Understanding Co-Occurring Disorders | Nova Rehab Centers
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About 7.9 million adults in the United States suffered from co-occurring disorders in 2014, according to the 2014 National Survey on Drug Use and Health published by the Substance Abuse and Mental Health Services Administration.1  Unfortunately, since co-occurring disorders are often very complex, many individuals only receive partial treatment that is inadequate. This can lead to higher instances of related issues, such as medical problems, homelessness, incarceration, suicidal behaviors or death.2

What Is a Co-Occurring Disorder?

A co-occurring disorder (previously referred to as dual diagnosis) is a clinical term that is used to describe the existence of a mental health and substance use disorder that exists simultaneously.2  For example, a person may be suffering from both alcohol addiction and depression. Or an individual may be addicted to methamphetamine and also have an eating disorder.

It’s not always clear which disorder developed first or which disorder caused the other. This is because substance abuse is often a form of self-medication. Conversely, the severity of an already-existing mood disorder may increase as a result of substance abuse. Regardless of which developed first, it’s important to understand that there is no single cause of addiction, but a person with a mental illness is certainly more likely to develop an addiction.3

There are a number of psychiatric disorders that may co-exist alongside addiction, including:4

  • Clinical depression
  • Mania
  • Borderline personality disorder
  • Schizophrenia
  • Panic disorder
  • Bipolar disorder
  • Eating disorders such as bulimia or anorexia

Substance abuse and psychiatric disorders may also occur simultaneously because addictive substances change the way the brain works, impacting a person’s mood, thoughts, and behaviors.4,5

Causes of Co-Occurring Disorders

Mental health and substance use disorders are highly complex and many of the same factors that cause mental illness also lead to substance abuse. These factors can be environmental or biological and often include6:

  • Genetics
  • Trauma
  • Stress
  • Early exposure to addictive substances

Symptoms and Signs of Co-Occurring Disorders

Because there are so many different combinations of co-occurring disorders, the symptoms and signs are vastly varied. This may make it difficult to diagnose all disorders that are affecting an individual. In addition, many of the signs and symptoms are overlapping.7

If a person is struggling with coexisting substance abuse and psychiatric disorders, they may exhibit the following signs and symptoms:

  • Deliberate isolation
  • Severe mood swings
  • Trouble at school or work
  • Strained relationships
  • Hallucinations
  • Extreme sadness or hopelessness for weeks at a time
  • Lying about whereabouts or activities
  • Sudden changes in appearance or hygiene
  • Withdrawal symptoms during attempts to quit drugs or alcohol
  • Loss of control over drug/alcohol usage

Treatment for Co-Occurring Disorders

In the past, many people struggling with substance abuse disorders and psychiatric disorders simultaneously were denied treatment until they were sober. Today, the standard for high-quality treatment regarding co-occurring disorders has changed.

Research has shown that treatment is much more effective when mental and substance use disorders are addressed at the same time.  This is called integrated treatment. Not only is this approach more affordable, but it is also more effective in treating all co-occurring disorders.2,8

Effective integrated treatment and care for co-occurring disorders should include the following characteristics9:

  1. Balanced use of psychotherapeutic medications and evidence-based therapies
  2. Parallel treatment of psychiatric disorders and substance abuse disorders
  3. Individual, group and family counseling

Although every person’s treatment plan should be individualized based on their circumstances and needs, the above characteristics of integrated treatment for co-occurring disorders can be met with a continuum of care plan that incorporates the following:

  • Comprehensive assessment
  • Multidisciplinary treatment approach
  • Medically assisted detox
  • Therapeutic services (individual, group and family)
  • Aftercare support services

Increasing your own awareness of dual diagnosis and co-occurring disorders may help you understand your own struggle with addiction or be more compassionate towards the struggle of a loved one. In addition, education on the topic may also aid in finding the best type of treatment.

If you are searching for integrated treatment for yourself or a loved one, please contact Nova Recovery Center today to learn more about our long-term drug and alcohol rehab programs.



  1. https://www.samhsa.gov/data/sites/default/files/NSDUH-FRR1-2014/NSDUH-FRR1-2014.pdf
  2. https://www.samhsa.gov/disorders/co-occurring
  3. https://www.drugabuse.gov/publications/research-reports/comorbidity-addiction-other-mental-illnesses/why-do-drug-use-disorders-often-co-occur-other-men
  4. https://www.psychologytoday.com/blog/the-anatomy-addiction/201110/what-is-dual-diagnosis
  5. https://www.drugabuse.gov/publications/research-reports/comorbidity-addiction-other-mental-illnesses/why-do-drug-use-disorders-often-co-occur-other-men
  6. https://www.psychologytoday.com/conditions/co-occurring-disorders
  7. https://www.nami.org/Learn-More/Mental-Health-Conditions/Related-Conditions/Dual-Diagnosis  
  8. http://www.dbsalliance.org/site/PageServer?pagename=education_brochures_dual_diagnosis