Treatment for Co-Occurring Disorders

Last Updated: October 16, 2023

Co-occurring disorders occur when an individual is diagnosed with a mental health disorder and a substance use disorder, the clinical term for a drug or alcohol addiction. In 2019, 9.5 million American adults had co-occurring mental health and substance use disorders. 

Co-occurring disorders require more complex treatment because each condition affects the other. At Orlando Recovery Center, dual diagnosis treatment simultaneously addresses the patient’s substance use and mental health disorders for the most successful recovery outcomes.

What Are Co-Occurring Disorders?

Co-occurring disorders, otherwise known as dual diagnosis, refer to a substance use disorder, like alcohol addiction, co-occurring with a mental health disorder, like depression or anxiety.

Risk factors for co-occurring disorders include genetics, environmental factors, history of trauma and difficult childhood experiences, but there is no direct cause. In many cases, people turn to substances to cope with mental health issues or to self-medicate. For others, substance abuse can initiate or worsen mental health symptoms due to changes in the brain. 

Symptoms of Co-Occurring Disorders

Only a mental health professional can diagnose a mental health or substance use disorder, but being able to recognize the symptoms of co-occurring disorders may tell you when it’s time to get help. In general, these symptoms can include: 

  • Isolating or avoiding relationships with family and friends
  • Sudden changes in behavior
  • Difficulty managing daily life
  • Risky behavior
  • Poor hygiene habits
  • Using substances in unsafe places
  • Feeling like substance use is out of control
  • Needing more of the substance to feel the same effects as before
  • Needing to use substances to feel normal
  • Feeling withdrawal symptoms if you stop using the substance

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Types of Co-Occurring Disorders

Many different mental health issues can co-occur with substance use disorders, though some occur more frequently than others. Regardless, only a qualified mental health professional can diagnose a mental health disorder. 

Eating Disorders 

People with eating disorders experience severe, persistent disturbances in their eating behavior, and feel distressing thoughts and emotions about eating. This group of conditions includes anorexia, bulimia, binge eating disorder, pica and others. Eating disorders develop most often in adolescence and young adulthood, and affect up to 5% of the population. 

According to the National Eating Disorders Association (NEDA), up to 50% of individuals with eating disorders have abused alcohol or used illicit drugs, at a rate 5% higher than the general population. One study found that alcohol and amphetamines in particular were associated with the risk for an eating disorder in both men and women. Among the women studied, their risk for an eating disorder was also associated with illicit drug use. 

Anxiety Disorders

People with anxiety disorders have chronic worry or fear that interferes with daily functioning, can worsen over time, and does not go away. There are several different types of anxiety disorders, including generalized anxiety disorder (GAD), panic disorder and phobias. 

Research has shown that anxiety disorders and substance use disorders often co-occur. Anxiety disorders and substance use disorders are also the most common psychiatric issues in the United States. Among anxiety disorders, GAD and panic disorder are the most likely to co-occur with substance use disorders. 

Mood Disorders 

mood disorder is a mental health condition that affects emotional states, leading to extreme sadness or happiness. Depression and bipolar disorder are examples of a mood disorder. These symptoms must be present for several weeks or longer to be diagnosed with a mood disorder. Substance use disorders are present in 32% of all people diagnosed with a mood disorder, and heavy substance use can induce mood disorders due to long-lasting physical changes in the brain brought on by substance use. 

Personality Disorders

People with personality disorders have long-standing patterns of thinking and acting that differ from what society considers typical. Symptoms of personality disorders can have significant adverse effects on relationships and make it difficult to work and care for oneself. 

People struggling with substance use are much more likely to have a personality disorder than the general population. A recent study estimated that roughly 10–14% of the general population had a personality disorder, compared to 34–73% of people being treated for addiction. 

Post-Traumatic Stress Disorder (PTSD)

Post-traumatic stress disorder (PTSD) is a chronic stress response that stems from exposure to traumatic events. PTSD and addiction have strong links. Both chronic substance use and PTSD create long-term changes in the brain. Research has shown that close to 50% of people with PTSD also have a co-occurring substance use disorder.  

Dual Diagnosis Treatment

As with most mental health treatments, the approach will depend on the specific diagnosis that is being addressed. Each mental health disorder would likely be treated differently, with the common thread being the substance use disorder. The first step would be to assess any medical needs that the individual might have, such as the need for medical detox

Once any medical needs have been addressed, secondary factors can be treated. For example, cognitive-behavioral therapy (CBT) has proven effective for treating both anxiety disorders and substance use disorders. Many substance use disorders arise as an attempt to cope with underlying mental health issues, which is why both diagnoses must be treated simultaneously. With the right treatment, the urge to use substances will lessen as mental health-related symptoms dissipate. 

Treating co-occurring disorders is complex. It requires careful deliberation and the ability to think with agility and utilize compassionate care practices. 

If you or a loved one is struggling with symptoms of co-occurring disorders, help is available. There are many programs that are specific to co-occurring disorders. The Orlando Recovery Center is a dual-diagnosis treatment facility that provides integrated and compassionate care. Contact us today to learn more about what recovery can look like for you.


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American Psychiatric Association. “What Are Eating Disorders?” March 2021. Accessed December 6, 2021.

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National Eating Disorders Association (NEDA). “Substance Abuse and Eating Disorders.” Accessed December 6, 2021.

National Institute of Mental Health (NIMH). “Anxiety Disorders.” Accessed December 6, 2021.

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