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The Recovery Expert
with Sharie Stines, Psy.D.

Cheat Sheet for Common Mental Illnesses Co-Occurring with Substance Abuse

I tend to work with addicts, alcoholics, abusers, and abuse victims.  Often, others are not quite sure what some of the typical symptoms are of some of the most common mental illnesses.  I decided to make my life a little easier so I typed up a little “cheat sheet” with descriptions of some of the most prevalent mental illnesses I come across, particularly when dealing with substance abusers.  This list is by no means exhaustive.  The definitions were taken from the DSM-V.

Psychotic Disorders

  • Schizophrenia – Defined by audio, visual, tactile hallucinations, or delusional thinking (beliefs of grandeur, persecution, thought control, or secret messages); disorganized speech (word salads); disorganized behavior; lack of expression (flat affect).
  • Schizoaffective Disorder
    • Bipolar Type – schizophrenia with major manic episodes.
    • Depressive Type – schizophrenia with major depression episodes.

Bipolar Disorders

  • Bipolar I Disorder – Defined by manic episodes involving extremely elevated mood which is beyond reason and can include irritability, grandiosity, excessive drug use, sexual activity, spending, gambling, or business activity; rapid stream of thoughts; requires very little sleep; excessive mood lasts at least one week in duration.
  • Bipolar II Disorder – Less intense levels of manic behavior than bipolar I, which last for at least 4 days in duration, includes behaviors of irritability, grandiosity, increased energy, talkativeness, distractible; also involves periods of major depression. Bipolar Ii may look like major depression with brief periods of unusual energy or irritability.

Depressive Disorders

  • Major Depression – Depressed mood most of the day, nearly every day; fatigue; lack of interest in anything; insomnia; hypersomnia; feelings of worthlessness and/or guilt; significant weight loss; inability to concentrate..
  • Dysthymia – Depressed mood for most of the day, for more days than not, for at least 2 years; same symptoms as major depression.

Anxiety Disorders

  • Generalized Anxiety Disorder – Defined by excessive anxiety and worry (apprehensive expectation), occurring more days than not for at least 6 months.
  • Panic Disorder – Recurrent unexpected panic attacks. A panic attack is an abrupt surge of intense fear or intense discomfort that reaches a peak within minutes, symptoms include: heart palpitations, sweating, shaking, shortness of breath, feelings of choking, chest pain, nausea, dizziness, chills, derealization, depersonalization, fear of going crazy or dying.
  • Phobias – Defined by a marked fear or anxiety about a specific object or situation.
  • Social Anxiety Disorder – Defined by a fear of social situations; exposure to possible scrutiny by others.

Obsessive Compulsive Disorders

  • Obsessive-Compulsive Disorder – Defined by obsessive thoughts and compulsive behaviors with an aim to reduce the distress triggered by the obsessions; compulsions are not connected in a realistic way to the feared event or are obviously excessive; compulsions are not done for pleasure.
  • Body Dysmorphic Disorder – Defined by obsession with how one’s body looks; preoccupation with one or more perceived defects or flaws in physical appearance that are not observable or appear slight to others.
  • Hoarding – Defined by compulsively saving material items; persistent inability to discard items, regardless of their actual value. Animal hoarding is another form of hoarding behavior.

Trauma- and Stressor-Related Disorders

  • Posttraumatic Stress Disorder (PTSD) – Defined by effects of an extreme trauma; after effects of witnessing or experiencing a traumatic event. Recurrent, involuntary, and intrusive distressing memories of the traumatic event; intense or prolonged psychological distress; dissociation; problems with concentration; startle effects; hypervigilance; and other intense reactions to external and internal stimulation.  PTSD is diagnosed when symptoms occur over 6 months after exposure to traumatizing event.
  • Acute Stress Disorder – Similar symptoms to PTSD, yet only lasting from 3 days to one month after experiencing or witnessing a traumatic event.
  • Adjustment Disorder – Emotional or behavioral symptoms of distress in response to an identifiable stressor occurring within 3 months of the onset of the stressor. Also known as complex PTSD; this is defined by ongoing abusive/neglecting experiences.

Dissociative Disorders

  • Dissociative Identity Disorder – Defined by psychic splitting; involves the existence of two or more personality states. Also known as split personality or multiple personality disorder.

Eating Disorders

  • Pica – Defined by eating non-typical (non-food) substances.
  • Anorexia Nervosa – Defined by significantly low body weight; intense fear of gaining weight.
  • Bulimia – Defined by overeating and binge eating followed by compensatory purging.
  • Binge Eating Disorder – Defined by eating large quantities of food compulsively.

Sleep-Wake Disorders

  • Insomnia – Defined by an inability to fall asleep or stay asleep at night.

Disruptive, Impulse-Control, and Conduct Disorders

  • Kleptomania – Defined by stealing; impulsively steals objects that are not needed for personal use or for their monetary value; stealing relives tension which exists prior to theft.

Personality Disorders (Cluster B)

  • Antisocial Personality Disorder – Defined by a pattern of disregard for, and violation of, the rights of others; deceitful; irresponsible; dishonest; indifference and lack of remorse for wrongdoing.
  • Borderline Personality Disorder – Defined by fear of abandonment; unstable and intense interpersonal relationships –  alternating between extremes of idealization and devaluation; self-injury; labile mood swings; surrounded by drama; impulsive; often suicidal; frequent lying; highly manipulative; self-sabotage.
  • Narcissistic Personality Disorder – Defined by Entitlement; very self-absorbed, selfish, self-important; requires excessive admiration and attention; utilitarian in interpersonal relationships; lacks empathy; arrogant; envious; fantasizes.

Common Psychological Definitions

Affect – A psychological term for an observable expression of emotion.

Depersonalization – Experiences of unreality, detachment, or being an outside observer with respect to one’s thoughts, feelings, sensations, body, or actions.

Derealization – Experiences of unreality or detachment with respect to surroundings.

Hypersomnia – Excessive sleepiness and time spent sleeping.

LabileUnstable, radically fluctuation emotions.

Manic – Elevated, expansive or unusually irritable mood, as well as notably persistent goal-directed activity is present

MoodPrevailing psychological state.

Rapid Cycling – Bipolar disorder with rapid cycling is diagnosed when a person experiences four or more manic, hypomanic, or depressive episodes in any 12-month period; can occur with any type of bipolar disorder.

Word Salad – A confused or unintelligible mixture of seemingly random words and phrases; found with some forms of schizophrenia.

Cheat Sheet for Common Mental Illnesses Co-Occurring with Substance Abuse


APA Reference
Stines, S. (2015). Cheat Sheet for Common Mental Illnesses Co-Occurring with Substance Abuse. Psych Central. Retrieved on June 26, 2019, from https://pro.psychcentral.com/recovery-expert/2015/12/cheat-sheet-for-common-mental-illnesses-co-occurring-with-substance-abuse/