Lori G, LPC
Therapy
Understanding
Co-Occurring Disorders
Co-occurring disorders refers to experiencing both a mental health concern and a substance use concern at the same time.
This may include anxiety, depression, trauma, bipolar disorder, ADHD, or other mental health symptoms alongside alcohol or drug use.
For some people, substance use begins as an attempt to cope with difficult emotions, stress, trauma, sleep problems, or mental health symptoms. For others, substance use may worsen symptoms that were already present or create new emotional and behavioral concerns over time.
The relationship between the two can be complicated, which is why treatment should look at the whole person rather than assuming one concern exists separately from the other.
How Mental Health &
Substance Use Can Interact
Mental health symptoms and substance use can affect each other in many ways.
Some common patterns may include:
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Using alcohol or drugs to cope with anxiety, depression, trauma, or stress
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Feeling temporary relief from symptoms followed by worsening mood or anxiety
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Increased impulsivity or risk-taking during periods of mood instability
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Substance use interfering with sleep, motivation, concentration, or emotional regulation
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Withdrawal or intoxication creating symptoms that resemble or intensify mental health concerns
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Difficulty determining whether a symptom is primarily related to mental health, substance use, or both
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Returning to substance use during periods of emotional distress
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Mental health symptoms becoming more noticeable after reducing or stopping substance use
Understanding these patterns can help make treatment more effective and realistic.
Which Came First?
People often ask whether the mental health concern caused the substance use or whether substance use caused the mental health symptoms.
Sometimes there is a clear answer. Often, there is not.
Substance use can produce or worsen symptoms such as anxiety, depression, mood instability, sleep disturbance, paranoia, or difficulty concentrating. In some cases, these symptoms may be substance-induced rather than evidence of a separate mental health disorder. In other cases, an independent mental health condition may have been present before substance use began or may continue even after substance use stops.
Early in recovery, it is not always possible to know immediately which symptoms are substance-induced and which reflect a stand-alone mental health condition. As sobriety or abstinence is maintained and the effects of intoxication, withdrawal, and early recovery begin to settle, the clinical picture often becomes clearer.
Rather than rushing to label every symptom, therapy can help track patterns over time, understand what changes with reduced use or abstinence, and identify what continues to need treatment.
Why Integrated
Treatment Matters
Treating mental health and substance use as completely separate concerns can sometimes leave important pieces of the picture unaddressed.
For example, focusing only on stopping substance use without understanding the anxiety, trauma, depression, or other concerns it may have helped someone cope with can make recovery harder to sustain.
At the same time, treating mental health symptoms without considering substance use may overlook something that is affecting mood, sleep, medications, relationships, or overall functioning.
Integrated treatment means looking at both concerns together and understanding how they interact.
Recovery Does Not
Require Perfection
Change may happen gradually.
Someone may be working toward sobriety, reducing harm, learning to manage cravings, addressing mental health symptoms, rebuilding routines, or developing healthier ways to cope.
Progress in one area can support progress in another.
A difficult day, worsening mental health symptoms, or a return to substance use does not mean that all previous progress has disappeared. It may provide important information about triggers, supports, unmet needs, and what may need to change moving forward.
Medication, Psychiatry & Coordinated Care
Medication can be an important part of treatment for both mental health and substance use concerns.
When appropriate, therapy can work alongside psychiatric or medical care. This may include medications for depression, anxiety, mood disorders, ADHD, or medications used in the treatment of substance use disorders.
If additional or specialized services are needed, I can also help connect you with appropriate professional referrals so care can be coordinated rather than fragmented.
How Therapy Can Help
Therapy for co-occurring concerns may include work around:
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Understanding the relationship between mental health and substance use
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Identifying triggers and patterns
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Managing cravings and urges
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Building healthier coping strategies
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Addressing anxiety, depression, trauma, or mood symptoms
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Improving emotional regulation
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Developing relapse-prevention strategies
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Exploring motivation and ambivalence about change
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Improving sleep, routines, and daily functioning
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Addressing shame and self-criticism
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Strengthening relationships and support systems
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Coordinating with psychiatric or medical providers when appropriate
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Developing a treatment plan that supports both mental health and recovery
What Therapy With Me
May Look Like
My background in both addiction treatment and mental health care strongly influences how I approach co-occurring concerns.
I do not believe someone should have to choose whether therapy focuses on their mental health or their substance use when both are affecting their life.
My approach is person-centered, collaborative, practical, and nonjudgmental. We can look at how these concerns interact, what role substances may be playing, what symptoms need more attention, and what changes feel realistic.
Depending on your needs, I may incorporate Motivational Interviewing, Cognitive Behavioral Therapy, Acceptance and Commitment Therapy, Internal-Family Systems, Solution-Focused Therapy, Narrative Therapy, Gestalt techniques, psychoeducation, relapse-prevention strategies, strengths-based approaches, and other interventions.
The goal is not simply to treat two diagnoses at the same time. It is to understand you as a whole person and develop a plan that supports both emotional well-being and recovery.
Ready to Get Started?
Ready to schedule therapy?
Visit Healthstead Psychiatry for scheduling, availability, and insurance information.
Not sure yet?
Contact me for a complimentary 15-minute phone consultation to see whether we may be a good fit.