What Are Co-Occurring Disorders?
Co-occurring disorders are disorders that occur in the same individual at the same time. In contrast, a co-morbid disorder occurs in the same individual but are separated by a period of time. There are individuals who might present with substance use disorders, who also have another psychological disorder. This would be a co-occurring disorder.
Seven out of 10 adults in the United States are reported to have a co-occurring substance abuse and other mental health disorder. The factors that might cause co-occurring disorders include biological, psychological, and social influences. These factors are not absolute and lie on a continuum, meaning that there can be a single factor or multiple factors that contribute to the development of both disorders.
Biological factors that influence co-occurring disorders include genetics and family history. There is a consensus that genetic factors might be involved in the development of both the substance use disorder and the mental health disorder. Some argue that a genetic component might only explain the development of one disorder; however, the link has not been established as to which disorder is affected. Family history can be a positive indicator of an individual developing a co-occurring disorder. Social environments might explain the misuse of substances among those with corresponding mental health disorders. Environment and the lack of a social support system can also influence co-occurring disorders.
When an individual with a co-occurring disorder seeks treatment, the mental health professional will need to conduct an assessment to fully understand the onset and course of both disorders. A substance abuser who has symptoms of a mood disorder could be experiencing withdrawal or intoxication related to the substance. It is also possible that the individual might have a mood disorder which exacerbated the substance use or the mood disorder was a pre-existing condition which developed further by the substance use. It is important that the mental health professional take a thorough history to gain insight into both disorders. Most professionals assess based on severity of the symptoms. The presentation of symptoms will often guide the treatment.
The most often co-occurring disorders are substance use disorder and mood disorders and professionals argue that this relationship is very strong. The prevalence of mood disorders among individuals who abuse alcohol is between 8 and 53%. The symptoms of a mood disorder can be exacerbated during alcohol withdrawal or during treatment for alcohol abuse. There is the likelihood that a mood disorder could be diagnosed prior to the substance abuse diagnosis and there is also the likelihood that the mood disorder can be sustained after abstinence has been obtained for a period of time.
The issues with alcohol and mood disorders lies with the idea that the alcohol abuse can either exacerbate a pre-existing mood disorder or the mood disorder can exacerbate the substance use. Most professionals argue that extensive alcohol use generally precedes the mood disorder. Due to the high correlation between alcohol abuse and mood disorders, the mental health professional must assess for both disorders and plan treatment accordingly to make sure both disorders are addressed and treated.