Common Co-Occurring Disorders

When someone who suffers from a mental health disorder also has a substance abuse problem, they have what is called co-occurring disorders, also commonly called dual diagnosis.

Co-occurring disorders could come about as an individual with mental illness subsequently develops a dependency on drugs or alcohol as they seek relief from unpleasant psychiatric symptoms. It could also happen when someone who has a substance abuse disorder then develops mental health disorders from the changes in the brain’s chemistry and structure that addiction can cause.

Typically, it’s difficult to determine which condition came first. Either way, all conditions need treatment at the same time for effective results. Many different variations exist with co-occurring disorders.

Common Co-Occurring Disorders and Addiction

Eating Disorders and Addiction

The brain is stimulated by pleasurable activities. Using drugs and alcohol can stimulate the same reward center of the brain, producing pleasurable effects. Gratifying stimulation comes from eating and enjoying food, and that experience can also block any unwanted, negative feelings and emotions. When pursuit of gratification to avoid negative feelings increases, an addictive cycle develops.

When food or the denial of food is the stimulus, it can lead to eating disorders such as bingeing or anorexia. People in this type of cycle frequently incorporate illicit substances to get the same stimulation, leading to the development of co-occurring disorders.

Depression and Addiction

Depression is found to be a common mental health issue among substance abusers. People who are depressed often use drugs and/or alcohol to block painful thoughts, memories and emotions.

On the other hand, people who frequently drink alcohol—a depressive substance—may bring on sadness as alcohol affects the brain with its depressive properties. Unfortunately, depression and substance abuse feed upon one another, which creates a continuing cycle of both.

OCD and Addiction

It is currently thought that OCD (obsessive compulsive disorder) is likely caused by an imbalance of brain chemicals. There are theories that this imbalance of brain chemicals also causes alcoholism and drug abuse, so the two are tightly interrelated. OCD sufferers also use substances for relief from obsessive thoughts, and regular use can lead to the development of addictions.

PTSD and Addiction

People who suffer from PTSD (post-traumatic stress disorder) experienced traumatic events. Difficult symptoms from PTSD include flashbacks, nightmares, sleeplessness, mood instability and paranoia. Many PTSD sufferers turn to readily available drugs or alcohol for relief and to numb themselves.

Dual Diagnosis Treatment

Proper treatment from trained professionals helps people suffering from co-occurring disorders to reach sobriety and manage psychiatric symptoms, opening up a healthy and productive life made possible by effective and comprehensive addiction programs.

Psychopharmacology: Medication is needed to treat any remaining psychiatric symptoms once detox is completed.

Psychotherapy: Group and individual therapies are needed to address mental health and addiction issues at the same time.

Behavioral Management: Cognitive behavioral therapy (CBT) teaches coping skills for how to respond to negative thoughts and actions. It teaches individuals to replace negative behaviors with positive ones, and rewards are given for positive actions. CBT has been proven effective in modifying addictive behaviors.

What is Dual Diagnosis in Mental Health

What is Dual Diagnosis

When a person has a substance abuse problem and also has accompanying mental health issues, this is known as a dual diagnosis. Also known as co-existing disorders, a person might find themselves chemically dependent on drugs or alcohol while also experiencing a disorder like depression, anxiety, or bipolar.

Addiction specialists need to discover all co-existing disorders to ensure a comprehensive dual diagnosis is reached. After complete identification, rehab programs need to treat all issues for successful recovery.

The National Alliance on Mental Illness reports:

  • A third of people with mental illness and half of people living with severe mental illnesses also have substance abuse problems.
  • A third of all alcohol abusers have been diagnosed with a co-existing mental illness.
  • More than half of all drug abusers have been diagnosed with a co-existing mental illness.

Dual Diagnosis Signs & Symptoms

Since dual diagnosis is a mental health and substance abuse disorder occurring simultaneously, there are many combinations of disorders that exist. The symptoms of dual diagnosis vary widely. Some of the symptoms include:

  • Isolation from friends and family
  • Sudden behavioral changes
  • Using substances under unsafe conditions
  • Acting out risky behaviors while under the influence
  • Loss of control over using substances
  • Doing things out of character to obtain drugs or alcohol
  • Developing tolerance to substances
  • Relapsing on substances after treatment
  • Legal problems
  • Showing withdrawal symptoms from substances
  • Feeling like drugs or alcohol are needed to function
  • Extreme mood changes
  • Confused thinking
  • Concentration and memory problems
  • Thoughts of suicide

Diagnosis of Co-Occurring Disorders

To properly diagnose dual disorders in a person, a professional performs an assessment that details the signs and symptoms being experienced. Since symptoms of substance abuse can mimic the signs of mental health disorders and vice versa, it might take a few days or weeks of observation before an accurate assessment can be made.

