Why Do Mental Health Disorders and Substance Use Disorders (SUDs) Co-occur?
Mental health disorders and substance use disorders (SUDs) do not discriminate. These conditions affect individuals from all walks of life. Unfortunately, many individuals with a mental health disorder are at a greater risk of developing a SUD and vice versa. The presence of a mental health disorder and SUD that co-occur is known as a co-occurring disorder or a dual diagnosis.
An infographic by the National Institute on Drug Abuse (NIDA) sheds light on the high prevalence of co-occurring disorders. It explains that of nearly 20.3 million adults with SUDs, 40% met the criteria for a mental illness. Further, of the 42.1 million adults with a mental illness, over 18% met the SUD criteria.
It is important to understand that co-occurring disorders are often comorbid. This means that the interactions that occur between disorders can exacerbate the symptoms and discourse of both. Becoming familiar with why these conditions co-occur can help individuals reduce risk factors and motivate them to seek intervention as early as possible.
What Are Mental Health Disorders?
Mental health disorders are often termed mental illnesses. The National Institute of Mental Health (NIMH) explains that these illnesses include a wide range of conditions that vary in degree of severity. These conditions can cause impairment in mental, emotional, and behavioral health. NIMH defines the following as two broad categories of mental illness:
Any mental illness (AMI): Encompasses all types of mental illness and varies in impact, from no impairment to mild, moderate, and severe impairment
Serious mental illness (SMI): A smaller and more intense subset of AMI, with conditions resulting in serious functional impairment that limits an individual's ability to function in daily life
Understanding that no mental health disorder surfaces the same way for different people is essential. However, most mental illnesses affect mood, thinking, and behavior in some way, as all of these functions are intertwined. Likewise, there is no one cause for why mental illnesses develop. Research explains that several different risk factors, such as one's genes and exposure to trauma, can contribute to the development of mental illness.
Examples of Mental Health Disorders
Mental health disorders can be broken down into various categories based on symptoms. Here are some common categories and examples:
Mood disorders: Such as depression or bipolar disorder
Anxiety disorders: Such as generalized anxiety disorder (GAD) or social anxiety disorder
Personality disorders: Such as borderline personality disorder (BPD)
Eating disorders: Such as anorexia nervosa
Trauma-related disorders: Such as post-traumatic stress disorder (PTSD)
Substance use disorders: Such as alcohol use disorder (AUD)
What Are SUDs?
The Substance Abuse and Mental Health Services Administration (SAMHSA) explains that SUD occurs "when the recurrent use of alcohol or drugs causes clinically significant impairment, including health problems, disability, and failure to meet major responsibilities at work, school, or home." As mentioned previously, SUD is also a type of mental health disorder that ranges in severity. Addiction is the most severe form of SUD.
An individual's initial decision to use drugs or alcohol is often voluntary. However, nearly all kinds of drug use produce intense surges of dopamine in the brain. These dopamine surges cause an individual to feel pleasure beyond what is felt from natural rewards. As a result, an individual will feel motivated to seek out substance use repeatedly.
Examples of SUDs
In addition to addiction and AUD, there are many types of SUDs. Some examples include:
General SUD
Marijuana use disorder
Opioid use disorder
Stimulant use disorder
Cocaine use disorder
Hallucinogen use disorder
Nicotine use disorder
Sedative use disorder
3 Possibilities to Explain Co-occurring Disorders
Because mental health disorders and SUDs have no one root cause, it can be difficult to understand why they commonly co-occur. It is crucial to know that the presence of a co-occurring disorder does not mean that one caused the other.
NIMH highlights three possibilities that could explain why these conditions co-occur:
#1. Shared Risk Factors
Both SUDs and mental health disorders develop from a combination of shared risk factors. For example, genes vulnerable to these conditions can be passed down through generations. In addition to genetic risk factors, environmental risk factors also play a role. Exposure to trauma, lack of parental involvement, and intense stress are just three examples of these risk factors.
#2. Mental Health Disorders Contribute to Substance Use
Research has shown that mental health disorders can also contribute to the development of SUDs. Often, this is a result of attempts to self-medicate distressing symptoms with the use of alcohol or other drugs. While individuals may experience temporary relief by doing so, self-medication practices will exacerbate symptoms long-term. These practices increase an individual's risk of developing chemical dependency and chronic health issues.
#3. Substance Use Can Trigger the Development of Mental Health Disorders
Substance use and SUD can also trigger the development of mental health disorders. This is because substance use causes changes in an individual's brain structure and function. As a result, an individual can be more likely to develop a mental illness, especially when combined with additional risk factors.
Effective Treatment for Co-occurring Disorders
Treatment for co-occurring disorders must be individualized. This includes tailoring treatment toward an individual's unique disorders and symptoms. Likewise, treatment must work to treat both conditions together at the same time. Treatment facilities often recommend a combination of behavioral therapies and medications for clients. While treatment is inevitably challenging, it is worth it. Individuals can feel motivated to engage in treatment by knowing that support is available and recovery is possible.
Mental health disorders and substance use disorders often co-occur. Research explains this happens as a result of shared risk factors, in addition to substance use triggering mental illness and vice versa. Support is available if you or a loved one is struggling with co-occurring disorders, and recovery is possible. Next Level Recovery Associates believe community and support are crucial to participating in treatment. We offer education to our clients to help them feel more informed throughout their recovery journey. We offer a variety of interventions, such as counseling and coaching, to create a truly individualized approach for each of our clients. To learn more, contact us today at consult@nextlevelra.com.