Learn about how addiction and mental health are connected and what the best treatment options are.
Addiction and mental illness frequently co-occur. In fact, recent data from the Substance Abuse and Mental Health Services Administration, commonly known as SAMHSA, indicates nearly eight million American adults have a co-occurring disorder.1 Co-occurring condition or disorder is the term used to describe a situation where someone struggles with both a mental health condition and a substance use disorder (SUD). Although substance abuse and mental illness are often discussed as part of the same conversation, they describe different things.
Unfortunately, co-occurring conditions are surprisingly common. The safest and most effective way to begin a journey towards lasting recovery is with treatment at a rehab that understands integrated alcohol or drug addiction and mental illness treatment, such as The PAC Program.
Addiction is described as a chronic dysfunction of the brain.2 When someone struggles with addiction, specific parts of the brain are impacted, including those that involve reward, memory, and motivation. People addicted to a substance will crave that substance, while people addicted to a behavior will crave engaging in that behavior. Addiction is a treatable disease, yet few people will ever go to rehab.
Mental illnesses are specific health conditions that involve changes in how someone thinks, feels, or behaves. Mental illnesses are usually associated with difficulties and challenges related to daily functioning in social, work, or family settings. There are several potential mental health conditions, and the symptoms for each vary widely.
Like addiction, mental illness is treatable, and with therapy, it is possible to learn how to safely and effectively manage symptoms without using drugs or alcohol to self-medicate. Unfortunately, self-medication is common in people who struggle with severe mental health symptoms. The high rate of substance use for symptom management is part of the reason why there is a high rate of co-occurring mental illness and substance abuse.
Two other terms often used in conjunction with addiction and mental health are comorbidity and dual diagnosis. These terms are often used interchangeably with co-occurring disorders; however, their meanings are slightly different.
Comorbidity describes a circumstance where someone has two or more simultaneous disorders. People with comorbid disorders do not explicitly have a simultaneously occurring addiction and mental health condition. For example, comorbidity can refer to having two or more mental disorders, such as being diagnosed with diabetes and major depressive disorder.
Similar to co-occurring disorders, a dual diagnosis occurs when someone has a mental illness and substance use disorder simultaneously. For example, when a person is diagnosed with generalized anxiety disorder and alcohol addiction.
Co-occurring disorders and substance abuse are common problems for millions of Americans. Several conditions frequently occur alongside SUDs. According to the U.S. Department of Health and Human Services, more than one in four U.S. adults living with a severe mental health condition also meets the criteria for a co-occurring diagnosis.2 Although any mental health condition can co-occur with a substance use disorder, some coexisting mental health disorders are more common than others.
Recent studies suggest as many as 32% of people with a mood disorder (including depression and bipolar disorders) could benefit from treatment for co-occurring conditions.3 When someone has depression, also referred to as clinical depression or major depressive disorder, they experience overwhelming and powerful symptoms of sadness, irritability, or emptiness that significantly affect their day-to-day lives. Their symptoms make it challenging and sometimes impossible to function each day. People who struggle with depression and addiction frequently start using a substance for the first time to self-medicate.
Without treatment to address depression, the symptoms accompanying a depression diagnosis can seem so overwhelming that they lead to the inability to function at home, work, or school. For depression to be clinically diagnosed, these symptoms must occur for a minimum of two weeks and be notably different from one’s previous level of functioning.
Data from the Anxiety and Depression Association of America suggests as many as 20% of people diagnosed with anxiety also have a co-occurring disorder. Anxiety is an ongoing or persistent emotional challenge that interferes with day-to-day life. Typically, anxiety symptoms begin in early childhood or adolescence and, if left untreated, will continue throughout adulthood.4
The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) lists several types of anxiety disorder, including phobias, generalized anxiety disorder (GAD), separation anxiety, and social phobias (social anxiety disorders). It is possible to have one or multiple anxiety disorders. It is common for those with an anxiety disorder to self-medicate with substances, eventually leading to a substance use disorder. Because symptoms of anxiety can be crippling and increase the risk of addiction, the best way to overcome any type of anxiety is to seek help at a treatment center like The PAC Program, where patients can learn safe and healthy tools for managing triggers and anxiety in the future.
