Concurrent disorders, medically known as co-occurring disorders, happen when someone suffers from two different disorders simultaneously. We typically use the term to describe co-occurring addiction and mental health disorders. Take schizophrenia as an example. Studies suggest that at least half of people with schizophrenia also have a substance use disorder (SUD). Yet, schizophrenia is not the only concurrent disorder with SUDs. SUDs can also co-occur with mood disorders, personality disorders, and even eating disorders. The substance used also varies. Someone may use substances like alcohol and drugs or turn to gambling and porn.
Do you or someone you love have a mental health or substance use disorder diagnosis? If so, they may be at a higher risk for a concurrent diagnosis. Check out this guide to learn more about the connection between SUDs and mental health.
The Link Between Addiction and Mental Health
Before you can understand the connection between substance use and mental health disorder, you need to know the difference between the two. Substance Abuse Disorders are mental health disorders. However, not all mental health conditions are SUDs.
Substance use disorders occur when someone is addicted to or reliant on alcohol or drugs. In Canada, approximately 22% of the population suffers from a SUD. That is more than 6 million people.
Meanwhile, 1 in 3 Canadians has either a mental health disorder or a substance use disorder. 3.5 million of these Canadians have symptoms of a mood disorder. 2.4 million Canadians meet the criteria for generalized anxiety disorder (GAD).
Mental health disorders are diagnosable conditions with specific symptoms. The symptoms of the condition lead to impairments in the person’s ability to function or participate in major life events.
When someone has a mental health condition, they are at a higher risk of abusing substances. The reverse is also true. People with SUDs tend to have a higher risk of mental health issues.
Which Comes First: Addiction or Mental Health Conditions?
It can be hard to identify whether SUDs or mental health disorders happen first. We do know that addiction can exacerbate mental health symptoms. Moreover, many people start using substances to cope with mental health issues.
Yet, addiction does not cause mental health conditions. Also, mental health symptoms do not necessarily cause someone to develop a SUD. The connection is far more complicated.
Mental health conditions, including SUDs, come from a combination of nature and nurture. Genetics, upbringing, and events that happened to you in the womb can increase or decrease your risk for mental health issues.
When Addiction Makes Mental Health Symptoms Worse
Addiction does not commonly cause mental health disorders. However, some substances can worsen mental health symptoms. In rare cases, abusing drugs can also cause temporary or permanent mental disturbances.
Plus, consider someone with an increased risk for mental health issues. This person may have a genetic predisposition to a certain disorder. Then, adverse life events increase the risk further.
Adding alcohol or drugs on top of these causes of mental health conditions can increase someone’s risk even further.
Methamphetamines and some other drugs are known to induce psychosis. Using these drugs in the long term can change the brain. These changes often mimic mental health disorder symptoms.
Also, some substances can worsen mental health symptoms via interactions with prescription medications. For example, people who take antidepressants should not drink alcohol. Alcohol can make antidepressants less effective.
When People Use Substances to Self-Medicate
It is unfortunately common for people with mental health conditions to abuse substances. They often do so to self-medicate their symptoms. Self-medicating is especially common in people with undiagnosed mental health conditions.
Alcohol is one of the most commonly abused substances in America. It is also the most common substance used for self-medicating.
Self-medicating may temporarily alleviate mental health symptoms. Yet, in the long term, self-medicating with substances can make symptoms worse. Additionally, self-medicating can increase the risk of developing a SUD.
For example, alcohol abuse can worsen symptoms of mood disorders like depression and anxiety disorders like GAD. Other substances can cause symptoms of additional disorders to appear.
The Most Common Concurrent Disorders With Addiction
If someone with a mental health condition chooses to enjoy a glass of wine occasionally, the risk of addiction is at a lower probability. However, it is important to be aware of the following signs that you or someone you love may be using substances to self-medicate:
- Regularly using substances to cope with symptoms
- Substances worsen symptoms
- An increasing tolerance to a substance
- Feelings of stress or anxiety when the substance is inaccessible
- Substance use is affecting relationships
Some conditions more commonly co-occur with SUDs than others. They are anxiety, depression, bipolar disorder, and PTSD.
There are five major types of anxiety disorders:
- Generalized anxiety disorder (GAD)
- Obsessive-compulsive disorder (OCD)
- Panic disorder
- Post-traumatic stress disorder (PTSD)
- Social phobia, also known as social anxiety disorder
All anxiety disorders share some symptoms in common. They feature restlessness or irritability, trouble concentrating, and sleep disturbances. Inability to relax, shortness of breath, and panic attacks can also occur.
People with anxiety self-medicate with substances to induce relaxation. Cannabis, alcohol, and opiates are nervous system depressants. They can temporarily relieve anxiety symptoms.
Other people with anxiety may use uppers. Uppers are also known as stimulants. Common stimulants used among people with anxiety disorders are cocaine and prescription amphetamines.
Stimulants may not be the most obvious choice for people who experience restlessness. Yet, uppers can combat concentration issues. They also increase feelings of self-confidence and sociability.
When self-medicating with these substances gets out of hand, people can develop concurrent SUDs. Anxiety also occurs alongside other disorders. For example, there is a link between OCD and depression.
