The 8 Most Common Co-Occurring Disorders

In the United States, 37.9% of people with substance use disorder (drug addiction) also have a co-occurring mental health condition. Many of these individuals developed addiction after using drugs to self-medicate their mental disorders.

Some disorders co-occur with addiction more often than others. Here are eight of the most common co-occurring disorders.

1. Depression

One of the most common mental illnesses, depression is also known as major depressive disorder. It causes ongoing feelings of sadness, hopelessness, and loss of interest in activities once enjoyed. Other symptoms may include:

  • irritability
  • guilt or shame
  • trouble sleeping or oversleeping
  • decrease or increase in appetite
  • difficulty concentrating
  • unexplained aches or pains
  • suicidal thoughts

To ease these symptoms, some people turn to drugs. Unfortunately, drug abuse only makes depression worse. It also often leads to addiction. According to one study, addiction affects almost one-third of people with depression.

2. Anxiety Disorders

Everyone feels anxious sometimes. However, some people experience constant, overwhelming anxiety that interferes with their daily lives. These people are typically diagnosed with anxiety disorders. Some of the most common anxiety disorders include:

  • generalized anxiety disorder, which causes excessive anxiety in non-threatening, everyday situations
  • obsessive compulsive disorder (OCD), which causes unwanted, disturbing thoughts (“obsessions”) that lead to irrational, repetitive behaviors (“compulsions”)
  • social anxiety disorder, which causes excessive anxiety in social situations

Many people with these conditions use drugs to try and calm down. This behavior typically leads to addiction. In one large sample of addiction treatment programs, 80% of patients had at least one co-occurring anxiety disorder.

3. Post-Traumatic Stress Disorder (PTSD)

After a traumatic experience, some people develop post-traumatic stress disorder (PTSD). The most common symptoms of this condition include intense anxiety, nightmares, and flashbacks to the traumatic experience. Other possible symptoms of PTSD include:

  • low self-esteem
  • guilt or shame
  • irritability or anger
  • trouble concentrating
  • poor memory
  • a tendency to self-harm or engage in reckless behavior

To reduce these symptoms, a person with PTSD may try to avoid people, places, objects, or other things that remind them of their trauma. They may also try to numb their symptoms with drug or alcohol use, leading to addiction.

One national study showed that nearly half of people with lifelong PTSD also had addiction.

4. Bipolar Disorder

Bipolar disorder is a mood disorder that causes intense shifts between depression and mania. Mania means you have an abnormally elevated mood. Common symptoms include:

  • excitement
  • racing thoughts
  • irritability
  • extreme talkativeness
  • increased energy and activity
  • recklessness

People with bipolar disorder face a much higher risk of substance abuse disorders than the general population. This is probably because their mood swings can seriously disrupt their lives when left untreated. In one study, almost 60% of people with the condition had engaged in drug abuse at some point in their lives.

5. Schizophrenia

Schizophrenia is a mental health disorder that causes episodes of psychosis. Psychosis is a loss of connection with reality. It can cause symptoms such as:

  • severe anxiety
  • paranoia (feeling irrationally mistrustful of others)
  • delusions (holding beliefs that conflict with reality)
  • hallucinations (seeing, hearing, or feeling things that aren’t really there)

When left untreated, schizophrenia can cause intense distress, increasing the risk of drug use. Up to 50% of people with schizophrenia live with illicit drug or alcohol addiction, while over 70% are dependent on nicotine.

6. Attention-Deficit Hyperactivity Disorder (ADHD)

People with attention-deficit hyperactivity disorder (ADHD) have trouble paying attention and resisting their impulses. Other common symptoms include:

  • distractibility
  • procrastination
  • trouble sitting still
  • difficulty staying organized
  • anxiety
  • depression

To cope with these symptoms, some people with ADHD turn to drugs. Many of them have also experienced childhood trauma, another common risk factor for drug use and addiction.

One study showed that young adults with ADHD are 69% more likely to develop an addiction compared to young adults without ADHD.

7. Borderline Personality Disorder (BPD)

Borderline personality disorder (BPD) is a mental health disorder that affects the way you feel about yourself and your relationships. Common symptoms include:

  • mood swings
  • fear of abandonment
  • difficulty controlling your behavior and emotions
  • low self-esteem
  • self-harm and/or suicidal thoughts

People with untreated BPD also have a tendency to engage in risky behaviors, including substance abuse. About 78% of them will develop addiction at some point in their lives.

8. Eating Disorders

Eating disorders are mental health problems that cause unhealthy eating behaviors and an excessive preoccupation with food.

The most common eating disorders are anorexia nervosa, which causes a severe restriction of food intake, and bulimia nervosa, which causes periods of extreme overeating followed by periods of intentional vomiting, excessive dieting, or excessive exercise.

Some people with these disorders abuse stimulant drugs (such as cocaine, methamphetamine, or prescription stimulants) to reduce appetite and lose weight.

They may also abuse other types of drugs to ease the anxiety and depression that often accompanies these disorders. All of these behaviors can lead to addiction.

People with addiction and co-occurring mental health issues need dual diagnosis treatment. This type of treatment addresses all of your mental health concerns at once.

To learn more, please reach out to Spring Hill Recovery Center. Our comprehensive treatment programs offer personalized, evidence-based care to help you or your loved one stay healthy.

  1. Current Opinion in Psychiatry — Major depression and comorbid substance use disorders
  2. DÄ International — Borderline Personality Disorder and Comorbid Addiction
  3. Dialogues in Clinical Neuroscience — Substance abuse in patients with schizophrenia
  4. National Institute on Drug Abuse — Comorbidity: Substance Use and Other Mental Disorders
  5. Psychiatric Times — Anxiety and Substance Use Disorders: A Review
  6. Substance Abuse Treatment, Prevention, and Policy — The prevalence and significance of substance use disorders in bipolar type I and II disorder
  7. United States Department of Veterans Affairs — Treatment of Co-Occurring PTSD and Substance Use Disorder in VA
  8. University of Toronto — Half of adults with ADHD have had a substance use disorder

Written by Spring Hill Recovery Editorial Team

Published on: July 7, 2023

© 2024 Spring Hill Recovery | All Rights Reserved

* This page does not provide medical advice.

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