Approximately 23% of people with a personality disorder and 38% of individuals with borderline personality disorder have a substance use disorder.4 Personality disorders are described as a group of mental health conditions characterized by unhealthy feelings, behaviors, and thought patterns. Many who have a personality disorder are rigid and inflexible in their thoughts and behaviors.
When someone has a personality disorder, they will generally struggle to foster and maintain healthy relationships with others. In addition, they have difficulties managing everyday stressors and problems in ways that are “acceptable” to those around them. They often believe their way of acting or thinking, while often contrary to what is socially acceptable, is entirely normal. The thoughts and actions of someone with a personality disorder often lead to them blaming their personal or social struggles on those around them. These blame-placing behaviors often lead to significant academic, personal, or employment problems.
PTSD and SUD are common co-occurring disorders. Some studies indicate as many as 46.4% of people with lifetime PTSD also have a co-occurring substance use disorder.5 Post-traumatic stress disorder can result from different types of trauma. For many, PTSD develops after they directly witness or experience a traumatic event.
Trauma and traumatic events can refer to any type of situation and are different for everyone. Examples of events that could cause or lead to trauma may include illness, assault, natural disasters, abuse, and experiencing or witnessing an act of terrorism. It is not necessary to directly experience trauma for PTSD to occur. For instance, PTSD can develop from learning about a trauma that affects a loved one. Regardless of the type of trauma, severe and complex mental health struggles requiring treatment do occur.
Youth and adults with ADHD are at a greater risk for co-occurring disorders.
Attention-deficit/hyperactivity disorder is a commonly diagnosed neurodevelopmental disorder. Some studies show up to 50% of adults with ADHD need co-occurring disorder treatment. In addition, it is estimated that approximately ten percent of children in the United States between the ages of two and seventeen have been diagnosed with attention deficit hyperactivity disorder.6
There are three common types of ADHD:
The DSM-5 is a manual used by mental health providers across the nation to assess the presence and severity of a mental health condition. The fifth and newest version of the DSM was released in 2013, and it lists one hundred fifty-seven distinct mental health conditions.7 Each potential diagnosis may present with different signs and symptoms. Because of the wide variety of potential co-occurring disorder combinations, creating a concise list of possible warning signs of a co-occurring disorder can be challenging. Nonetheless, several indicators may present in most cases regardless of the mental health condition occurring with addiction.
Mental health challenges and substance use disorders are often accompanied by behavioral changes. Many of these changes are sudden and surprising to friends and loved ones. Several examples of behavioral changes can occur with both addiction and co-occurring mental health conditions, such as mood swings, increased secrecy, aggression, lashing out in anger, increased risk-taking behavior, and a lack of interest in activities or hobbies they previously enjoyed.
Someone struggling with addiction and mental health symptoms will often go out of their way to avoid public events or socialize. This is especially true for many mental health conditions characterized by social anxiety or fear.
In addition, addiction may cause social isolation, as many make a conscious effort to drink or use a substance outside of the view of others. Many individuals strive to keep their addictive behaviors secret; therefore, when drinking or engaging in substance abuse, they will try to do so in private.
As with other warning signs, erratic behavior or impulsivity can characterize various mental health conditions or addiction. Several mental health conditions, including attention-deficit/hyperactivity disorder, schizophrenia, and borderline personality disorders, list erratic behavior as a symptom. Thus, an individual with any of these diagnoses (among several others) may display erratic behaviors as a symptom of their mental illness.
Additionally, increasingly erratic behavior and impulsive actions accompany SUD symptoms. For example, many substances lead to dangerous, impulsive, and erratic behaviors due to reduced inhibitions and changes in the brain caused by repeated use.