The following methods are used to evaluate and diagnose addiction and mental health disorders:

  • Interviewing the client, family and friends about past and current psychiatric symptoms and substance use.
  • Conducting lab tests to detect the presence and quantity of drugs or alcohol that are currently in the body.
  • Holding a physical exam and/or lab tests to look for any physical problems that could cause psychiatric symptoms.
  • Completing a checklist regarding alcohol or drug use, psychiatric history and health.

Treatment for Dual Diagnosis Disorders

Treatment for dual diagnosis is usually a program of medication, therapy and behavioral counseling. All disorders must be treated at the same time to be effective and to prevent relapse.

There are several treatments available for dual diagnosis: psychopharmacology, psychotherapy and behavioral therapy.

Psychopharmacology treats each disorder with prescription medications. Ongoing assessments are made to track the effectiveness of treatment of each disorder.

Psychotherapy uses counselors and therapists to help resolve mental or emotional problems by discussion. Root causes of substance abuse and trauma are uncovered and analyzed.

Behavioral therapy examines behaviors, focusing on the negative consequences and harmful effects. Positive behaviors are developed to avoid these negative consequences using improved judgements. Positive and negative reinforcements are used to foster better decisions.

Is Drug Addiction a Mental Illness

Drug addiction is a complex issue, and so is mental illness. Both disorders display serious and persistent symptoms.

When the best treatment options are being decided, it’s crucial that all issues are included. An addiction treatment program that addresses all these points results in effective recovery and helps to prevent relapse.

The Effects of Addiction on the Brain

According to the National Institute on Drug Abuse, drug addiction can be considered a mental illness in and of itself because using substances causes fundamental brain changes.

The results of these brain changes alter the priorities of the person suffering from addiction. After addiction has taken hold, obtaining and using drugs or alcohol becomes the person’s main priority. Compulsive behaviors—those with little impulse control—dominate the person’s life without regard to the resulting consequences, which is one indication of mental illness.

The Relationship of Addiction and Mental Health Issues

Research has shown that most people who abuse drugs or alcohol also have mental health issues, and the reverse is true as well.

  • People who have anxiety or mood disorders are twice as likely to also have a substance abuse disorder.
  • People with mental health disorders, such as antisocial or conduct disorders, are also twice as likely to have addiction problems.
  • People with substance abuse problems are also twice as likely to suffer from mental health disorders like mood and anxiety disorders.

Some areas of the brain are affected by both substance abuse and other mental illnesses. One affected area is the pathways that are used by neurotransmitters. Since common areas of the brain are affected by addictive substances, they may also be involved in mental health disorders like depression.

Drug Addiction Treatment Options

The first and most important step in addiction programs is to evaluate a client to understand all the mental health issues, besides addiction, that are present and need treatment. Many individuals need qualified help for alcohol withdrawal symptoms, as alcohol detox can be quite dangerous. A comprehensive assessment by trained professionals is needed to do this.

People entering addiction treatment programs need screening for additional mental health issues. Also, people entering mental health treatment need screening by trained healthcare professionals to uncover any substance use disorders.

Once all the symptoms a person is experiencing are diagnosed, it’s crucial to treat all disorders at the same time. Substance abuse and mental health disorder symptoms are typically persistent and resist treatment in someone with co-existing disorders, so a plan of treatment that recognizes this will be most effective.

Finding the Right Help

Drug Addiction treatment plans that will be most effective include:

Medications: Using medicines that are effective in the treatment of substance abuse and mental health issues. Sometimes these medications will help multiple problems.
Behavioral Therapies: Behavioral therapies like cognitive behavioral therapy that modify behaviors, when used alone or with a medication program, have proven to be effective in helping clients with co-occurring disorders.

Finding the most effective treatment involves multiple approaches. This creates a comprehensive substance abuse treatment program that supports clients who are struggling with addiction to reach sobriety, and it helps to prevent relapse.

Bipolar Disorder and Substance Abuse Is There A Link

Studies indicate that between forty and seventy percent of those with bipolar disorder also have a current or previous history of substance abuse. Compared with those without a co-occurring disorder, those with co-occurring illnesses may derive less benefit from treatment for their mood disorder, recover more slowly from episodes, spend more time in hospitals and have higher risks for suicide than those without a dual diagnosis.

These facts demonstrate the importance of considering both the bipolar disorder and any substance use disorder when determining the best treatment and management strategy.

What Is Bipolar Disorder?

Bipolar disorder is a mental illness that causes dramatic mood swings that can go from elated and joyful to sad and hopeless, often with normal mood periods in between. The periods of highs and lows are called episodes of mania and depression. Along with these mood swing episodes, bipolar disorder also causes severe changes in energy and behavior.

The symptoms of bipolar disorder can be quite severe, and they are not the same as normal ups and downs that everyone experiences from time to time. For those dealing with bipolar disorder, the symptoms make it very difficult to engage in everyday life. This can result in damaged relationships, diminished performance at school or work and even suicide.

Bipolar Disorder and Substance Abuse

It is difficult to explain the high rate of substance abuse and among individuals suffering from bipolar disorder, and there are numerous factors involved.

