCD) 
  • depression 
  • bipolar disorder
  • ADHD 
  • borderline personality disorder 
  • antisocial personality disorder 
  • schizophrenia 

When a person with an addiction also has a co-occurring disorder, it’s important for healthcare professionals to address both during the person’s recovery. 

Correlation or Causation?

Do mental illnesses cause substance abuse, or does substance abuse cause mental illness? Or do these illnesses simply exist together? Researchers don’t yet know whether substance abuse causes mental illness or vice versa, but they do know that they reinforce each other. 

It’s difficult to pinpoint which illness usually comes first. A lot of factors complicate the research. 

Common Risk Factors 

Substance use disorders and other mental illnesses share several risk factors, which include: 

  • genetics 
  • trauma 
  • environment 
  • stress 
  • chronic medical conditions 
  • grief 
  • social isolation 

Some of these risk factors may lead to substance abuse and other mental illnesses at the same time. In this case, though the addiction and co-occurring condition may influence each other, one did not necessarily arrive as a result of the other. 

Mental Illness Progression 

Some mental illnesses progress slowly, which can make it difficult to determine which illness arrived first. Depression, for example, doesn’t generally arrive suddenly. It may start with fatigue, grow into feelings of overwhelm and guilt, and then turn into numbness. 

If a person starts dealing with alcohol abuse or another addiction during this time, they may not know if their addiction started before or after the first signs of depression. 

Furthermore, both addiction and other mental illnesses can create brain fog and memory problems. As a result, a person who deals with these issues may not be able to remember which problem came first. 

Mental Illnesses May Occur Together 

Addiction is a mental illness itself, and many mental illnesses occur together. Comorbid mental illnesses often come from the same parts of the brain. 

For instance, a lot of people with depression also have anxiety. This overlap may occur because both depression and anxiety can come from a lack of serotonin, a brain chemical that signals happiness and calmness. 

Could the anxiety have caused the depression, or might the depression have caused the anxiety? It’s possible, but it’s also possible that both disorders simply arrived from the same source. When addiction occurs alongside another mental illness, it’s also possible that these mental illnesses simply developed together. 

How to Address Co-Occurring Disorders 

If you deal with a substance abuse disorder and you suspect that you have a co-occurring condition, you should tell a healthcare professional about both of these concerns. When looking for treatment options, search for rehabs or clinics that address dual diagnoses. 

Clinics that address dual diagnoses will usually offer a personalized approach to treatment. They’ll provide a mental health evaluation to confirm your diagnoses, and then they’ll move forward with your care. 

Getting addiction treatment matters, but so does your mental health as a whole. When you find an option that addresses both, you’ll have a better chance of a successful recovery. 


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