What is a Co-Occurring Disorder?: A Comprehensive Overview

What is a co-occurring disorder? Why is it important to pursue dual diagnosis treatment? Find out here.

What is a Co-Occurring Disorder?

A co-occurring disorder is often also known as a dual diagnosis. Dual diagnosis refers to having mental health and a substance use disorder at the same time.1

With dual diagnosis, each disorder can worsen the symptoms of the other. The complex interaction often leads to more severe symptoms and complicates treatment.

With dual diagnosis, each disorder can worsen the symptoms of the other. The complex interaction often leads to more severe symptoms and complicates treatment.

what is a co occurring disorder

Integrated Approach to Dual Diagnosis Recovery

Co-occurring disorders present unique challenges in diagnosis and treatment. Individuals with co-occurring disorders need an integrated approach to address both diagnoses at the same time rather than solely treating the subsequent symptoms.
If treating only one, the untreated disorder may continue to fuel the other. This untreated disorder can hinder recovery. If left untreated, it may lead to a worsening of both conditions.

What to Expect From This Article

This article aims to answer the question, “What is a co-occurring disorder?” and its prevalence. It will also explain the symptoms and risks that come with dual diagnosis. It will also discuss the various treatment strategies that are used to address dual diagnosis.

By understanding the common patterns of co-occurring disorders, individuals can make informative decisions about finding treatment.

How Common Are Co-Occurring Disorders?

Co-occurring disorders are common. Research studies have estimated that 7.7 million adults may have a co-occurring condition.2 The exact cause of co-occurring disorders is not known. However, some factors contribute to dual diagnosis.3
Understanding these factors is critical for early intervention and treatment of co-occurring disorders. Finding comprehensive treatment for both diseases can help break the cycle and promote recovery.
Some factors that could cause co-occurring disorders include:

Genetic Factors

Individuals may have a genetic predisposition to mental health disorders or substance misuse. Genetics can increase the likelihood of developing co-occurring conditions.

Environmental Factors

Exposure to harmful environments can contribute to developing a co-occurring disorder. These toxic environments might include:
  • Chronic stress
  • Trauma
  • An environment where substance use is regular
  • Family history
  • Peer pressure
  • Social environment

Psychological Factors and Self-Medication

Those struggling with mental health issues might turn to substances to self-medicate. Self-medication is an attempt to ease symptoms of the mental health condition without consulting a healthcare professional.
Examples of self-medication include:
  • Illicit drugs
  • Alcohol
  • Nicotine
  • Food
  • Self-ham

Self-medication can lead to addiction or substance use disorder (SUD). This approach creates a cycle where each disorder worsens the other, only exacerbating symptoms and challenges.

Neurobiological Connections

Both mental health and substance use disorders can affect the same brain areas. These are often those related to reward and stress.4 This can create vulnerability where one disorder increases the risk of the other.

Societal and Economic Factors

Lack of access to healthcare can also contribute to co-occurring disorders. Treatment for disorders is extensive and can be costly. Some insurance providers do not cover this treatment. The stigma surrounding mental health might prevent someone from seeking help.5

Challenges in Seeking Treatment for Co-Occurring Disorders

Individuals with co-occurring disorders face many challenges when seeking treatment. The interaction between conditions can make treatment more complicated. If left untreated, these disorders can often worsen.

Challenges in Seeking Treatment

Here are some challenges when seeking co-occurring disorder treatment and what can happen if left untreated:
  • Difficulties in differentiating between symptoms of mental health disorders and substance use
  • Limited access to specialized care and finding facilities trained in treating co-occurring disorders
  • Societal stigma can deter individuals from seeking help
  • Financial barriers to treatment can be expensive, and insurance coverage limited
  • Coordinating care between mental health and addiction services might also be challenging
  • Substance use or mental illness may impair motivation and engagement in treatment

Exacerbation of Conditions if Left Untreated

Individuals with co-occurring disorders face challenges in accessing and engaging in effective treatment. Finding specialized and empathetic care is essential to promoting recovery. If left untreated, these conditions can greatly impact a person’s well-being.
Here are some of the risks that come with not treating co-occurring disorders:
  • Mental health issues may drive an individual to misuse substances as a form of self-medication. Also, substance abuse can worsen mental health symptoms
  • Without treatment, the symptoms of both disorders can worsen
  • Chronic substance abuse can lead to various health complications. At the same time, untreated mental health conditions may contribute to self-neglect or other risky behaviors
  • Co-occurring disorders can lead to social issues and creates barriers to recovery
  • Treating one disorder while ignoring the other can lead to chronic relapses

Diagnosing Co-Occurring Disorders

What is a co-occurring disorder, and how are they diagnosed? Diagnosing co-occurring conditions is a complex process. It is difficult to identify and understand two connected but distinct conditions. Careful evaluation is essential. It helps to differentiate between the symptoms and address both disorders.
Diagnosing co-occurring disorders requires a nuanced approach. It involves careful evaluation to understand the complex interactions. But an accurate diagnosis is critical to provide effective treatment and support recovery.