One contributing factor may be that many individuals attempt to self-medicate to reduce the troubling symptoms of their bipolar disorder. Rather than experience anxiety, depression, sleeplessness and pain, some turn to drugs and alcohol to temporarily escape.

An individual’s age and gender may also play a role, according to some research. For example, based on a study published in the journal Bipolar Disorders, drug abuse is more common in young men with bipolar than in females or older age groups. However, alcoholism is seven times higher among women with bipolar disorder than among the general population.

Clinical researchers are studying additional factors that influence both mental illness and substance abuse, including the effects of brain chemistry on both.

In individuals with bipolar disorder, there are often abnormal levels of serotonin, dopamine and norepinephrine. These chemicals affect numerous bodily functions and directly contribute to one’s mood and emotions. Drugs and alcohol further interfere with the how the brain processes these chemicals, causing even more severe emotional instability, erratic energy levels and depression.

It is unclear whether the mental disorder is causing people to turn to drugs or alcohol out of an unconscious need to stabilize their moods, or whether the substance abuse is triggering or intensifying the symptoms of the disorder. But whatever the precise nature of the link, substance abuse has a detrimental effect and makes the symptoms of bipolar disorder worse.

Treatment Options

Regardless of which came first, bipolar disorder or substance abuse, effective treatment necessarily involves addressing both problems. There are varying approaches to treating a dual diagnosis, depending upon the specific needs of the individual. According to Mayo Clinic, finding an effective treatment may include:

  • Initial treatment. It is vital to work with a doctor or other professional who can prescribe medications to balance your moods. Once the symptoms of bipolar are under control, you’ll be better able to determine the best long-term treatment.
  • Ongoing treatment. Because of the underlying causes of bipolar disorder, it requires lifelong treatment, even when you’re feeling better. Maintenance treatment may involve medications, psychological counseling and education or support groups.
  • Substance abuse treatment. If there are problems with alcohol or drugs, substance abuse treatment is essential. In some cases, this issue must be dealt with first, before effective treatment of bipolar disorder is possible.
  • Hospitalization. If your symptoms are particularly severe, hospitalization may be recommended. This is important if you’re behaving dangerously, feel suicidal or become detached from reality. Psychiatric treatment can help keep you safe while stabilizing your mood.
Depression and Alcoholism Co-Occurring Disorders

There are many reasons why individuals suffer from alcoholism, and genetics, environmental factors and mental health issues are just a few explanations. Co-occurring disorders occur when an individual suffers from both a mental health issue and an addiction. Though they are completely treatable, co-occurring disorders are especially delicate and require integrated clinical therapy to achieve lasting results. >/p>

Depression Statistics

Nearly a third of individuals who suffer from major depressive disorder also suffer from alcoholism. Though it can be hard to determine with certainty, in many cases the depression is present before the addiction takes place.

These numbers are compounded by the fact that 10 percent of Americans experience depression, yet more than 80 percent of those who deal with depression go undiagnosed and untreated. In the absence of professional treatment, it’s not uncommon for those suffering in silence to deepen their relationship with alcohol.

Negative Feedback Loops

Whether alcoholism is caused by depression or vice versa varies on a case-by-case scenario, but what remains the same is the impact that the two have on one another. For an individual struggling with alcoholism and depression, the negative feedback loop is self-perpetuating.

A person drinks in an attempt to feel better, only to find that the relief is merely temporary, if at all. This may lead to further attempts to self-medicate by drinking larger amounts with more frequency. Through this process, depression compounds these factors, leading the individual to quickly descend into addiction.

Social Consequences

The seemingly endless cycle of addiction has residual social repercussions as well. Many times people find themselves not caring about anything outside of their addiction. They may be unwilling to speak with others, show up at work or do anything that might interfere with their drinking routine. The inability to listen to reason, combined with disconnection from the world around them, produces a potent fertilizer in which depression, anxiety and addiction can grow.

Dual Diagnosis Treatment

Quitting cold turkey can not only be ineffective, it can be dangerous. Receiving help from certified professionals through a medically supervised detox program will greatly increase chances of recovery and decrease the dangers that come along with detoxing.

Trained specialists look at the root of the addiction and mental health issue and treat them both from the very start—healing both mind and body. Peoplecan learn new ways to cope with their mental health issues and begin to discover the potential that they may have thought was gone forever.

Types of Therapy

Many dual-diagnosis treatment facilities go beyond conventional individual and group therapy, giving individuals the chance to get to know themselves again through activities like art, yoga, exercise and music. When administered effectively and adhered to, therapy can help resolve co-occurring disorders and give people suffering from addiction the tools they need to overcome obstacles in a healthy and positive way.

Anyone who is suffering from alcoholism or who may be developing a drinking problem shouldn’t wait to treat these issues. The more time that passes, the more difficult it will be to break the negative feedback loop.