A co-occurring disorder is the term utilized when an individual has both a mental illness and a substance use disorder. Both illnesses may affect a person physically, socially, psychologically and spiritually. Each has symptoms that interfere with a person’s ability to function effectively. The illnesses may affect each other, and each disorder predisposes to relapse in the other disease. At times, the symptoms can overlap and even mask each other, making treatment and diagnosis difficult. To fully recover, a person needs to address and treat both illnesses. Other names used to refer to a co-occurring disorder include co-morbid disorders, concurrent disorders, co-morbidity, dual diagnosis, and dual disorders.
It is challenging to determine conclusively how many people have a co-occurring disorder because research has often examined different populations and utilized different screening tools. Further, people with dual disorders are frequently misidentified as diagnosis can be more difficult because one disorder can mimic another. Research studies vary, but indicate that roughly fifty percent of individuals with serious mental disorders are affected by substance abuse and conversely, 37% of persons who abuse alcohol and over 53% of persons who use drugs also have at least one serious mental illness. Relapse rates for substance use are higher for people with a concurrent mental disorder, as are the chances that symptoms of mental illness will return for those with a concurrent substance use disorder.
Why is there such a strong relationship between mental illness and substance use? This too, can be difficult to determine, but a number of factors seem to come into play. Those with a mental illness can be very sensitive to the effects of drug abuse; not only can it be easier to abuse drugs, it can also be harder to quit. Drug use can interfere with prescribed medications, increase symptoms of a mental condition, and increase the risk of relapse. Some believe that an identity based on drug addiction or alcoholism is more acceptable than to admit that one has a mental illness. A person with co-occurring disorder may sincerely try to recover from one illness and not acknowledge the other. As a person neglects the mental illness, that illness may resurface. This recurrence may, in turn, lead a person to feel the need to “self medicate” through drug or alcohol use to combat symptoms of the mental illness or side effects of medications. However, such relief or change is temporary at best, and frequently leads to the need for hospitalization or other intervention.
Support for those with co-occurring disorders has traditionally been scattered. Programs historically have not addressed the unique problems of those struggling with both disorders, instead treating the mental illness and substance use as separate problems. This has not proven to be an effective approach. Ideally, both problems should be addressed simultaneously and more programs, including Community Alliance, are trying to enhance their efforts to assure that individuals with co-occurring disorders are welcomed and assisted by their services.
Information was gathered on this topic and additional resources are available from the following sources:
Substance Abuse and Mental Health Services Administration (SAMHSA)
National Alliance on Mental Illness (NAMI)