A co-occurring disorder is a situation in which one simultaneously suffers from addiction and a mental health ailment at the same time. In many situations, those who suffer from a mental health disorder have also turned to substance use or abuse as a method of coping. Previously referred to as dual diagnoses, co-occurring disorders occur more frequently than most would think. According to a survey by SAMHSA (Substance Abuse and Mental Health Services Administration), roughly 7.9 million adults in the U.S. had co-occurring disorders in 2014. The same survey found that roughly 1 in 5 adults (aged 18 and older) suffered from some form of mental illness. That is around 18 percent of all adults in the U.S. or around 43.6 million adults.
Though relatively common, co-occurring disorders can be extremely difficult to diagnose. Those with co-occurring disorders often seek treatment for one disorder while not realizing that the other is present. This is true for the diagnosing health professional as well as many of the symptoms that present themselves are found in both substance use and various mental health issues. If left untreated, co-occurring disorders can lead individuals down a dangerous path.
The Challenge of Diagnosing Co-Occurring Disorders
There are several factors that can make diagnosing co-occurring disorders difficult. It is particularly challenging to pinpoint which came first. Individuals may be unable to pinpoint the start of substance abuse making it difficult to determine which disorder came first. There are several things that are considered when diagnosing and treating co-occurring disorders:
- Drug use can cause the onset of a variety of symptoms, many of which are also found in mental illness. Yet, it is the rate or severity at which these symptoms present themselves in various drug users that makes a case for a co-occurring diagnosis.
- Individuals that are suffering from mental illness have a higher likelihood of turning to drug abuse. Often, these individuals turn to drug use as a means of treating the mental health symptoms they are experiencing. This is frequently true of those suffering from schizophrenia and there is a growing body of research that suggests those individuals are particularly susceptible to developing an addiction.
- Mental illness and drug abuse can both occur as a result of brain disorders or protein deficiencies, genetic predisposition, high levels of stress exposure, or severe traumatic events.
Knowing that these factors makes more healthcare professionals consider a dual diagnosis more frequently when treating patients that seeking treatment for addiction and vice versa.
Common Co-Occurring Mental Health Issues
When examining co-occurring disorders, there are several mental health issues that have higher instances of occurrence. These can be separated in to mood-related disorders, anxiety-related disorders, severe mental illness.
Mood-related disorders include:
- Major depression
- Bipolar disorder
Anxiety-related disorders include:
- PTSD (Post-traumatic stress disorder)
- Panic disorder
- Social anxiety (anti-social personality disorder)
- Generalized anxiety disorder
- OCD (Obsessive-compulsive disorder
Severe Mental Illnesses include:
- Schizoaffective disorder
According to research, these disorders and illnesses each come with their own set of issues that can be hindered by drug use. In many cases, drug use can make many treatment methods for mental illness ineffective.
In addition, there are several types of substance abuse that occur more frequently with certain mental health issues. For example, those suffering from anti-social personality disorder or social anxiety, there is a higher likelihood of suffering from alcoholism as a co-occurring disorder. This happens because many individuals look to alcohol to help them relax in social situations. Other connections that have been drawn include:
- Opioid addiction and PTSD
- Heroin addiction and depression
- Marijuana addiction and/or cigarette addiction and Schizophrenia
Whatever the set of issues, what is important is getting treatment that will address both issues at the same time.
Integrated Treatment for Co-Occurring Disorders
In the past, mental health issues and addiction were treated as separate issues, but it has been proven through extensive research that the most effective method of treatment is an integrated treatment method. An integrated treatment method is an evidence-based method that includes several key factors.
It is important that those receiving this type of treatment experience shared decision making, as it is important that they have agency over their own treatment. Additionally, the treatment should be implemented by the same person or team of people in order to develop a level of trust between the patient and the medical professionals. Treatment should be comprehensive and should address the multiple aspects of the patient’s life that have been affected by their co-occurring disorders.
Within this entire process, there is of course the medical detox that is often necessary for substance addiction as well as various levels of therapy, both individual and group. The recovery rate for those suffering from co-occurring disorders varies widely, due to the difficulties in treating multiple disorders at once, and as such the treatment plan must be one that is geared for the long hall. The process will not be easy and will most likely take a great deal of time and as such, both the patient and the medical professionals must be willing to commit the time and energy necessary for a recovery.
