How Focusing on Co-Occurring Disorders Can Help Your Addiction Recovery

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The best way that I can sum up co-occurring disorders, previously known as dual diagnoses, is they are these annoying assholes that accompany your fake friend addiction.

Probably not the most professional or clinical way of saying it, however, I would argue that it is the most accurate way to describe them. Formally, co-occurring disorders are mental health diagnoses that coexist with your addiction. By coexist, I mean they can really cause a lot of issues and complications in your life. However, they are not impossible to overcome and thrive in recovery. 

Co-occurring disorders are often thought of as mental health diagnoses connected to substance use-related issues, however, they can accompany any sort of addiction or other primary behavioral addictions/diagnoses. From substance use issues to eating disorders, to other severe mental health diagnoses, co-occurring disorders can be there. Sometimes we can overlook them because it may not be the “primary thing” we focus on. 

My recovery story involves recovery from binge eating disorder. I had spouts of recovery here and there… or at times what I thought was recovery. At times I thought success in significant overeating meant not eating at all. That works short-term in the early stages of recovery but often falls flat for long-term success. It wasn’t until I entered therapy that I started seeing results and long-term success patterns. I received counseling for my ADHD as well as unresolved family issues and trauma that I had not addressed or flat out ignored because “What is the point? I just need to not overeat significantly,” I thought. 

To tell you the truth, in therapy we probably touched on eating-related issues and urges to binge no more than 20% of our sessions together. It was very mental health-focused, something that I did not think would even help me, and ended up giving me a life full of joy, freedom, and tools ready for battle in case my eating disorder symptoms decide to rise up. 


According to Alta Mira Recovery Programs, “8.2 million American adults (3.4 percent [of the United States Population]) had a mental illness (AMI) as well as a substance use disorder within the past year. It also found a co-occurrence of serious mental illness (SMI) and a substance use disorder within 2.6 million (1.1 percent) of American adults.” According to SAMHSA, in a given study 36.7% to 41.3% of patients with an alcohol or substance use disorder had a confirmed co-occurring disorder between 2007 and 2011. These statistics show how common these co-occurring disorders are to us in recovery. This also shows how often these factors and diagnoses can be overlooked in theory since these are the ones that are 100% confirmed.  

How a Co-Occurring Disorder Can Affect You

Let me give an example of physical health. Let’s say somebody has diabetes and they want to focus on that. That is great! However, they also have chronic back pain. They want to focus on their diabetes treatment and eating better, but they are not worried about other appointments for the back pain because they think they can handle it. Well, this is great in theory. However, what the person with diabetes failed to realize is that his eating habits are off because of his back issues. Maybe because of the back pain, he lays down and eats unhealthy food all day instead of cooking well-balanced meals. He might use his back pain as an excuse to just go through the drive-through after his long day at the office and get something unhealthy there because it’s easier. His pain also might lead him to not utilize any sort of physical fitness, as a certain level of back pain might limit his mobility. 

So, one day he decides to finally get his pain checked out. Not even thinking it might help his eating habits, but just to get it treated. Prior to getting back pain treatment, he was doing okay with his diabetes management but could do a lot better. He wasn’t completely following the orders of his doctor. Now, several months later and his back pain has been significantly reduced through his chiropractor and muscle relaxants. It is still there, but not as bad. Suddenly our example case is able to more easily follow his food plan, takes his medication regularly, and start to exercise three times a week. He’s feeling so much better he even joins a gym. All of a sudden, because of treating his back pain and therefore following his doctor’s plan, this person’s blood sugar levels are evened out.

In this case above, the diabetes diagnosis was considered the primary diagnosis, and the chronic back pain was considered the co-occurring diagnosis. Now, take this with addiction and mental health. You have an individual that has had a cocaine addiction for the last 10 years. She is attempting to stop her use yet only can go for a few days before using it again. Her counselor has identified that her triggers come from feelings of sadness and boredom, so it seems. They work on addressing these triggers and come up with a plan of tools to utilize when these feelings arise. They are successful some of the time, but not all of the time. So, why is the recovery plan not fully working? 

Well, after a few weeks they decided to get her an assessment for mental health. Turns out, the client also has Major Depressive Disorder and a lot of the time is not just having feelings of sadness or boredom but rather symptoms of depression and fatigue related to the depression. Due to the decision of the client and counselor to get her assessed, not only does this provide the additional framework for the counselor to work within her treatment plan, but it also allows the client to have additional treatment options including group counseling, support groups, medication if needed, as well as gives the client a more holistic approach to what is going on with them and what they face. 

Choosing Both Substance Use Treatment and Mental Health Treatment

If you are someone who is struggling with long-term recovery, you are not alone. Also, if you are someone with a mental health diagnosis and a substance use disorder then you are most certainly not alone. They often go hand and hand and they are both able to be overcome with treatment. It’s could be a long battle and is going to be tough at first (I don’t sugarcoat it, it really is going to suck in the beginning, and that’s fine), but in time getting treatment for your mental health and addiction at the same time can be the ultimate difference between short-term and long-term recovery. Basically, if you have to choose between getting treatment for your addiction or getting treatment for your mental health… choose both anyway. They are equally important and, to be real, nobody is ever going to physically make you choose between the two. So, just get both checked on and live your best life.

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Justin Gillespie is a recovery coach with Workit Health. He has a passion for finding alternative treatments for clients that are evidence-based. He has utilized these alternative interventions with many of his patients and speaks passionately about the balance of fitness, mental health and substance use disorder recovery in other ventures outside of Workit. Justin has his own journey in recovery from Binge Eating Disorder as well as several other co-occurring disorders and uses fitness as well as several other alternative methods to continue his long-term recovery.

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