The most common types of depressive disorders are:
- Major depressive disorder (MDD), also known as clinical depression
- Persistent depressive disorder, also known as dysthymia
- Postpartum depression
These depressive syndromes share some common symptoms. For example, depressive disorders tend to feature a loss of pleasure in activities; feelings of guilt, shame, or worthlessness; fatigue; and negative thought patterns.
People with depression commonly use alcohol to self-medicate. Studies show that binge drinking and depression co-occur in a statistically significant way. Postpartum depression and alcohol use are also common.
Alcohol recovery and depression do not mix. Overcoming an alcohol addiction with a concurrent depression diagnosis is much more complex. Mental health symptoms will still remain after recovery, which could push a person to return to alcohol abuse and excessive drinking.
Depression and sexual addiction are also linked, especially porn addiction and depression. A 2019 study found that a depression diagnosis strongly predicts a co-occurrent porn addiction.
Recent research has come out with promising findings for MDMA and depression. MDMA is also known as ecstasy. It is a stimulant with hallucinogenic properties. Despite findings that MDMA could help treat depression, nobody should attempt to self-medicate with this drug. Access to safe and well-tested MDMA from pharmaceutical companies is not available although, it might be in the future. The MDMA that is accessible on the street could be mixed with other drugs to increase its potency. These added ingredients could worsen symptoms or even harm health.
Bipolar disorder is a type of mood disorder. Mood disorders include the three depressive disorders we discussed earlier, seasonal affective disorder (SAD), and premenstrual dysphoric disorder (PDD).
People with bipolar disorder may have type I or type II. In bipolar I, people fluctuate from depressive episodes to mania. In bipolar II, people fluctuate from depressive episodes to hypomania.
The depressive episodes people with this disorder experience mimic the symptoms of depressive disorders. Mania is a period of feeling extremely energized and confident. Hypomania is similar but less severe.
People with bipolar often use substances during these episodes. They may abuse uppers like cocaine or amphetamines during depressive episodes. Then, they may switch to depressants like alcohol and cannabis during mania.
Using substances may temporarily relieve bipolar symptoms. Unfortunately, self-medicating can ultimately lead to more frequent or intense episodes.
cPTSD and PTSD
People with concurrent mental health and substance use disorders have overwhelmingly experienced trauma at some point in their lifetimes.
People who have experienced trauma may develop post-traumatic stress disorder (PTSD) or complex PTSD (cPTSD).
PTSD is a type of anxiety disorder. It develops after a person experiences a life-threatening or otherwise traumatic event. The event alters the brain’s ability to deal with stress healthily.
People can also develop complex PTSD or cPTSD from experiencing repeated or chronic trauma. cPTSD is common in survivors of childhood abuse or neglect. However, people can also develop cPTSD from traumatic events in adulthood.
The hallmark symptoms of PTSD include flashbacks to the traumatic event, nightmares, and panic attacks.
cPTSD shares similar symptoms, with the addition of feelings of shame and guilt, trouble controlling emotions, and relationship problems.
As the name suggests, PTSD also comes with an unhealthy response to stress. As such, people with these disorders turn to substances that decrease stress. Alcohol is typically the substance of choice for people with PTSD and cPTSD.
Tips for Caregivers of People With Co-Occurring Disorders
Are you the parent of or a caregiver for a person who may have a SUD, mental health condition, or both? If so, you may be wondering how to recognize the difference.
Unfortunately, it is extremely hard to differentiate between the two. Instead, speak to a mental health professional or a healthcare provider. A professional can help your loved one get the help they need.
As a caregiver, it is not only important for you to take care of your loved one. It is necessary to make time for yourself. Caring for someone with concurrent disorders can make you feel stressed or helpless.
It is critical to take care of yourself if you start to feel overwhelmed. Create a self-care strategy. The plan may include relaxation techniques like yoga or meditation and designated time to spend with other members of your family.
Consider seeing a mental health professional yourself. At Simcoe Rehab, we offer family counselling services. We can help you better relate to your loved one while also teaching you tools to take care of your well-being.
What Can be Done for Your Concurrent Disorder?
Feeling hopeless at times is normal If you or a loved one has a concurrent SUD and mental health condition, you may feel hopeless. At Simcoe, we have treatment services available to get you the help you need.
Drug and Alcohol Detox
Withdrawals are among the most difficult barriers to overcome when getting clean. At Simcoe, we offer drug and alcohol detox services to help individuals safely and comfortably through withdrawals.
Detoxing from substances is only the first step to recovery from concurrent disorders. You must receive treatment for your SUD.
Finding an inpatient residential programme and convenient virtual outpatient services to help you can be really overwhelming. That’s why we are curating a list of options that would best suit your needs depending on your location. Stay tuned for the upcoming list on our blog!
Mental Health Counselling
To avoid relapsing after rehab, we recommend undergoing mental health counselling. You can get the help you need for your disorder. You will also learn coping strategies to use in place of substances.
Searching for Addiction and Mental Health Services in Ontario?
A concurrent disorder can make it harder to recover from addiction. Yet, with the right mental health services, you or your loved one can get the support and tools needed to address your SUD and mental health issues.
Do you need help with a co-occurring disorder in Ontario? Simcoe Rehab has the addiction and mental health services you need. Contact us today to learn more about how we can assist you.