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Why Are Co-Occurring Disorders So Common?

May 24, 2022

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By Anna McKenzie

“Co-occurring disorders,” sometimes referred to as a “dual diagnosis” or “comorbidity,” is a term used to identify when a person has both a substance use disorder and a mental health condition. The incidence of co-occurring disorders is fairly common because of the way a person’s physical condition and their mental and emotional state affect each other. Addiction and mental health disorders often perpetuate each other: People may seek out substances to self-medicate mental health symptoms or they may develop a mental health condition due to the effect of substances on the body. While a serious drug or alcohol addiction may seem to take precedence, both conditions need to be treated so that a person can live a fulfilling life in recovery.

How Common Are Co-Occurring Disorders?

How common are co-occurring disorders? According to the National Institute on Drug Abuse (NIDA), roughly 50% of people who experience a mental health condition will also experience a substance use disorder (and vice versa). About 25% of people with a serious mental illness also have a substance use disorder. 

Physical health and mental health are intricately connected. Chemical imbalances in the body and brain can have a number of effects, including severe mood swings, depression, anxiety, fatigue, or alternatively, overstimulation. These can fuel a lack of nutrition, weight gain or loss, suicidal ideation, a negative outlook on life, and even a decreased ability to heal.

Conditions like bipolar disorder, personality disorders, and schizophrenia tend to have a high rate of co-occurring substance use due to a desire to control unwanted thoughts, feelings, or impulses. The pervasive nature of depression and anxiety conditions can also fuel a person’s desire to self-medicate with substances. The layering of these conditions can not only alter a person’s view of their life and reality — increasing their hopelessness — but it can foster self-isolation and a sense of shame that keeps that person from seeking treatment.

The development of co-occurring disorders is caused by a number of factors. People are more susceptible to develop mental health conditions or substance use disorders if they have a history of trauma or abuse; however, environment, personality, background, and physiology all factor into whether a person may ultimately present with co-occurring disorders. Further research from NIDA indicates as many as 40-60% of people are genetically predisposed to substance use disorders, though, as mentioned, a number of other factors play a role in whether an addiction will actually develop.

Further research from NIDA indicates as many as 40-60% of people are genetically predisposed to substance use disorders.

Addiction and Co-Occurring Disorders Risk Factors

There are some risk factors for addiction and co-occurring disorders. While these increase the likelihood that a person will develop these conditions, every person is unique. Some may present with co-occurring disorders, and some may never develop either condition. It’s worthwhile to know the risk factors and to be able to spot the signs of addiction and mental health conditions as they progress. With intervention and treatment, those with co-occurring conditions can heal and live fulfilling lives in recovery.

Here are a few risk factors for addiction and co-occurring disorders from NIDA:

Genetics and environment

While both can influence a person’s likelihood of developing co-occurring disorders, they can also interact with each other, causing changes in gene expression that can foster predisposition in family lines.


Stress is known to have a number of adverse effects on the body, and higher levels of stress can decrease motivation and increase impulsivity. 


Trauma is a complex condition that can get more severe over time. As a person encounters triggers from past experiences or repeated incidences of trauma, they are more susceptible to developing an addiction or mental health condition. 

Intervention and support are key to helping a person get back on track and start feeling like themselves again.

If you or someone you know is experiencing an increase in mood swings, negative thinking, or impulsive behavior, start asking questions or consult a treatment professional. If that person becomes more isolated, their eating and sleeping patterns become erratic, or they become evasive (even lying or stealing); they may be experiencing the effects of an addiction or mental health condition. Intervention and support are key to helping a person get back on track and start feeling like themselves again.

Common Co-Occurring Disorders

What are some common co-occurring disorders? According to NIDA, the following are mental health conditions that regularly coincide with drug or alcohol addiction:

  • Anxiety disorders (including generalized anxiety disorder, panic disorder, and PTSD)
  • Depression
  • Bipolar disorder
  • Attention deficit hyperactivity disorder (ADHD)
  • Psychotic illness
  • Borderline personality disorder (BPD)
  • Antisocial personality disorder (ASPD)
  • Schizophrenia

Also not uncommon is for those who are receiving mental health treatment to be using the following substances, says the Substance Abuse and Mental Health Services Administration (SAMHSA):

Because these addictions and mental health conditions can perpetuate each other, it’s important that both are treated simultaneously to help prevent relapse. Our treatment professionals can diagnose co-occurring conditions and offer a comprehensive plan for recovery.

Co-Occurring Disorders Treatment at The Meadows

Here at The Meadows, we have research-backed treatment programs that provide evidence-based practices for treating addiction and mental health conditions in the same setting. We are experts at co-occurring disorders treatment, and we would love to help you or your loved one start the journey to a new, fulfilling life in recovery. Contact us today to learn more about how we can help.