What do Healthcare Professionals Look for During Diagnosis?

The diagnostic process begins with screenings and comprehensive assessments.6 These assessments include a detailed understanding of the individual’s history.
Screenings often include:
  • Medical history and physical exam
  • Substance use history
  • Family background
  • Current symptoms
  • Previous diagnoses or treatments
Professionals use standardized screening tools designed to identify symptoms. The Structured Clinical Interview for DSM-V (SCID-5) is an example of a standardized screening tool.7 This is an interview guide for making DSM-5 diagnoses.
Information from family members, friends, or other healthcare providers is also valuable. This information creates a comprehensive picture of the individual’s behavior and symptoms.

Strategies to Differentiate Symptoms

Healthcare professionals use various strategies to differentiate symptoms of co-occurring disorders. Some examples include:
  • Timeline Monitoring: Professionals analyze the timeline of the onset of symptoms. This can help distinguish between substance-induced symptoms and an independent mental health disorder. For example, if mental health symptoms were present before substance use, it may show a separate mental health condition.
  • Detox Observations: If substance misuse is present, observing symptoms during detox can help. This approach helps to determine whether the mental health symptoms are independent of substance use.
  • Diagnostic Criteria: Healthcare professionals use diagnostic criteria to differentiate mental health and substance-induced disorders.
  • Professional Collaboration: Healthcare professionals collaborate with addiction and mental health professionals. Collaboration ensures a more accurate diagnosis.

Common Patterns of Co-Occurring Disorders

Co-occurring disorders can present themselves in various patterns. Certain mental health conditions are often linked to specific substances. These patterns are often nuanced and can vary based on the types of mental health disorders and substances involved.
Notably, some mental health conditions tend to have stronger links with specific substances. Understanding these patterns is vital for diagnosis and treatment.

Mental Health Conditions Linked to Substance Use

Some examples of common mental health conditions linked to substance use disorder include:


Many individuals with depression often use alcohol to ease symptoms. Almost one-third of those with major depressive disorder also have problems with alcohol.8

Anxiety Disorders

Those with anxiety disorders might misuse benzodiazepines or alcohol to reduce symptoms. 26% of people prescribed benzodiazepines reported a lifetime history of misuse.9

Anxiety and alcohol use is common as well. About 20% of those with social anxiety also suffer from alcohol use disorder (AUD).10

Bipolar Disorder

People with bipolar disorder might misuse stimulants like cocaine during manic phases. They may misuse alcohol during depressive phases. Reports show that people with Bipolar Disorder have a 21% to 59% increased risk of also having a substance use disorder.11


Individuals with schizophrenia have higher rates of alcohol and cannabis use. 50% of those with schizophrenia have a co-occurring substance use disorder. The most frequent ones being alcohol or cannabis.12

Post-Traumatic Stress Disorder (PTSD)

Those with PTSD might turn to substances to numb trauma-related symptoms. According to some studies, 46.4% of individuals with PTSD also met the criteria for a substance use disorder.13

How Co-Occurring Disorders Impact Treatment Approach

Co-occurring disorders can impact treatment approaches. They often need a more complex treatment strategy. Addressing both conditions at the same time is essential.
They integrate treatment to manage all aspects of both disorders by:
  • Addressing the complexity of assessment and planning
  • Utilizing a multidisciplinary team
  • Extending treatment length and offering ongoing follow-up care
  • Educating individuals about the relationship between mental health and substance use disorders
Addressing both mental health and substance abuse is essential for adequate recovery. This approach acknowledges the complex nature of the disorders and general well-being. The comprehensive treatment approach can provide long-lasting recovery.

Therapeutic Interventions for Co-Occurring Disorders

When researching “What is a co-occurring disorder?”, some individuals may wonder how it is treated. Effective treatment employs various therapeutic interventions. These interventions should recognize the unique needs and challenges of each individual.
By embracing an integrated approach, improving the quality of life and supporting sustained recovery is possible. Some examples of interventions include:

Integrated Dual Diagnosis Treatment (IDDT)

This approach combines substance abuse with mental health services.14 It recognizes that an integrated approach is the most effective treatment of co-occurring disorders.