New or worsening financial issues are a frequent complication of addiction. Substance abuse often leads to significant spending to accommodate or satisfy the addiction, while mental health issues can lead to damaging life events. For instance, using savings to buy drugs or alcohol, quitting/getting fired from a job due to poor behavior or decisions, or owing money and growing debt from the inability to manage money. In addition, stealing from strangers, friends, and family can result from spirling behavior, losing control, and struggling to communicate for help.
Finally, significant changes in health and personal hygiene are another warning sign for co-occurring disorders. A substance can quickly become a priority over self-care, while mental health can prohibit the ability to care for themselves. For some, this may mean wearing ill-fitting or dirty clothing, and for others, it may mean not showering or caring for their bodies. Some may begin to lose teeth or hair due to poor hygiene and failure to take care of themselves.
Research and multiple studies have shown behavioral therapies to be successful in helping people with co-occurring conditions manage symptoms related to both conditions.8 Because co-occurring disorders share many overlapping symptoms, an integrated treatment that successfully addresses both alcohol or drug addiction and mental illness is vital to achieving lasting sobriety and recovery.
Many therapy models address mental disorders caused by addiction or psychological disorders stemming from drug use. Of the multiple therapeutic models for addiction and mental health treatment that professionals use, some are more widely used than others.
Another therapy model used in mental health and addiction recovery programs is dialectical behavior therapy (DBT). DBT is based on the cognitive behavioral therapy model; however, where CBT focuses on changing thoughts and behaviors, DBT focuses on regulating emotions and improving relationships. The goal of DBT is to examine patients’ emotions, validate why they feel this way, and use validation to elicit behavioral change.
Assertive community treatment (ACT) is an evidence-based treatment model that strives to help those with severe mental illnesses who struggle to live within their community. In many cases, people who benefit most from ACT have struggled to find success with traditional treatment programs, including outpatient therapy.
Therapeutic communities (TCs) are a form of long-term treatment for individuals struggling with addiction and mental health disorders.10 Most TCs utilize a residential approach (similar to sober living homes) where clients and providers live in the same environment. Though, many of today’s programs have evolved into day units or day treatment programs.
In addition to therapy, medication can be prescribed to alleviate symptoms caused by co-occurring disorders. For example, antidepressants may be given to help symptoms of depression, and certain medications can be used to help with the drug withdrawal process.
We at The PAC Program prioritize our patients’ well-being, health, and recovery. Our professional medical staff understands that each individual is unique and has their own situation and background. So, we offer various treatment options to ensure our patients receive the care needed for proper recovery. As a result, developing individually designed treatment plans that focus on the person and not their diagnosis provides the greatest opportunities for positive treatment outcomes. Here are the most common steps in the The PAC Program’s treatment process.
Detoxification, which is often the first step in treatment, is the process of ridding substances, chemicals, and toxins from the system. During detox, medical providers may prescribe certain medications to help reduce the intensity and severity of withdrawal symptoms. These medications can make withdrawal safer and more effective as they allow the patient to focus on healing rather than the discomfort caused by withdrawal.
Once detox is complete, the patient will work with their treatment team on a comprehensive treatment program that addresses both their mental health and substance use disorders. In some cases, medications are part of the treatment program. The use of medication depends on a range of factors unique to the person, including their current mental health, past struggles with addiction, and their reaction to medications. Mental health drugs can help manage symptoms, such as anxiety, mood swings, hallucinations, and agitation.
At The PAC Program, we combine individual, group, and family therapy settings with comprehensive, evidence-based therapy models proven successful in treating co-occurring disorders.
We are here to support our patients through each step of their recovery, beginning with detox and continuing through comprehensive aftercare. Our knowledgeable and compassionate staff can help you look towards tomorrow free from addiction and mental health challenges. If you are ready to start your recovery, contact us today for more information about co-occurring disorder treatment.
If you or a loved one needs help, please call us at
(888) 744-9969 and our team at Blueprints For Recovery in Arizona will help.