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Teens Ask: What Is a Co-Occurring Disorder?

Teen addiction

Question: What do mental illness and substance use have in common?

Answer: They both tend to initially manifest during adolescence.

In plain English, the teenage years are when individuals often first experiment with alcohol or drugs, and it is also the time in one’s life where many kinds of mental illness symptoms first begin appearing. When a person has two or more disorders (such as mental illness and substance abuse issues), physicians refer to these disorders as co-occurring.

How Common Are Co-Occurring Disorders?

The prevalence of co-occurring disorders is also known as comorbidity. It may not surprise you to learn that comorbidity of substance abuse and mental illness is quite common, especially among the teen population.

According to the National Survey on Drug Use and Health in 2014, roughly 7.9 million adults have a co-occurring disorder of some kind. Regarding adolescents, about 1.4 percent of all teens aged 12 to 17 admitted to using illicit drugs and experiencing a “major depressive episode” in the previous year. And another survey reports that 45 percent of people in the U.S. who seek treatment for drug or alcohol abuse have also been diagnosed with a mental disorder of some kind.

Why Do Disorders Co-Occur?

So why are these two conditions more likely to be co-occurring than most other pairs of disorders? The European Monitoring Centre for Drugs and Drug Addiction offers three hypotheses: 

  1. The mental illness is a risk factor for substance abuse.
  2. Substance abuse triggers the development of an independent mental illness.
  3. Mental illness is a consequence of the intoxication caused by the use of (or withdrawal from) alcohol or illicit substances.

Though there are studies which support each of these three hypotheses, there is no consensus on which one is the most accurate for this type of comorbidity.

Disorders That Are Co-Occurring With Substance Abuse

Decades of research have produced a list of several types of disorders that are frequently co-occurring with substance abuse. They are:

  • Depression. Studies have shown bidirectional comorbidity with substance abuse. In other words, depressed people are at higher risk to abuse drugs and alcohol, and substance abusers are more likely to develop major depression.
  • Anxiety. This can be both a symptom of drug or alcohol withdrawal and a reason to self-medicate using drugs or alcohol. 
  • Post-traumatic stress disorder (PTSD). People who have experienced some type of severe trauma in their past are anywhere between 2 and 4.5 times more likely to have a substance abuse disorder.
  • Attention deficit hyperactivity disorder (ADHD). A growing body of evidence suggests that untreated ADHD in childhood is a major risk factor in developing substance abuse problems, although some studies suggest that only individuals who also have a co-occurring conduct disorder are more likely to abuse drugs or alcohol.
  • Psychosis. Psychotic episodes like delusions or hallucinations (including those associated with bipolar disorder) can be precipitated or exacerbated by substance abuse.
  • Personality disorders. Individuals suffering from schizophrenia or similar personality disorders who also have co-occurring substance abuse problems may experience more problematic or severe symptoms or behaviors.
  • Eating disorders. Anorexia, bulimia, and similar eating disorders tend to co-occur frequently with substance abuse disorders.

How Do You Treat Co-Occurring Disorders?

Teen addiction

The recommended treatment for people with co-occurring substance use disorders and mental illnesses is simple to identify yet challenging to carry out. It is to treat both or all of the disorders at the same time with integrated treatment regimens. Difficulties can sometimes arise when trying to coordinate various health care routines, so it is important that every treatment plan is tailored specifically to the individual.

In practice, this means drug rehab counselors and psychiatrists must collaborate on issues like medications, types of therapy, and recommended alterations to the patient’s life. Some of the most widely-used approaches for teen substance abusers with co-occurring disorders include cognitive-behavioral therapy, multisystemic therapy, and brief strategic family therapy.

For teenagers with co-occurring disorders, the road to recovery can be arduous and perilous. By identifying the problematic conditions and prescribing appropriate therapies for behavior modification and improved mental health, even the most overwhelmed adolescent can eventually lead a normal and productive life.

If your teen is having problems with substance abuse and a co-occurring disorder, contact us today.

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