Cognitive-Behavioral Therapy (CBT)

CBT can treat both mental health and substance use disorders. It helps individuals recognize and change negative thought patterns and behaviors. At the same time, CBT teaches coping skills for both conditions.15

Dialectical Behavior Therapy (DBT)

DBT is a form of CBT. It is effective for individuals with mood disorders and substance use disorders.16 This therapy emphasizes:
  • Mindfulness
  • Emotional regulation
  • Interpersonal effectiveness

Motivational Interviewing (MI)

MI helps individuals find the motivation to change their behavior and engage in treatment. This person-centered therapy focuses on using the individual’s own incentives to make positive changes. MI is beneficial for those struggling with addiction.

Medication Management

Medications are often prescribed to manage mental health symptoms and withdrawal. Typical psychiatric drugs are used to treat mental health. Medication-assisted treatment is often used to treat withdrawal and reduce cravings.

Advancements in Co-Occurring Treatment

There have been a variety of advancements in treatment approaches for co-occurring disorders. These advancements have significantly impacted how to understand and treat these disorders.
The integration of these advancements has revolutionized the care for co-occurring disorders. These advances have facilitated more comprehensive and evidence-based approaches. These approaches recognize the complex nature of these disorders.
Integrated treatment models have helped to address the impact of co-occurring disorders. Some integrated approaches include the following:

Holistic Approach

Integrated treatment models treat the individual as a whole. This approach makes sure to address both disorders. Including holistic approaches in treatment allows the individual to focus on their overall well-being.
Some examples of holistic methods used in treatments are:
  • Meditation
  • Yoga
  • Mindfulness practice
  • Gratitude journaling
Holistic approaches help individuals recognize the connection between the physical, psychological, and emotional factors of a person’s well-being.

Tailored Treatment Plans

Personalized treatment plans are essential for recovery success. These plans are based on assessing the individual’s needs, challenges, and strengths. Tailored treatment plans ensure individuals are given the proper treatment course that best fits their recovery goals.

Comprehensive Care from Healthcare Professionals

Various healthcare professionals work together to create the best treatment plan for individuals. By coordinating care across professionals and services, healthcare professionals can reduce missed diagnoses and conflicting treatments.

Focus on Recovery

Integrated models often emphasize long-term recovery and quality of life. Focusing on recovery can provide ongoing support and resources to help individuals maintain progress and build fulfilling lives.

Neurobiological Insights

Besides using integrated treatment models, there have been several advancements in understanding the brain’s response to co-occurring disorders.17
Understanding the brain’s responses has highlighted the connected nature of these disorders. This has reinforced the importance of treating both conditions at the same time.
Advances in neuroscience have provided a better understanding of the brain mechanisms of these conditions. This understanding has led to more targeted treatments, including medication and therapy techniques.

Impact of Neurobiological Insights and Developments

Insights into how the brain functions have led to new and more effective therapies. These include techniques that target specific pathways involved in mental health and addiction.
what is a co-occurring disorder

How South Shore Recovery Center Can Help You Heal

If you are wondering, “What is a co-occurring disorder?” and how to treat it, South Shore Recovery Center can help. Navigating the complexity of co-occurring conditions is challenging. It often requires specialized care and a compassionate approach.
At South Shore Recovery Center, we understand the unique challenges of co-occurring disorders. We are committed to providing you with a personalized approach to healing that meets your recovery goals.

Located in Plymouth, Massachussettes, our facility offers individuals a peaceful setting to focus on their treatment. We are here to help you overcome addiction and heal from co-occurring disorders.

Our Restorative Approach to Recovery

Our experienced staff will work with you to create a personalized recovery plan that addresses mental health and substance use conditions.
Our kind and knowledgeable South Shore Recovery Center team provides insightful information about co-occurring disorders for participants. This education helps individuals better understand their conditions.

South Shore Recovery Center’s Personalized Treatment Opportunities

Our team recognizes the benefits of utilizing a multifaceted approach for treating co-occurring disorders. We offer various therapeutic interventions and holistic practices to ensure a comprehensive treatment meets your needs.
Some of our treatment opportunities include:
  • Day Treatment Programs (DTP)
  • Half-Day Treatment Programs (HDTP)
  • Outpatient Drug Programs
  • Drug Rehab Aftercare
  • 12 Step Model
  • Art Therapy
  • Educational Support and Guidance
  • Harm Reduction Techniques
  • Motivational Enhancement Therapy (MET)
  • Psychoeducational Groups
  • and more

Take the First Step Toward Recovery Today

Don’t wait to take the first step toward recovery. Reach out to South Shore Recovery Center today to begin healing, putting you one step closer to the healthy, happy, and uninhibited life you deserve.

Table of Contents

Questions About Treatment?

If you or your loved one are ready to begin healing from substance use disorder or mental health challenges in Plymouth, Massachusetts, South Shore Recovery is here for you. Let us guide you on your journey toward sustainable wellness by reaching out to our knowledgeable and compassionate team today.