Written by Amethyst Recovery

Amethyst Recovery is a foremost authority on addiction and a trusted online source of substance abuse information. Their expert team of addiction professionals provide well researched content for people in the grip of addiction. All posts are fact checked and sourced.

Is There A Mental Illness and Substance Abuse Relationship?

People who suffer from various mental illnesses are also, unfortunately, more likely to struggle with substance abuse as well. There is a definitive link between mental illness and substance abuse. If someone seeks treatment for substance abuse, it’s important that their mental illness be diagnosed and treated at the same time.

If a mental illness isn’t diagnosed or treated during addiction treatment, it’s unlikely the person will be able to have a sustainable long-term recovery.

Of course, just because someone struggles with mental illness, it doesn’t mean they’re also addicted to a substance. The same is true in the opposite direction as well—not everyone with a substance use disorder has a mental health disorder aside from that addiction.

Unfortunately both mental illness and addiction can often have such a stigma that people are overwhelmed in terms of seeking treatment, or they don’t want to seek treatment because they fear they will be judged.

It is possible to seek treatment for both a mental illness and substance abuse simultaneously, and this is usually the most effective route.

According to the Substance Abuse and Mental Health Services Administration (SAMHSA), there are more than 43.6 million Americans aged 18 and up who have some form of mental illness. An estimated 20.2 million Americans had a substance use disorder in 2014. Of these people, 7.9 million had both a mental health and substance use disorder.

Speak to an Addiction Specialist Now

Co-Occurring Disorders Warning Signs and Symptoms

When someone has a substance use disorder and also a mental health disorder, it’s called a co-occurring disorder.

A mental disorder is a condition that causes a change in someone’s thinking, mood or behavior. A mental disorder can lead to someone having problems forming or maintaining relationships with others, and it can affect their life choices and decision-making.

There are different types of mental disorders, and they can also occur at varying levels of severity. Some of the most severe mental disorders cause visual and auditory hallucinations and distortions of reality.

Depending upon the mental disorder, some people may experience symptoms that begin at different points of their life. For example, with anxiety disorders, warning signs and symptoms may occur as early as age 6. Other mental disorders that may start to become apparent during childhood include attention deficit hyperactivity disorder and perhaps depression as well.

Some co-occurring disorders’ warning signs and symptoms don’t start to appear until adolescence or young adulthood, such as schizophrenia.

There is also a differentiation made among mental health disorders regarding whether they’re described as “serious.” Serious mental illness is a term that is used to diagnose mental illness or disorder that causes functional impairment and limitations in a person’s life.

Some of the serious mental illnesses that are most commonly diagnosed include major depression, bipolar disorder, and schizophrenia.

There are also what are called serious emotional disturbances or SEDs. This is a term that is used to refer to children and young people. Young people with an SED tend to have a level of functional impairment that causes difficulties for them at school, home, with family and in community activities.

Why Is There A Link Between Mental Health Disorders and Substance Abuse?

A substance use disorder is also a diagnosable condition, as is a mental health disorder. Substance use disorder refers to the continuing and compulsive use of drugs or alcohol. Substance use disorder is diagnosed by looking at the level of impairment it causes the person. For example, if someone has a substance use disorder, they may have difficulty functioning at school or work, and they may have problems with relationships, legal troubles, and financial difficulties.

According to SAMHSA, around 21.5 million Americans ages 12 and above had a substance use disorder in 2014. Of those people, SAMHSA estimated 2.6 million had a problem with both drugs and alcohol. 4.5 million reportedly had problems with just drugs, and 14.4 million had a problem only with alcohol.

While there are clear links between mental health disorders and substance abuse, which develops first can vary depending on the person. For example, some people might start having a substance use disorder, and then they may develop symptoms of a mental health disorder.

There’s debate as to whether that’s because the substance causes changes in the brain or the person always had an underlying condition, and substance abuse brought it to the forefront. It’s likely a combination of both.

Other people might long experience symptoms of a co-occurring disorder and they may turn to drugs or alcohol as a way to alleviate the symptoms and self-medicate.

There tend to be many contributing factors to both mental health disorders and substance use disorders that are the same or similar to one another. For example, family history, a history of trauma and the chemistry of a person’s brain are all important factors that play a role in mental health and substance abuse.

Understanding Self-Medicating and a Co-Occurring Disorder

It’s not entirely uncommon for people to self-medicate using drugs or alcohol. For some people, this may be something they do situationally. For example, they might drink more than they would typically during a stressful situation. For other people, self-medication can be something they do because they are coping with ongoing symptoms of mental illness.

Some of the drugs often use to self-medicate a co-occurring disorder include:

  • Stimulants such as cocaine or methamphetamine might be used for someone who’s self-medicating symptoms of ADHD, but also perhaps depression which can cause symptoms such as a lack of focus and fatigue
  • Central nervous system depressants, which include alcohol, opioids, and benzodiazepines, can help people feel more relaxed and reduce anxiety
  • Opioids including heroin and prescription pain medicines create euphoria and then relaxation.
  • Some people use marijuana as a way to relax and alleviate symptoms of mental health conditions like anxiety

Looking for Immediate Help?

Speak with a Specialist Now

The Most Common Dual Diagnosis Symptoms and Co-Occurring Disorders

Some of the most common symptoms of mental illness that people may want to self-medicate or deal with using drugs or alcohol can include hopelessness, a lack of motivation, intense sadness, and fear of being in social situations.

