A person who has both an alcohol or drug problem and an emotional/psychiatric problem is said to have a co-occurring disorder. To recover fully, the person needs treatment for both problems.
How common is a Co-Occurring Disorder?
It is more common than you might imagine. According to a report published by the Journal of the American Medical Association:
"Thirty-seven percent of alcohol abusers and fifty-three percent of drug abusers also have at least one serious mental illness. Of all people diagnosed as mentally ill, 29 percent abuse either alcohol or drugs."
What kind of mental or emotional problems are seen in people with a co-occurring disorder?
The following psychiatric problems commonly occur in tandem with alcohol or drug dependency:
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Depressive disorders, such as depression and bipolar disorder.
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Anxiety disorders, including generalized anxiety disorder, panic disorder, obsessive-compulsive disorder, and phobias.
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Other psychiatric disorders, such as schizophrenia and personality disorders
Which develops first - substance abuse or the emotional problem?
It depends. Often the psychiatric problem develops first. In an attempt to feel calmer, more peppy, or more cheerful, a person with emotional symptoms may drink or use drugs; doctors call this "self-medication." Frequent self-medication may eventually lead to physical or psychological dependency on alcohol or drugs. If it does, the person then suffers from not just one problem, but two. In adolescents, however, drug or alcohol abuse may merge and continue into adulthood, which may contribute to the development of emotional difficulties or psychiatric disorders.
In other cases, alcohol or drug dependency is the primary condition. A person whose substance abuse problem has become severe may develop symptoms of a psychiatric disorder: perhaps episodes of depression, fits of rage, hallucinations, or suicide attempts.
If someone I know appears to have a substance abuse problem and the symptoms of a psychiatric disorder, how can I help?
Encourage the person to acknowledge the problems and seek help for themselves. Suggest a professional evaluation with a licensed physician, preferably at a medical center that’s equipped to treat addiction problems and psychiatric conditions. If the person is reluctant, do the legwork yourself - find the facility, make the appointment, offer to go with the person. A little encouragement may be all it takes. If you talk to the physician first, be honest and candid about the troubling behavior. Your input may give the doctor valuable diagnostic clues.
There Is Hope
As a relative or friend, you can play an important role in encouraging a person to seek professional diagnosis and treatment. By learning about co-occurring disorders, you can help this person find and stick with an effective recovery program.
The more you know about co-occurring disorders, the more you will see how substance abuse can go hand-in-hand with another psychiatric condition. As with any illness, a person with a co-occurring disorder can improve once proper care is given. By seeking out information, you can learn to recognize the signs and symptoms and help someone live a healthier or more fulfilling life.
