Understanding Co-Occurring Disorders


understanding co-occurring disorders

Understanding Co-Occurring Disorders

Thursday, March 19th, 2020

Almost a third of people in the US who have been diagnosed with a substance use disorder also have a mental illness. Those who are diagnosed with both are described as having co-occurring disorders. This is also referred to as a dual diagnosis. Understanding co-occurring disorders more clearly will help you know how to get help for your specific substance problem and mental health issues.

Dual Diagnosis

The term “dual diagnosis” does not actually refer to a specific diagnosis. Rather, it means a combination of diagnoses, usually one involving substance use and one involving a form of mental illness. The National Alliance on Mental Illness states that mental health issues do not necessarily cause substance use disorders, but people with mental illness are more susceptible to problems with substances.

People who are experiencing mental health issues may turn to drugs or alcohol as a form of self-medication. Unfortunately, the use – and abuse – of such substances typically only worsens the symptoms of mental illness. According to the National Survey on Drug Use and Health, 9.2 million U.S. adults experienced both mental illness and a substance use disorder in 2018. 

Evaluation for Recommended Treatment

An understanding of co-occurring disorders can help you know when it is time to get help as well as what kind of help you might need. An experienced addiction professional such as a psychotherapist, psychiatrist, or psychologist can do an evaluation to determine an appropriate course of treatment. An evaluation will enable the professional to:

  • Determine if you are addicted to drugs or alcohol
  • Evaluate the extent of your substance problem
  • Discover whether co-occurring conditions exist, including any physical or mental health concerns
  • Gauge how much the substance use is harming you
  • Develop a complete understanding of you and your circumstances, establishing a baseline that will be used to build an appropriate treatment plan for both disorders.


Co-occurring disorders are diagnosed in people who have co-existing mental health and substance abuse disorders. Symptoms will include those that are generally seen in people who have an addiction to drugs or alcohol as well as symptoms seen in people who have a mental illness. Although symptoms of both disorders vary with the individual, and with the specific substance use or mental illness diagnosed, generally symptoms may include:

  • Withdrawal from friends and family
  • Sudden changes in behavior
  • Using substances under dangerous conditions
  • Engaging in risky behaviors
  • Loss of control over use of substances
  • Developing a high tolerance and withdrawal symptoms
  • Feeling like you need a drug to be able to function
  • Extreme mood changes
  • Confused thinking or problems concentrating
  • Thoughts of suicide.

Treatment Options

If you are experiencing co-occurring disorders, you may feel as if your substance use and mental illness have taken control of your life. Help is available, though. The most effective treatment will integrate care for both substance use and any mental illness. Treatment options will depend on the nature of the use and of the mental illness, but may include:

  • Psychotherapy: An important component of dual diagnosis treatment, psychotherapy helps you learn how to cope without the use of substances. Specifically, motivational interviewing can help a person change their addictive behaviors. This type of therapy involves a mental health professional helping a person determine whether substance use aligns with their goals, values, and what “healthy living” means.
  • Intensive outpatient treatment: Usually more intensive and structured than psychotherapy and often includes group therapy, family counseling, and overall more comprehensive mental health treatment.
  • Inpatient or residential treatment: This may be an option for more severe cases that require medical and mental health care 24/7. These centers offer therapy, support, medication and mental health and medical services.
  • Transitional and supportive housing programs: Designed to help people who are newly in recovery avoid relapse and practice the skills they have learned in real life situations.
  • Support groups: As you work through your co-occurring disorders with a professional, you may feel challenged and isolated. Support groups enable their members to share frustrations, celebrate successes, and exchange healthy encouragement to stay clean.

Rebuild Your Life

Co-occurring disorders that go untreated can create further difficult complications in your life. It is critical that you are evaluated so that we can address your challenges. When you have a substance use issue as well as a mental illness, one disorder can often exacerbate the other.

At R&A Therapeutic Partners, Raymond Estefania and Ana Moreno involve family and treatment professionals in the evaluation process whenever possible to gather valuable information about you and your addiction and mental illness. We can then arrange for testing that can help more effectively address any co-occurring disorders, including psycho-educational testing, neuropsychological testing, and psychiatric or medical evaluations. Call our Miami team today at 786-452-7352 to learn more and arrange an evaluation.

At R&A Therapeutic Partners Raymond Estefania and Ana Moreno specialize in substance use and mental health disorder evaluations, treatment, intervention and therapeutic/educational consulting for clients throughout the greater South Florida area, as well as nationally and internationally. For more resources and information please visit Therapeutic-Partners.com or on Facebook.

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