Co-occurring disorders are a medical concern that impacts millions of individuals worldwide. But, exactly, what does the phrase imply?

The presence of two diseases or illnesses in the same person is known as co-occurring disorders. Although this word can apply to any combination of illnesses and diseases, it is most commonly used to describe someone who has a drug use problem as well as another psychiatric ailment (e.g., severe depression). Symptoms from both illnesses may interact to affect the course and prognosis of both. These illnesses affect the individual at the same time, and they all affect the same parts of the brain. Dual diagnosis and co-occurring disorder are terms that are used interchangeably.

Co-occurring disorders might be one mental health problem and one drug use disorder, or they can be a combination of addictive and psychiatric disorders. Many persons who have been diagnosed with depression, for example, will struggle with both an alcohol use problem and a painkiller addiction. Those who suffer from Post Traumatic Stress Disorder (PTSD) may also be depressed or have a drug addiction issue.

While certain co-occurring illnesses are more prevalent than others,  any combination of addiction and mental illness is termed a "co-occurring condition." The following are some examples of common co-occurring disorders:

• Depressive disorders and alcoholism.

• Anorexia nervosa and cocaine addiction.

• Post-traumatic stress disorder (PTSD) and heroin addiction.

• Anxiety disorders and prescription medication abuse.

• Marijuana addiction and ADHD.

Co-occurring disorders are widespread, recurring, and often deadly illnesses. They are, however, quite curable, and many patients do recover with the right therapy.

How common are co-occurring disorders?

Co-occurring disorders affect about eight million people in the United States today. They may impact people of all ages and from all areas of life, according to the Substance Abuse and Mental Health Administration. Those who have been diagnosed with a mental illness, on the other hand, are twice as likely to develop a drug abuse problem. The same may be stated for the other way around. Those who struggle with drug abuse are twice as likely to have a mental health problem.

What causes co-occurring disorders?

When it comes to co-occurring disorders, either the drug use disorder or the mental health illness might emerge first. People who are suffering from a mental illness frequently turn to drugs or alcohol to help them cope with their symptoms (this is called self-medication). In some circumstances, people have used drugs or alcohol for a long time, causing or exacerbating psychological issues. Certain substances, or long-term substance use, has been shown in studies to increase the symptoms of mental illness.

A person's vulnerability to acquiring a co-occurring disorder is increased by the following risk factors:

• Any type of mental disease.

• Substance misuse that occurs often.

• Inadequate treatment for one or both of the aforementioned condition.

• A painful life experience or a history of trauma.

• A familial or genetic history of mental illness and/or addiction.

It might be challenging to diagnose co-occurring conditions. Substance abuse or addiction symptoms can conceal indications of mental illness, and mental disease symptoms might be confused with addiction symptoms. People who suffer from mental illnesses may fail to address their drug abuse because they do not feel it is related to their difficulties.However, there are certain common tendencies among people with co-occurring disorders.

Even while undergoing therapy, mental health issues increase. Those who have been diagnosed with mental illnesses frequently take drugs to help them feel better. People who are anxious may desire something that will make them feel cool and collected; people who are depressed may desire something that will make them feel more energetic; people who are afraid of others may desire something that will make them comfort and less restricted; and people who are in psychological pain may desire something that will make them feel numb.

Using alcohol or other drugs can not only fail to treat a mental health issue, but it also stops a person from acquiring effective coping skills, having rewarding relationships, and feeling comfortable in their own skin. Alcohol also interferes with the effectiveness of antidepressant drugs. In summary, drug and alcohol abuse exacerbates mental illnesses.

People with co-occurring disorders may be able to quit using alcohol or other substances, but they will continue to struggle as long as the symptoms of their mental illnesses persist. Treatment facilities, physicians, and addiction experts may not be equipped to deal with both issues. Furthermore, some traditional peer recovery groups may require complete abstinence from all drugs, even those prescribed for mental health conditions. As a result, addressing drug abuse problems without simultaneously treating mental health issues is extremely challenging for those with co-occurring illnesses.

Causes

A variety of variables contribute to mental health and drug use issues. Certain people are at a higher risk of developing such diseases due to their genetic makeup, but the environment can also play a role in their development. Alcohol use disorder, for example, is linked to illnesses like bipolar disorder, schizophrenia, and antisocial personality disorder, according to the DSM-5, and alcohol use disorder may also be linked to certain anxiety and depressive disorders. Other substance-related problems frequently co-occur with mental disorders. It's conceivable that a drug use disease, such opioid use disorder and depressive disorders, contributes to the development of additional mental health issues or worsens an existing illness.

Treatment

• The Substance Abuse and Mental Health Services Administration (SAMHSA) advises an integrated treatment strategy to offer appropriate treatment for co-occurring disorders. Instead of treating each illness independently without regard for the other, integrated therapy entails combining drug addiction and mental health therapies.

• Behavioral treatments, such as cognitive-behavioral therapy or dialectical behaviour therapy, are frequently used in integrated treatment to assist enhance coping skills and minimise maladaptive behaviours. These can be used in conjunction with prescription medications. Collaboration between physicians and groups that provide assistance with matters such as housing, health, and job may be part of treatment.

• As part of programmes to treat co-occurring disorders, psychoeducational seminars can help improve awareness of disease symptoms and the relationship between mental illness and drug addiction.

Dual-recovery groups, whether on-site or off-site, can help in recovery by providing a safe place to talk about mental symptoms, medication, substance-related urges, and coping methods.

• Answering the question, "Did the drug addiction issue or the mental health illness begin first?" is not always straightforward. In some situations, the drug abuse problem appears to have preceded the mental illness, whereas in others, the mental illness appears to have before the substance misuse problem.

• Some medicines are considered to possibly elicit or imitate symptoms of certain mental diseases, which might, in some situations, lead to the development of more long-term mental problems if used repeatedly. Cannabis and cannabis-related psychosis are one example of this.

In this case, nicotine appears to have a minor therapeutic impact on some of the symptoms of schizophrenia, and people with schizophrenia are far more likely to have tobacco use issues. It's worth noting, too, that tobacco use disorder frequently co-occurs with other mental health issues including anxiety and mood disorders. According to a third point of view, drug use disorders and other mental health illnesses share many risk factors and are frequently linked to particular environmental events such as physical or emotional abuse. As a result, the emergence of both a mental health and a drug use disease merely demonstrates a common predisposition to co-occurring disorders.