Risks of Leaving a Co-Occurring Disorder Untreated
The risks associated with addiction are often quite widely discussed, but when this addiction is coupled with a mental illness, these same risks are multiplied. Those suffering from co-occurring disorders have higher rates of homelessness, incarceration, unemployment or difficulty maintaining employment, unstable relationships, and other chronic health problems.
These issues make it more likely for these individuals to harm themselves or attempt suicide as well. It is for these reasons, that it is imperative that if you or someone you know is suffering from addiction or mental illness or potential co-occurring disorders that you seek treatment immediately. Recovery is more likely when the situation is addressed in the early stages of addiction. With the right treatment, you can begin to feel more like yourself again.
Warning Signs of a Co-Occurring Disorder
Though many feel it possible to self-diagnosis and treat, the only way to know for sure if you are, in fact, suffering from co-occurring disorders, is to seek the opinion of a mental health professional or addiction specialist. These experts will be able to evaluate your symptoms more objectively and may be able to identify problems you can’t see yourself.
It is possible, however, to identify potential warning signs that you may have co-occurring disorders. You should seek professional help if you have experienced any of the following:
- Feelings of sadness or hopelessness for a period of more than two week, even when not under the influence of drugs or alcohol
- Tendency to use drugs or drink alcohol when recalling painful memories or struggling with feelings of anxiety or fear
- Reliance on drugs or alcohol to control your moods or fear that you fear or anxiety cannot control mood without them
- Struggle facing social situations without the use of drugs or alcohol
- Experience difficulty when focusing on work without drugs or alcohol
- Becoming increasingly reclusive due to substance abuse
- Struggle with maintaining employment for any length of time
- Trouble keeping up with rent or mortgage
- Difficulty maintaining relationships due to substance abuse or anxiety
- Have previously received treatment for depression, anxiety, or any other psychiatric disorder
- Have a history of abuse or trauma that has never been treated or addressed by a mental health professional
If you have experienced any of the above, it is possible that you may be suffering from co-occurring disorders or at the very least mental illness or addiction. The sooner you get help the better.
How Can I Get the Help I Need for Co-Occurring Disorders?
If you feel that you need treatment for co-occurring disorders, you may not know what your next step should be. Seeking treatment for one disorder is difficult to begin with, let alone two. When searching for the facility to best suit your needs as a patient suffering from co-occurring disorders, it is important to look for facilities that have a history of treating patients with similar diagnoses. Many facilities specialize in treating various addictive behaviors, but don’t have the capacity or training to adequately treat mental health issues.
Additionally, it is important to search for a facility that will treat both disorders concurrently. In the past, co-occurring disorders were treated separately, but research has suggested that treatment may be more effective when both are address at the same time through an integrated recovery program. Best practices in treating addiction and mental illness can be combined to create a treatment program that best suits your unique situation.
What are other important features to look for in a treatment facility? The staff should of course have the appropriate credentials and training for integrated treatment for co-occurring disorders. The therapy sessions that are offered should also allow flexibility for those with mental illness as they often have difficulty focusing, suffer from social anxiety, as well as other symptoms that may make it difficult for them to be active participants in the meetings.
When you are presented with your treatment plan, make sure that it has been individually designed to meet your specific needs. Some of the components of such a plan would include:
- A thorough collection of your health history including your mental health and your substance use history.
- Detailed plan for psychotherapy that helps you confront the connection between your mental illness and your substance abuse problem.
- Any necessary medicine to treat the mental illness or substance abuse that you specifically are facing.
- A therapy session in a group format for those suffering with co-occurring disorders.
- A supportive education platform that helps you and your family learn how to best approach your co-occurring disorder to best ensure and happy and healthy home life.
- Opportunities to try holistic therapies such as acupuncture as a supplemental treatment.
- Support that follows you once you’ve graduated from rehabilitation to ensure you are progressing well without setbacks or relapse.
It is important to know that you can get the help that you need. There is a treatment program that will work for you or your loved one. Take time to learn about your co-occurring disorder and what situations, environments, and people may be causing you to experience the symptoms that you have. You may fight yourself with calling to get information and treatment, but you have everything to lose if you don’t.
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