Co-occurring Disorders

Causes of co-occurring disorders

Co-occurring disorders are linked to several factors, including:

• Genetics: If someone in your family has a mental health condition or substance use disorder, you are more likely to develop co-occurring disorders.
• Brain chemistry: Changes in the brain caused by a mental health disorder can make you more likely to develop a substance use disorder, and vice versa.
• Environmental stressors: Trauma, abuse, neglect and chronic stress can increase the likelihood of developing a dual diagnosis.
• Access to care: Lack of available treatment for one condition, and the absence of a strong support system, can lead to co-occurring disorders.

Who is at risk for co-occurring disorders?

Mental health and substance use disorders affect people from all walks of life and all age groups. Approximately 21.5 million adults in the United States have a co-occurring disorder, representing more than 8% of the adult population. Risk factors include:

• A family history of mental health and substance use disorders
• Trauma, abuse, neglect and chronic stress
• An untreated mental health disorder or substance use disorder
• Lack of a solid support system

Co-occurring disorders treatment options

To achieve recovery, it is imperative to treat co-occurring disorders at the same time through integrated treatment. Treatment can be complex. It must be carefully managed to address each person’s unique combination of disorders.

The skilled behavioral health specialists at Main Line Health focus on understanding how each condition impacts the other to determine the best individualized approach to treatment. Initial treatment may include medically supervised detoxification in an inpatient or intensive outpatient program (IOP).

• Behavioral therapy: Behavioral therapies shown to be effective in treating dual diagnosis are:
  • Cognitive behavioral therapy (CBT), which teaches you how to cope with and change ineffective patterns of thinking.
  • Dialectical behavioral therapy (DBT), which can reduce self-harming behaviors such as substance misuse.
• Medication: Your healthcare provider may prescribe medication for one or both of your conditions. Some medications can help alleviate the symptoms of both conditions.
• Support groups: Support groups can provide the emotional and social encouragement needed to maintain sobriety. Your peers can share their experiences, answer questions and offer tips on how to deal with everyday challenges.
• Inpatient care: People experiencing a dependent pattern of substance use combined with a mental health disorder may benefit from a dual diagnosis treatment center. This type of center provides medical and mental healthcare including medication, therapy and support.

Diagnosis and testing for co-occurring disorders

A dual diagnosis is not one diagnosis, but rather, a combination of diagnoses. In people with co-occurring disorders, symptoms can overlap. Their symptoms are also often more persistent and severe compared to those who have only one disorder. Your co-occurring disorders assessment may include:

• Psychiatric/psychological assessment: A mental health provider will use a comprehensive set of assessment tools to conduct a detailed psychological evaluation for multiple disorders.
• Physical exam: An exam by a physician will assess physical health and identify any medical concerns that may be related to symptoms.