Co-occurring Disorders and Dual Diagnosis

"Co-occurring disorder" and "dual diagnosis" are terms used often in the field of mental health and addiction treatment. What is a co-occurring disorder? What are dual diagnosis rehab centers?
Join Avenues Recovery, experts in addiction treatment, as we explore the phenomena of dual diagnosis and co-occurring disorders, how they occur, and what the options are for a dual-diagnosis treatment facility.

What is a Dual Diagnosis?

Dual diagnosis definition: When a person suffering from substance use disorder is dually diagnosed with a co-occurring mental health disorder. Illnesses such as depression, bipolar disorder, and anxiety have long been linked to drug and alcohol addiction. When entering drug or alcohol rehab, in order to achieve sobriety, it is vital for both issues to be addressed in tandem.

How Common Are Dual Diagnosis and Co-occurring Disorders?

It is very common for people with substance use disorder to be struggling with serious mental health issues concurrently. Data shows that mental illnesses in all of their forms, including both anxiety disorders like PTSD, and mental disorders such as bipolar disorder, manifest at significantly higher rates in people suffering from addiction than in the general population. Furthermore, people with serious mental illness (SMI) are at an even higher risk for addiction.  

The Journal of the American Medical Association reports that nearly 50% of people with serious mental disorders are affected by addiction. SMI is defined by the National Institute of Mental Health (NIH) as a mental, behavioral, or emotional disorder resulting in serious functional impairment, which substantially interferes with or limits one or more major life activities. These include major depression, schizophrenia, and bipolar disorder, among others. Almost a quarter of individuals diagnosed have a SUD as well.

Avenues Recovery's Matt Engler explains the connection between mental health and substance addiction with Great Day Louisiana:

Addiction or Mental Illness, Which Comes First? 

The cause and effect of co-occurring addiction and mental illness have been hotly debated for years. It has become increasingly clear that there is not one specific way that co-occurring disorders are caused. Although neither makes the other happen directly, their link to one another is obvious, and backed by research and proven data.

There are three basic categories of correlation between the two.

3. Mental illness can lead to addiction and SUD:

   In an attempt to alleviate the symptoms of mental illness, many often turn to drugs or alcohol. The pain is great and the temporary relief these substances provide serves as an escape from the darkness. 

   Unfortunately, the side effects that follow in its wake can be lasting. The initial comfort it provides quickly subsides. It may even worsen as an addiction develops and the body creates a tolerance for the substances chosen. A person suffering from depression may look to heroin to increase dopamine levels. With regular use, dopamine levels will plunge even further, and the depression will only be exacerbated.
   
   Self-medication is the cause of 70% of cases of addiction in women
   
   

4. Drug and alcohol use increase the risk of mental health disorders:

   Mental health disorders are rooted in many different elements. 

   They include: 
   
   • Genetics
   • Environmental factors
   • Life stresses
   With drug and alcohol use and abuse, the risk of developing a mental illness increases. There have been studies showing dual diagnosis examples, with an increase in depression amongst opioid users, as well as psychosis from extended marijuana use.
   
   

5. Alcohol and Drug use exacerbates mental illness:

   Substance abuse may trigger an already underlying illness. Symptoms will rise to the surface and create dysfunction in a person’s day-to-day routine. Sometimes, if someone is taking medications for his mental health disorder, adding drugs will create a cocktail in the body, making the needed medications less effective and even harmful.

Diagnosis for Co-occurring Disorders

Properly diagnosing co-occurring disorders can be difficult. Symptoms of drug and alcohol abuse can mimic those of a mental health disorder. Common manifestations of depression include concentration problems, strong feelings of guilt or a debilitating lack of self-esteem. These symptoms can also stem solely from addiction. Identifying the cause of these symptoms is critical to ascertaining a dual diagnosis. It takes time and significant clinical effort from experienced professionals to properly categorize where a particular chronic feeling is coming from.  However, there are basic warning signs that may point to a co-occurring disorder.

