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Guest Post: The Baggage of Co-Occurring Disorders

Many of those who struggle with a substance use disorder or addiction, carry with them excess baggage. The baggage includes their use of course and all the weight that brings with it. Imagine your biggest piece of luggage stuffed to the brim adding up to a full combat load of 80+ pounds. Well… crap. The wheel just broke off your luggage and you can no longer string it along behind you with the handle. You now have to carry it.

You begin to carry it, but soon throw your back out. You’re in an airport, late for a flight, with no one to help you get to your terminal. You’re ticked off because the bag was heavy and broken but more ticked off because you’re not longer able to carry it. Now you know what it’s like to have a co-occurring disorder.

Why the Excess Baggage?

A co-occurring disorder is a combination of a mental illness and a substance use disorder. Many of us over-pack our bag with the things we think will help us. The things we think will help us ultimately end up weighing us down. Most often, the reason those with co-occurring disorders pack so much stuff is that they are looking to manage the symptoms of their underlying illness with substances. It winds up being this metaphorical “which came first” game. So which came first, the mental illness or the substance use disorder? The answer may surprise you. The answer is that it doesn’t matter.

Over packing doesn’t help…

What really matters is that you accept that you struggle with both, the underlying mental illness and the substance use. As a mental health provider, I see it all the time in my line of work. The depressed often turn to alcohol and the anxious often turn to marijuana. The problem is they “over pack” with excess substances which leave their mental illness worse off than before.

I know in my journey, it was a depression and anxiety disorder that led to my substance abuse. Social anxiety symptoms were unbearable for me as a teenager, so I started to drink alcohol until the symptoms dissipated and I could function like a “normal” person in a social setting. Drinking took the edge off. Unfortunately, I became a binge drinker that threw up and blacked out at parties…..which is anything but cool. When my depression was at its worst my senior year I began to abuse opioids and ecstasy in search of…well….ecstasy. My serotonin was depleted because of the underlying depression, so I used ecstasy because it felt good, but as soon as I came down from the high I was more depressed than before. I was left with a complete lack of serotonin which left me worse than before I used. So I used again to restore what I depleted, and the cycle continued until I literally drove myself crazy. What really saved my life was treating the depression, and recovering from the drug use through sobriety.

The Problems of Unpacking

What you see in co-occurring disorders is a vicious cycle of improper symptom management. The mental illness is unbearable, so you medicate. Because you medicate, you intensify the very symptoms you are trying to treat. Once you get into this cycle it is incredibly difficult to see the big picture. The biggest problem of treatment is getting out of that place of denial not once, but twice. You have to step out of denial about the mental illness, and the substance use disorder. Ouch, right?

Another problem of treatment is having the right sources available. A good Chemical Dependency Counselor can identify a substance use disorder and recommend treatment, but they can’t diagnose mental illness. This is where the rubber meets the road so to say because it is up to the individual to seek mental health treatment as well. Quality substance abuse treatment and mental health treatment cost money, big money. The problem is most addicts don’t have money or insurance.

Time to Unpack

There are affordable options out there though, it takes some digging and researching, but there are a lot of community outreach programs available. These take some of the hard work out of it for you. At a lot of these outreach programs, you’ll find someone ready to talk to you about taking the first step, and they can help get you pointed in the right direction for your specific community.

So if you’re struggling with a co-occurring disorder, or know someone who is, get ready to unpack that bag. It’s overloaded and it is broken. The bag can be emptied. It can be repaired. You can get to your destination with everything you need but you can’t do it alone.


Written by: Rachel Stephens

I write what my heart tells me to in an effort to carry out the 12th step…serving others. I have a BA in Sociology and am working my MA in Human Services Counseling specializing in Addiction and Recovery. I hope to be an LCDC sometime in the next year. My biggest success though is sobriety from drugs and alcohol, and recovery for depression and anxiety. I own 25 acres recreational land of Texas, which includes a stocked pond, a creek, trees, and trails for exploring. If I’m not working or running the kids to soccer or swim, you can find me there.