Chicken or the Egg: Addiction and Co-Occurring Disorders

Modern-day addiction recovery treatments have evolved to include a focus not just on addictive disorders, but on mental health and wellness issues, as well. The practice has become so prevalent that readers will find references of dual diagnosis and co-occurring mental health disorders from even the most cursory of Google searches for addiction recovery treatment programs. The main reason programs like Choice House have adapted to this dual diagnosis treatment methodology is the overwhelming medical evidence that supports the connection between substance misuse and mental health disorders.

 In a report released by the Substance Abuse and Mental Health Services Administration (SAHMSA) on The Evolving Field of Co-Occurring Disorders<span style=”font-weight: 400;”>, initial studies in the early 1990s showed that addiction treatment programs reported 50 to 75 percent of patients had co-occurring mental disorders, while mental health clinicians reported 20 to 50 percent of their patients suffered from a co-occurring substance misuse and addictive disorder. The link between addictive and mental disorders is clearly evident, making dual diagnosis treatment methods an integral part of providing a successful treatment program. By broadening the scope of treatment services, addiction treatment programs can teach the necessary skills designed to promote an increased self-awareness of all disorders — which, in turn, can help those in addiction recovery maintain long-term sobriety.

What Exactly Are Co-Occurring Mental Health Disorders?

A co-occurring mental health disorder is any mental illness that potentiates and/or exacerbates an individual’s substance misuse and addictive disorder. As the field of addiction recovery treatment has expanded, medical experts noted that mental health disorders are not only present in patients with addictive disorders, but they are also intrinsically linked as both a cause and a contributing factor to that addictive disorder. Some examples of the mental health disorders that co-occur with addiction include PTSD, anxiety, depression, ADHD, personality/mood disorder, and panic disorder.  

Dating back to around the 1970s, the shift in treatment programs to include therapeutic modalities that address both addiction and mental health began as doctors noticed similarities in individuals diagnosed with either disorder. Addiction itself is differentiated from other illnesses by being both a psychological and biologically physical ailment. To only add to that complexity, many addiction recovery patients also have further mental illnesses that are intrinsically linked to their addictive disorder. 

As the field of psychology has progressed, the existence of co-occurring mental illness in addiction starts to make perfect sense. The very nature of mental illness is cyclical in the sense that one malady feeds into the other when left untreated. An individual suffering from PTSD may begin to feel more and more anxiety. This anxiety peaks particularly in social situations, which causes them to become withdrawn and depressed from a lack of social interaction. The rising depression and anxiety then in turn is its own traumatic event, thus exacerbating the individual’s original PTSD symptoms. Rarely is a patient suffering from an untreated mental illness simply diagnosed with a single disorder. 

This example is presented to show how mental illnesses can feed into each other, thus expounding upon the complexity of treating any one mental illness disorder. Furthermore, when a propensity for a behavioral addictive disorder is added to the cycle, along with Americans’ tendencies to self-medicate rather than seek help, the end result is the tangled, interconnected web of addiction and co-occurring mental health disorders from which many Americans suffer.

The Chicken or the Egg? Addiction or Mental Illness?

Each case and treatment program will vary depending on the individual, but mental illness is arguably first on the scene when it comes to addictive disorders. Although many individuals have a biological propensity for addictive behavioral traits, the majority of addiction recovery cases begin with self-medicating through substance misuse for an untreated and generally undiagnosed mental health disorder

Ultimately, the question of which comes first — addiction or mental illness disorder — may seem like a moot point. The result of substance misuse and the need to stop that misuse changes little by understanding how an individual arrived at the point of needing treatment. However, understanding the motivations and instigating factors behind an addictive disorder drastically improve the chances of maintaining long-term sobriety. Through an increased level of self-awareness, addiction recovery patients can develop the necessary skills to avoid future triggers and avoid the same pitfalls that exacerbated their mental health and addictive disorders in the first place.

The ouroboros cycle of mental illness and addiction disorder necessitates the dual-diagnosis treatment modalities that so many treatment programs have thankfully begun to adopt. This is not to say that one disorder cannot take precedent as being the root or primary cause of a mental health disorder, but you cannot address one disorder without taking on the other causes feeding into that addiction disorder.


If you or someone you love is in need of treatment for substance misuse and a co-occurring mental health disorder, Choice House can help. We offer dual diagnosis treatment for addictive and mental health disorders and utilize a variety of therapeutic modalities to help men achieve and maintain long-term sobriety. Within the greater Boulder County area of Colorado, we offer men the opportunity to create a foundation of love and empathy through their newfound lens of sobriety. Addiction recovery treatments at Choice House include a 90-day inpatient program, intensive outpatient services, and the opportunity to take up guided residency at our sober living campus. Our facilities are conveniently located just minutes from the bustling city of Louisville and a few steps away from the Rocky Mountain National Park. We take full advantage of having the Rocky Mountains in our backyard with a unique outdoor wilderness therapy in which men can begin to reconnect with themselves and others by creating long-lasting bonds of friendship through physical activities like hiking, rock climbing, and kayaking. The close proximity to the city is also beneficial for those interested in our sober living campus and outpatient services; these individuals can seek out and maintain employment and social lives while still under the guidance and supervision of their program. To find out more about Choice House’s facilities and treatment programs, please give us a call today at (720) 577-4422.

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