When a young adult experiences both a mental health condition and a substance use disorder simultaneously, this is known as a co-occurring disorder. This complex interplay of conditions affects millions of young adults in the United States, impacting their daily lives, relationships, and future prospects. Understanding co-occurring disorders is crucial because these conditions often feed into each other, creating unique challenges that require specialized attention and care. The good news is that with proper support, understanding, and treatment, young adults can learn to manage these conditions effectively and lead fulfilling lives.

Co-occurring disorders represent a complex relationship between mental health challenges and substance use issues. For example, a young adult might experience depression while struggling with alcohol dependency or anxiety alongside drug use. These conditions don’t simply exist side by side – they often interact with and influence each other in significant ways.

Think of it like a two-way street: sometimes, mental health challenges might lead someone to use substances as a way to cope with difficult emotions or symptoms. In other cases, substance use might trigger or worsen mental health issues. Each person’s experience is unique, and there’s no single “typical” pattern of how these disorders develop or manifest.

Common mental health conditions that frequently co-occur with substance use disorders include:

• Depression – Depression often intertwines with substance use, creating a challenging cycle. Young adults might use substances to lift their mood or escape feelings of emptiness temporarily, but this usually leads to deeper depression over time. Common substances involved include alcohol, marijuana, and prescription medications.
• Anxiety Disorders – People with anxiety disorders might turn to substances to manage overwhelming feelings or social situations. While substances might provide temporary relief, they typically worsen anxiety symptoms in the long run. This combination is particularly common among young adults navigating social pressures and academic stress.
• Bipolar Disorder – The intense mood swings of bipolar disorder can drive individuals to use substances differently during manic and depressive episodes. During mania, substance use might escalate due to impulsivity, while during depression, it might serve as self-medication.
• Post-Traumatic Stress Disorder (PTSD) – Young adults with PTSD might use substances to numb traumatic memories or manage hypervigilance. Research highlights that individuals with PTSD are 2 to 4 times more likely to develop an SUD compared to those without PTSD.
• Attention-Deficit/Hyperactivity Disorder (ADHD) – Those with ADHD might struggle with impulse control or attempt to self-medicate attention issues. Some might misuse their prescribed medications or seek out other substances to manage their symptoms.
• Personality Disorders – Young adults with personality disorders like Borderline Personality Disorder (BPD) or Antisocial Personality Disorder (ASPD) may use substances to manage intense emotions or cope with relationship difficulties. This combination often creates a challenging cycle where substance use temporarily relieves emotional pain but ultimately makes managing relationships and impulses even harder.
• Eating Disorders – The combination of eating disorders and substance use is particularly complex for young adults. Some might use stimulants to suppress appetite, while others might turn to substances to numb feelings of shame or anxiety around food.

Remember, experiencing any of these conditions doesn’t define you or your future. Many young adults successfully manage co-occurring disorders with proper support and treatment, going on to lead fulfilling, balanced lives.

Young adults face a unique set of challenges that can make them particularly susceptible to developing co-occurring disorders. The transition from adolescence to adulthood brings numerous pressures and life changes that can impact mental health and potentially lead to substance use. Let’s explore why this age group is especially vulnerable:

• Brain Development – During young adulthood, the brain is still actively developing, particularly a crucial region called the prefrontal cortex. Think of this area as your brain’s control center for making good decisions, managing impulses, and handling emotions. While most of the brain develops earlier in life, this essential region isn’t fully mature until around age 25. This timing creates a challenging situation for young adults, making them more prone to engaging in risky behaviors like substance use, which can lead to addiction or exacerbate mental health challenges.
• Genetic Vulnerability – Family history plays a significant role in the development of co-occurring disorders – think of it as inheriting not just physical traits but also predispositions to mental health and substance use challenges. Young adults with family members who have substance use or mental health disorders are more likely to develop similar struggles, especially when multiple family members are affected. This includes conditions like depression, schizophrenia, and bipolar disorder. However, genetic predisposition doesn’t mean these conditions are inevitable.
• Social and Peer Influences – The social landscape of young adulthood creates unique vulnerabilities to substance use and mental health challenges. During this stage, peer relationships take on heightened importance, and the desire to fit in can lead to experimentation with substances. What might begin as casual use in social settings can develop into problematic patterns, especially for those already managing mental health symptoms. The combination of peer influence, newfound independence, and the natural tendency to test boundaries during this developmental period can create a perfect storm where substance use intertwines with emerging or existing mental health challenges.
• Environmental Stressors – Young adults often face an overwhelming mix of challenges – from the intense pressure to succeed academically to the complexities of navigating new relationships and the stress of becoming financially independent for the first time. Young adults who have experienced trauma, abuse, or neglect earlier in life may also find these transitions particularly challenging, as past experiences can resurface during times of stress. These pressures don’t just exist in isolation – they often interact with each other, creating a compound effect that can increase vulnerability to both mental health challenges and substance use issues.
• Self-Medication – Many young adults turn to substances as a way to cope with overwhelming mental health challenges. While these substances might seem to offer relief in the moment, they often create a problematic cycle: the temporary escape feels like a solution, but over time, substance use actually intensifies the very symptoms someone is trying to manage. This pattern can quickly spiral into both worsening mental health and growing substance dependence, making it harder to address either condition effectively.
• Preexisting Mental Health Disorders – Young adults who already have mental health conditions face a significantly higher risk of developing substance use disorders. Research from the National Alliance on Mental Illness (NAMI) shows that someone with a mental health condition is twice as likely to develop a substance use disorder compared to those without mental health challenges.

