What On Earth is a Co-Occurring Disorder?

Mental health disorders and substance use disorders often occur at the same time. In a way, this fact makes perfect sense. The state of our mental health and the quality of what we put into our bodies go hand-in-hand. After all, our brain is a part of our body, and our body is intrinsically connected to our brain. When someone has both a diagnosed mental illness and a substance use disorder, these are referred to as “co-occurring disorders.”


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It’s easy to understand why a person who struggles with a persistent mental health condition would try to seek relief in any way possible, even if that meant turning to drugs, alcohol or an addictive behavior like gambling to find some temporary relief.

Similarly, it would be hard to imagine not feeling depressed or anxious if you were in the midst of a severe addiction. When toxic substances enter the body, everything is impacted, including the brain. Substance abuse and the temporary, inconsistent flood of dopamine from addictive behaviors can bring an undiagnosed mental illness to the surface or worsen an existing mental disorder.

Co-occurring Disorders by the Numbers

The Substance Abuse and Mental Health Services Administration (SAMHSA) estimates that over 7.9 million American adults have co-occurring disorders. The problem is actually quite common, yet many people avoid treatment because they are afraid of the stigma associated with both of these issues or they simply don’t know where to go for good help.



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Most mental health conditions and addictions begin slowly. Often, people are unable to determine just when the problems got serious. Sometimes, a mental health condition has gone on so long, the person who suffers with it isn’t even aware of it — life with a mental illness just feels like normal, everyday life. Unfortunately, life with a mental illness is often miserable and stressful for the person who struggles. Untreated mental illness is isolating, it can be frightening, and it is often very discouraging to experience.

The Self-medicating Lie

Sometimes people try to feel better through the use of drugs or alcohol. No one wakes up and says, “Hey, I can’t wait to be an addict!” Most people first use substances in an effort to feel less anxious or depressed, more socially comfortable, in an attempt to self-soothe, to ease physical or emotional pain, to numb memories of trauma or in an attempt to fit in with peers. Eventually, using substances becomes habit, and the habit grows until it no longer works. By that time, most people are already fully stuck in the muddy cycle of trying to maintain some semblance of feeling “okay” through continued substance use.

While all this is happening, people who use substances are fully aware of the stigma that comes along with addiction. They know that they are not engaging in healthy behavior and they probably understand, deep down, that the behavior is problematic. The problem continues when the addicted person must battle both the addiction and any emotional or mental health concern that accompanies it. It’s like a double-whammy, and it makes it very difficult to climb your way out once you are already in that rut.

Stopping the Cycle

So, what is the best way to get out of a nasty cycle of addiction? Most people agree that any type of healing begins when we fully examine our lives and admit there is a problem. That admission doesn’t necessarily mean you are ready to change the problem, though.

Change is scary. Letting go of a behavior that helped you feel better at one point in time is not easy. Recovery requires a good bit of determination and a little bit of help. You may feel like you are all alone, but the chances are very high that someone out there in this wide world understands.

“My advice would be that as hard as it’s going to be at the beginning, and as scary as it’s going to be, walk through the fear and your life will change. Life can be great.” – John K. shares with Heroes in Recovery.

Addiction and mental illness isolate us. Healing only truly begins when we accept help from others. Humans were not meant to live isolated lives. Chances are, someone out there will understand what you are going through. The power of connection is one of the biggest weapons against a co-occurring disorder. A quality rehab program should understand this and empower you to connect with yourself and with others. Similarly, most 12-Step groups are centered around the concept of community, and they offer a great place to meet others who share the same goals of recovery and a better life.

It isn’t easy to live with a mental health disorder or an addiction. It’s like trying to live the normal life everyone else lives but with a very heavy obstacle in front of every goal. Fortunately, modern medical science has shown us that both of these conditions have neurobiological causes. These are physiological issues, not issues of how moral or strong you are. Even better, these conditions are treatable.

Even if you have sought treatment in the past, new approaches, new medications and new medical interventions are being released every day. So don’t give up. While one condition may feed the other, it is possible (and even preferable!) to treat both mental health and addiction issues at the same time. It’s even possible that with the right treatment you can live free from the struggles that created the addiction in the first place.

By Kathryn Millán, MA, LPC/MHSP

A writer for The Life Challenge

Also known as the L+C, is a recovery initiative to support those who have, and will, face challenges. Whether your challenge is getting out of bed in the morning, reconnecting with a loved one, or making strides towards a personal goal, we are here for you. We are a positive and motivational community. Together we will break down life’s barriers and celebrate the accomplishments along the way.




1. SAMHSA. Co-Occurring Disorders. March 2016. Web. Retrieved 20 Nov 2017.