Identifying signs that you or someone you care about might have co-occurring disorders — the combination of mental health challenges and substance misuse — can be challenging, because symptoms may overlap and vary depending on the mental health disorders and substances involved. Still, there are some common warning signs to look out for:
- Routinely or atypically engaging in impulsive or risky behaviors.
- Mood swings, intense bursts of energy, significant sadness, hopelessness, despair, anxiety or depression.
- Difficulty focusing, finishing tasks or making decisions. Frustrated easily.
- Isolating, avoiding family and friends.
- Loss of interest in school, work, hobbies and responsibilities.
- Increased or secretive use of nicotine, alcohol or other drugs.
- Frequently asking to borrow money or stealing money.
- Unexplained physical health issues, weight changes, neglect of hygiene or appearance, sleep difficulties.
- A known personal or family history of substance use or mental health disorders.
- Suicidal thoughts, self-harming behaviors or suicide attempts.
How You Can Help
When someone you care about is struggling, it can be difficult for everyone in their life. It’s hard to know what to say or how to help. While these conversations can be challenging, stepping in when you see the signs of co-occurring disorders could save a life. If you are unsure about the level of risk, always err on the side of caution and seek guidance from a professional.
Low Risk:
Changes in mood, behavior, or habits that are noticeable but do not yet interfere significantly with daily life.
What to Do:
Maintain communication, encourage healthy coping strategies, and check in regularly.
Moderate Risk:
Persistent struggles affecting school, work, relationships or daily functioning. Signs of increased isolation, difficulty managing emotions or early substance use.
What to Do:
Express concern, suggest seeking professional support and monitor for worsening symptoms.
High Risk:
Signs of severe distress, self-harm, suicidal thoughts, heavy substance use or medical danger.
What to Do:
If you or someone you know is struggling with mental health and/or substance use, you are not alone. Seek immediate intervention —call 911 for medical attention; 988 for the Suicide and Crisis Lifeline; or 1-800-662-HELP for the SAMHSA (Substance Abuse and Mental Health Service Administration) National Helpline. Carrying naloxone (Narcan) can help reverse an opioid overdose.
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