These factors collectively make young adults a high-risk group for co-occurring disorders, necessitating early intervention and integrated treatment approaches.

Co-occurring disorders can significantly impact various aspects of daily functioning, creating challenges that may feel overwhelming at times. Understanding these effects is crucial for both those experiencing these conditions and their loved ones.

• Academic and Professional Impact – Living with co-occurring disorders can make it difficult to maintain focus and meet deadlines in school or work. The combination of mental health symptoms and substance use can affect memory, decision-making, and overall performance, potentially disrupting educational goals or career progress.
• Relationships and Social Life – These conditions often affect how young adults interact with others and maintain relationships. They might withdraw from friends and family, experience mood swings that strain relationships, or find it challenging to form new connections. Social anxiety might increase, leading to isolation or dependency on substances in social situations.
• Financial Management – Managing co-occurring disorders can strain financial resources, both directly through treatment costs and indirectly through impacts on work ability or spending patterns. Substance use might lead to financial difficulties, while mental health symptoms can affect decision-making around money management.
• Self-Image and Identity – These conditions can affect how young adults view themselves and their place in the world. They might struggle with self-esteem, question their abilities, or feel different from their peers.
• Daily Responsibilities – Simple tasks like maintaining a clean living space, paying bills on time, or keeping up with personal hygiene might become more challenging. The combined effects of mental health symptoms and substance use can make it difficult to stay organized and manage daily responsibilities.

Despite these challenges, it’s essential to remember that co-occurring disorders are treatable conditions. With appropriate support, treatment, and coping strategies, young adults can learn to manage these impacts effectively and lead fulfilling lives.

Recognizing the signs of co-occurring disorders is an important first step toward getting help and beginning the journey to recovery. While everyone’s experience is unique, there are common patterns and signs that may indicate the presence of co-occurring disorders. Understanding these signs can help young adults and their loved ones identify when professional support might be needed.

Co-occurring disorders often first appear as noticeable changes in someone’s typical behavior patterns. You might notice:

• Sudden loss of interest in previously enjoyed activities
• Significant changes in sleep patterns or energy levels
• Difficulty maintaining regular routines or responsibilities
• Changes in eating habits or unexplained weight fluctuations
• Neglect of personal hygiene or appearance
• Increased risk-taking behaviors

Pay attention to shifts in emotional well-being and mental state:

• Persistent feelings of sadness, anxiety, or emptiness
• Rapid mood swings that seem out of character
• Difficulty managing stress or everyday challenges
• Increasing social isolation or withdrawal from loved ones
• Persistent feelings of hopelessness or worthlessness
• Trouble concentrating or making decisions
• Racing thoughts or persistent worry

Watch for changes in substance use behavior:

• Using substances to cope with emotional pain or stress
• Needing increasing amounts of substances to feel the same effects
• Continuing substance use despite negative consequences
• Having difficulty controlling or limiting substance use
• Experiencing withdrawal symptoms when not using
• Making excuses or becoming defensive about substance use

Notice shifts in how someone interacts with others:

• Unexplained conflicts with family or friends
• Changes in social circles, especially toward peers who use substances
• Difficulty maintaining healthy relationships
• Withdrawing from social activities or family gatherings
• Increasing isolation or secretive behavior

Look for changes in performance and responsibility:

• Declining grades or work performance
• Frequently missing school, work, or other commitments
• Difficulty meeting deadlines or completing tasks
• Problems with concentration or memory
• Reduced motivation or initiative

Remember: These signs don’t necessarily mean someone has co-occurring disorders, but they do suggest that professional evaluation might be helpful. It’s important to approach these concerns with compassion and understanding, recognizing that seeking help is a sign of strength, not weakness.

If you or someone you know is showing these signs, know that help is available and recovery is possible. Many young adults successfully manage co-occurring disorders with proper support and treatment. The earlier these signs are recognized and addressed, the better the chances for positive outcomes.

At Portum Behavioral Health, our specialized Intensive Outpatient Program (IOP) offers comprehensive evening care designed specifically for young adults ages 18-35 who are managing co-occurring disorders. Our experienced team understands the unique challenges you face and provides the support, tools, and flexibility you need to work toward recovery while maintaining your daily responsibilities.

Ready to take the first step? Contact us to learn how our evening IOP can help you build a stronger foundation for lasting wellness.