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Addiction and Other Psychological Disorders

A. Tom Horvath, Ph.D., ABPP, Kaushik Misra, Ph.D., Amy K. Epner, Ph.D., and Galen Morgan Cooper, Ph.D. , edited by C. E. Zupanick, Psy.D.

This series of articles are focused on addiction. Nonetheless, it is important to recognize that addictive disorders frequently occur with other psychological disorders.

Why do addictions so frequently overlap with other psychological disorders?  There are several possible explanations.  Perhaps addictions and other psychological disorders represent overlapping genetic vulnerabilities. For instance, maybe an imbalance of neurotransmitters play a role in both disorders.  Another possible explanation is the overlap of diagnostic criteria. The DSM is by no means without problems.  One such problem is that the same symptom can be included in many different disorders.  Therefore, co-occurring disorders may simply be due to overlapping symptoms in the diagnostic criteria.  Furthermore, it is easy to imagine how some psychological disorders might lead to the development of an addiction.  For instance, a depressed person might drink excessively in an effort to feel better (briefly). This is very similar to the psychopathological theory of addiction.  However, the reverse could also be true.  Maybe addiction causes psychological disorders such as depression.  These debates will continue.  Fortunately, they do not need to be resolved to recover from addiction.

Several symptoms of Substance Use are also symptoms of other disorders.  These include mood disturbances; anxiety, irritability, compulsions, sleep disturbance, paranoia, hallucinations, delusions, impulsivity; and emotional dysregulation.  The following list of psychiatric disorders include one or more of these same symptoms:

It is worth noting that people with psychological disorders are more likely to also have a tobacco use disorder as well. Roughly 55-90% of people with a psychological disorder smoke. Compare this to the general population where 21% of people are current smokers (DSM-5, 2013).

In this section, we will review several types of disorders that commonly occur together with addiction. Clinicians call these co-occurring disorders.