It's not uncommon for people with addiction to experience mental health issues such as anxiety, depression, bipolar disorder, post-traumatic stress disorder (PTSD), schizophrenia, or others. In fact, according to the Substance Abuse and Mental Health Services Administration, about 9 million people have dual diagnosis. Despite this, only 7% of these people get treatment for both conditions, and 60% receive no treatment.
Dual diagnosis, also known as co-comorbidity or co-occurring disorders, refers to the simultaneous presence of a substance use disorder (SUD) and a mental health disorder in an individual. In other words, it's when someone simultaneously deals with addiction and a mental health condition.
This can involve various combinations of diseases, such as depression and alcoholism, anxiety and cocaine addiction, bipolar disorder and opioid dependence, and many others. It's essential to understand dual diagnosis because the presence of one condition can often complicate the diagnosis, treatment, and recovery of the other.
Mental and substance use disorders often overlap, making it hard to know if you're dealing with a dual diagnosis. But there are some common signs to watch out for, including:
SUD and mental health disorders interact in complex ways; each condition can influence and worsen the symptoms of the other. But this does not mean that one necessarily leads to the other, even when one condition appears first. Here are some factors that contribute to the co-occurrence of addiction and mental illness:
Both addiction and mental health disorders can arise from shared risk factors, such as genetics, family history, childhood trauma, and environmental factors. Evidence shows that about 40-60% of someone's vulnerability can be attributed to genetics. So, a person with a genetic predisposition to depression might also have a genetic susceptibility to addiction. Besides, some drugs trigger symptoms of certain mental illnesses – like how marijuana increases the risk of psychosis.
Some individuals with mental health disorders may turn to drugs or alcohol as a form of self-medication. They might use substances to alleviate distressing symptoms or emotional pain temporarily. For example, someone struggling with social anxiety might use alcohol to feel more comfortable in social situations. They may also use substances to escape from their distressing symptoms.
The brain's reward system and neurotransmitter pathways affect addiction and mental health. Changes in brain chemistry due to substance abuse can contribute to the development or exacerbation of mental health symptoms and vice versa.
Addiction and mental health disorders can create a cycle of reinforcement. For instance, someone with depression who finds relief in alcohol might continue using alcohol to manage their mood. However, over time, alcohol dependence can worsen depression, creating a harmful feedback loop.
Both addiction and certain mental health disorders can impair decision-making abilities. This can lead to increased risk-taking behavior and difficulty seeking or adhering to treatment.
Treating dual diagnosis presents numerous challenges and complexities. The intertwined nature of these conditions can make diagnosis, treatment planning, and recovery more intricate.
One of the biggest treatment challenges is determining which condition came first – whether it's a substance use disorder or the mental health disorder. Substance abuse can sometimes mask or mimic symptoms of mental health disorders, making accurate diagnosis complicated.
Many symptoms of substance abuse and mental health disorders overlap, such as changes in sleep patterns, appetite, energy levels, and mood. This can lead to misdiagnosis or underdiagnosis if clinicians are not well-trained in recognizing co-occurring conditions.
One condition can exacerbate the other in a bidirectional manner. For example, substance abuse can worsen the symptoms of a mental health disorder, and a mental health disorder can lead to increased substance use as a coping mechanism.
Individuals with dual diagnosis might not respond well to traditional treatment methods due to the interaction between the two conditions. For instance, a mental health disorder might impede an individual's ability to engage fully in addiction treatment and vice versa.
Dual-diagnosis treatments must be comprehensive, integrated, and tailored to the individual's needs. These plans should address both conditions simultaneously to promote lasting recovery. Here's an overview of the components that are typically included in dual-diagnosis treatment plans:
A thorough assessment is conducted by mental health and addiction professionals to accurately diagnose both the mental health disorder and the substance use disorder. The evaluation considers the individual's medical history, substance use patterns, mental health symptoms, and any co-occurring medical conditions.
Professionals, including psychiatrists, psychologists, therapists, addiction counselors, and medical doctors, collaborate to create a cohesive treatment plan that addresses mental health and substance use components. These may include:
These medical and therapeutic strategies can be done in an inpatient or outpatient rehab setting, depending on the extent of addiction and patient preference.
Addressing co-occurring disorders requires a comprehensive and integrated approach to treatment. At More Than Rehab, we understand the intricate relationship between substance use and mental health disorders. That's why we provide an integrated care plan that thoroughly addresses both aspects, providing individuals with the best possible chance for lasting recovery and improved well-being.