Major depression often occurs with cocaine addiction, while alcohol addiction tends to more often occur with anxiety and specifically social anxiety or panic disorders. People with severe mental health disorders may be more likely to experience polysubstance addictions. These severe mental health disorders can include schizophrenia and borderline personality disorder.

Some of the possible symptoms of co-occurring disorders, in general, can include:

  • Euphoria
  • Changes in appetite
  • Sleep changes
  • Sweatiness
  • Shakiness
  • Hyperactivity
  • Nausea
  • Vomiting
  • Changes in personality
  • Changes in performance at school or work
  • Rapid mood shifts
  • Paranoia

Is There a Difference Between Dual Diagnosis vs. Co-Occurring Disorders?

Dual diagnosis and co-occurring disorders are two terms for the same thing. There is no comparison between dual diagnosis vs. co-occurring disorders for that reason. Both dual diagnosis and co-occurring disorders refer to a situation where a person has a mental health disorder and a substance use disorder occurring at the same time.

If someone has an untreated co-occurring disorder, they’re more likely to experience difficulties and challenges.

For example, they’re more likely to experience an overdose, have problems with family and relationships, and they are more likely to stop taking their medication prescribed to them. If someone is struggling with a co-occurring disorder, they’re less likely to go to talk therapy or counseling, they may engage in risky activities, and they may be increasingly violent or aggressive.

What Is Dual Diagnosis Treatment?

Dual diagnosis treatment is a fairly new and integrative approach to treating addiction and mental health disorders at the same time. When someone receives integrated care for both their mental health disorder and their substance use disorder, outcomes tend to be better.

During dual diagnosis treatment, there is a consideration for how both the mental health disorder and the addiction affect with and interact with one another.

With dual diagnosis treatment, most people begin with detox. Then, they may participate in an inpatient rehab program. During this time, there is an in-depth evaluation to help understand not only the person’s history with substance abuse but also their mental health history. Once someone completes inpatient rehab, they may be recommended to a lower level of care. This could include partial hospitalization, outpatient rehab or a supportive housing environment.

Dual Diagnosis Medication

Dual diagnosis treatment usually brings together multiple treatment approaches. Most dual diagnosis programs will include psychotherapy, such as cognitive behavioral therapy.

Psychotherapy can help people understand their harmful, destructive ways of thinking, and they can then learn ways to change them. Psychotherapy can also help people learn how to reduce and manage stress and come up with healthy coping mechanisms rather than self-medicating with drugs or alcohol.

Along with psychotherapy, dual diagnosis very often includes medications as well. Certain medicines might be used to help someone as they detox from drugs or alcohol. Beyond that during treatment, they are likely to be prescribed certain medications that will help them manage the symptoms of their mental health disorder.

Dual Diagnosis and the 12 Steps

Support groups tend to be an integral part of recovering from an addiction to drugs or alcohol. Support and recovery groups can also play a role in a dual diagnosis treatment program. 12 step programs such as Alcoholics Anonymous and Narcotics Anonyms (AA and NA), are among the ones that people most commonly participate in. There are others as well. There is Cocaine Anonymous (CA) and Marijuana Anonymous (MA).

There are also 12-step programs specifically for people with a dual diagnosis. One is Dual Recovery Anonymous, and the other is Double Trouble in Recovery.

These kinds of programs are valuable not only because they help people abstain from alcohol, but they also prevent isolation and promote social support which is essential during recovery.

Along with participation in a support group, most people with a dual diagnosis are also referred to a therapist or counselor who they can see on a regular basis to ensure their symptoms remain under control. That person may also help them with medication management.

Speak to an Addiction Specialist Now

Dual Diagnosis FAQs

The following are some commonly asked questions about dual diagnosis and treatment for co-occurring disorders.

What Are the Symptoms of Dual Diagnosis?

When someone has a dual diagnosis, it’s difficult to say for sure what their symptoms might be. The symptoms of a dual diagnosis depend on the specific mental health disorder, the substance they are addicted to, and also them as an individual. There can not only be very different symptoms seen between individuals, but the severity of those symptoms can vary quite a bit as well.

How Common Is a Dual Diagnosis?

A lot of times people are afraid or nervous to seek help because they feel along. Having a mental health disorder and a simultaneous addiction is more common than they might realize. The Journal of the American Medical Association indicates that around 37 percent of people with an alcohol use disorder have at least one serious mental illness. 53 percent of people who abuse drugs are believed to have at least one serious mental illness.

Is There a Higher Risk of Suicide?

Unfortunately, when someone has a dual diagnosis, they are at a higher risk of attempting suicide. There is also a higher potential for violence to occur or harm to others. However, this can be treated and managed.

Can Any Rehab Center Treat a Co-Occurring Disorder?

When someone is looking for a rehab center for their addiction, a big consideration should be whether or not the center offers dual diagnosis treatment. Not every rehab center is equipped or able to provide dual diagnosis treatment. Without that, a person’s likelihood of having positive outcomes is significantly reduced. A rehab center should take an integrative and multi-disciplinary approach to treating the addiction and any psychiatric disorders at the same time.

If you would like to learn more about dual diagnosis treatment and co-occurring disorders, please reach out to Amethyst Recovery Center today. We provide dual diagnosis treatment and can answer any additional questions you may have.











Related Topics


24/7 Help for Drug & Alcohol Use

If you or someone you love is suffering from the addiction, there is no reason to delay. Start working on a solution today. Our phones are open 24 hours a day, 7 days a week. Our staff are trained to deal with drug and alcohol problems of any kind, and will recommend the right treatment for you based on your situation. Call now!

Call Us Now