People suffering from addiction can ask themselves the following questions:

• Are drugs and alcohol something you turn to when dealing with difficult moods, situations, or uncomfortable memories and feelings?
• Is there a connection between using substances and how you feel mentally at a given time? I.e. When you drink or use, do you feel sad, worthless, or insignificant as a human being?
• Is there a history in your family of mental health disorders?
• Did you struggle with mental health even before you started to abuse drugs or alcohol?
• When you are sober, how do you feel? Are you in a better place mentally, or are your struggles similar even while not under the influence?
• What is your treatment history? Have you been diagnosed with any conditions relating to mental health in the past? Have you been in addiction treatment in the past and feel that it failed due to unresolved mental illness?
• Is there any unresolved emotional trauma or experiences in your past?

The answers to these questions can help determine if your battle with addiction is accompanied by or compounded by a mental illness.

Understanding Denial

Just as denial is common in addiction, it is common in mental health. Facing conditions that a person feels is beyond his or her control can be understandably intimidating. Admitting the destruction it is causing in life and the consequences it brings is very scary, and sometimes it is easiest just to ignore it in the hope it will dissipate by itself. Shame and feelings of weakness can also deter an individual from tackling the issue head-on. It is quite understandable. However, it is critical to remember that mental illness and drug addiction is a disease and can happen to anybody. Allowing yourself to admit that is the first, and perhaps most important step to turning around your life and entering recovery.

Co Occurring Mental Health Disorders in Teens

The statistics for young adults becoming involved in alcohol and drugs have been mounting over the years, which is disheartening news in itself, but reports have also shown that there is a prevalence in the co-occurrence of addiction and anxiety disorders in teens and young adults as well. This can be brought on by several triggers including educational stress, financial stress, anxiety due to social situations, and pressure felt in many other areas of life.

Young adults are facing far more pressure now than in years before, making it difficult to determine who might be at risk and who is not. For this reason, proper screening and regular visits to a physician are a good idea for all young adults, whether psychiatric issues are involved or not. When issues are identified at an earlier stage it prevents untreated mental illness in adolescence from spiraling and causing further issues like substance use disorders often necessitating intervention such as dual diagnosis adolescent treatment centers.

Mental Illnesses Co-occurring with Substance Use Disorder

Dual Diagnosis Treatment

Treatment for a patient suffering from co-occurring disorders must be integrated to address both issues. Long-term recovery is predicated on discovering any possible underlying issues concurrent with the addiction and learning how to manage them. Mental illness will sometimes require medication, counseling, and understanding how to cope. Going through the clinical process to achieve sobriety, such as drug detox treatment and residential and outpatient therapy, will not be enough, should the mental health component be ignored. It is irrelevant which came first or if one element is more serious than the other. To sustain recovery and avoid relapse, the healing process must include the entirety of a client’s struggle. 

What Is the Best Treatment for Dual Diagnosis?

Treatment for dual diagnosis may include:

1. Integrated dual diagnosis treatment (IDDT): IDDT is a great method of treatment targeting co-occurring mental health issues and substance use disorders. It is done by combining the care provided by mental health services with those of substance abuse treatment centers. In this way, IDDT can help a person overcome multiple disorders, without the need to treat them individually one after the other. 
2. Cognitive-Behavioral Therapy (CBT): CBT is widely used in dual diagnosis treatment. It helps individuals recognize and modify negative thought patterns and behaviors. By addressing both mental health symptoms and substance use, CBT promotes healthier coping strategies and improved well-being 
3. Dialectical Behavior Therapy (DBT): DBT combines cognitive-behavioral techniques with mindfulness. It’s effective for managing intense emotions, reducing self-destructive behaviors, and enhancing interpersonal skills.
4. Group Therapy: Group therapy sessions allow individuals to share experiences, learn from others, and develop coping skills. They provide a supportive environment where participants can discuss both mental health and substance use challenges.
5. Medication: Your healthcare provider may prescribe medication for one or both of your conditions. Some drugs can help alleviate the symptoms of both the conditions of a dual diagnosis.

Treatment for Dual Diagnosis and Co-occurring Disorders at Avenues Recovery

At the Avenues Recovery network of drug and alcohol rehab facilities, we are committed to helping our clients fully understand the scope of what they are dealing with and giving them the tools to overcome their adversity. Our dual-diagnosis treatment centers include teams of medical professionals, expert clinicians, and seasoned sobriety counselors who are trained to see the warning signs of dual diagnosis and map out a treatment plan appropriate to the needs of each individual. 

Reach out today to find out about our dual-diagnosis residential treatment centers. No one is beyond hope and everyone has a way back. We help each person find it.