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Co-Occurring Disorders: When Substance Use and Mental Health Interact

During treatment for substance use disorder (SUD), other issues beyond the main problem of addiction are identified in order to best help the patient succeed in achieving recovery. These issues take form in co-occurring disorders – defined as any mental health disorders that are present at the same time as SUD. This is also known as “dual diagnosis.” Some of the most common co-occurring disorders noted in patients with SUD are:

  • Generalized anxiety disorder
  • Eating disorders
  • Bipolar disorder
  • Post-traumatic stress disorder (PTSD)
  • Attention deficit hyperactivity disorder (ADHD)

Symptoms between the two disorders (for example, SUD and anxiety disorder) can interact, negatively influencing the healing process and worsening the prognosis for both disorders.

How many people suffer from co-occurring disorders?

Co-occurring disorders are far more common than you may think. According to a 2015 study by the National Survey on Drug Use and Health (NSDUH), approximately 8.1 million adults in the U.S. have co-occurring disorders. This constitutes more than 40% of those with substance use disorder.

Where do co-occurring disorders come from?

Generally, there are a few known factors that contribute to co-occurring disorders arising and persisting:

  • Developmental factors: The way you are brought up during your childhood and adolescence, periods of extreme importance in terms of brain development, can have a direct impact on the development of both SUD and mental health disorders. Substance use during an early stage of life can affect the brain and increase risk for developing mental health disorders.
  • Environmental factors: Life events that happen around you in your immediate environment, such as trauma, stress, standard of living, and more, can increase the risk and likelihood of both SUD and mental health disorders.
  • Genetic factors: Just as addiction can be passed down as a genetic trait, so too can traits that lead to mental health disorders such as anxiety, schizophrenia, or bipolar disorder.

How can we best treat co-occurring disorders while managing SUD?

The best plan of action for tackling co-occurring disorders begins with simply understanding their importance. Often, too much emphasis is placed on one area, whether it be SUD or mental health disorders, rather than taking an approach that encompasses the best practices of care for both. One cannot be managed successfully while the other persists.

In the treatment of SUD, many facilities, including Fellowship Hall, dedicate time during the treatment process to mental health disorders that can be exacerbating the patient’s SUD.

With May being Mental Health Awareness Month, it’s a good time to check in with your loved ones suffering from substance use disorder and offer to be a source of support and encouragement in discussing mental health issues. Open discussion and understanding of different mental health disorders can be the key to an accurate co-occurring disorder diagnosis which leads to a more well-rounded and successful recovery plan.


For more information, resources, and encouragement, “like” the Fellowship Hall Facebook page and follow us on Instagram at @FellowshipHallNC.


About Fellowship Hall

For 50 years, Fellowship Hall has been saving lives. We are a 99-bed, private, not-for-profit alcohol and drug treatment center located on 120 tranquil acres in Greensboro, N.C. We provide treatment and evidence-based programs built upon the Twelve-Step model of recovery. We have been accredited by The Joint Commission since 1974 as a specialty hospital and are a member of the National Association of Addiction Treatment Providers. We are committed to providing exceptional, compassionate care to every individual we serve.