You’re already in treatment for substance abuse, and now your counselor is tacking on various mental illnesses to your chart like it’s a rap sheet and she’s got a quota to fill. What gives? In the interest of World Mental Health Day today, October 10th, let’s discuss how mental health and addiction are related and why it’s important to treat them together.
What are Co-Occurring Disorders?
If you’ve been diagnosed with co-occurring disorders or dual diagnosis, this just means that you’re struggling with more than just addiction— you have some type of mental health disorder to grapple with as well. Believe it or not, this can actually turn out to be good news. You’ve probably been trying to identify why your current treatment isn’t really cutting it, and now one of your providers has finally figured it out. Now both your substance use disorder and your mental illness can be treated at the same time.
How Common are Co-Occurring Disorders?
Over 45% of adults with a substance use disorder also struggle with mental illness (Center for Behavioral Health Statistics and Quality, 2018). These statistics vary depending on the mental disorder and particular substance abused, the combinations of which are almost endless.
The most common mental disorders among individuals who experience addiction include:
- bipolar disorder
- post traumatic stress disorder (PTSD)
- schizophrenia (and other psychoses)
- personality disorders
Not only does the co-occurrence of these disorders make good common sense, but research repeatedly backs up the idea that addiction and mental illness often come in pairs.
Does Substance Abuse Cause Mental Illness? Or the Other Way Around?
Researchers have been arguing for decades about which comes first: mental illness or addiction? But most professionals now agree: it’s too individual of an issue to generalize. As such, you may be able to discover the root cause(s) of your dual diagnosis through the course of your treatment. There are usually three possibilities:
- You could be using drugs or alcohol out of a desperate need to self-medicate. If you suffer from an undiagnosed or untreated anxiety disorder, for example, a few hits of marijuana to calm your nerves can seem like the only thing standing between you and flunking speech class.
- Your mental health disorder could be caused by substance abuse. Drug use may open a door in the brain that was already ajar due to genetics or other factors. Your substance use was just the tiny spark needed to ignite a full-blown mental illness. In addition, drug abuse can physically alter the brain, disrupting its ability to function normally.
- Both your mental health disorder and your substance use disorder are stemming from a third factor, such as trauma or genetics.
Regardless of the cause, it’s obvious that co-occurring disorders are more common than not, and it is crucial for treatment to reflect that.
How are Co-Occurring Disorders Diagnosed?
It can sometimes be extremely difficult to diagnose co-occurring disorders— but why?
- Symptoms of substance abuse can look like a mental health disorder and vice versa. For example, someone who’s sweating and animated could be suffering from a panic disorder, or they could be loaded on cocaine. The overlap of symptoms is overwhelming. If you’re already in treatment, even the symptoms of withdrawal can mimic a psychological disorder. This means that you need to be significantly established in treatment before an accurate diagnosis can be obtained.
- People with mental illness experience chemical imbalances in the brain. It’s not their fault– some people have varying levels of brain function, serotonin, and so on. In a healthy body, these chemicals help to regulate sleep, appetite, metabolism, stress management, mood, and emotions. When these chemicals get out of order, it can wreak havoc on both the body and the brain. Addictive substances interact with these same chemicals, causing a disturbance in normal brain function. This can lead to mood swings, erratic behavior, and dysfunctional thinking. It’s no wonder there’s such crossover between mental illness and addiction.
How Is a Dual Diagnosis Treated?
No matter which unique combination of disorders you experience, it is clear that an integrated, or combined, approach is crucial for the best treatment outcomes. Not only that, but an individualized treatment plan with caring professionals is also needed. This means that the treatment is geared toward the person in their unique circumstances with the goal to best help his or her specific disorders.
Mental Health and Addiction Treatment
One of the best features of integrated treatment for mental health and addiction is that it’s a one-stop-shop. Your one team of providers collaborate on one treatment plan at one treatment facility for you. Everything works together in a system that’s designed to provide you with the care that’s best for you. At such an integrated facility, your team of providers can discuss your treatment plan together and with you directly under confidentiality as it best suits you, not through emails that get lost between Whole Foods coupons and ads for diet pills. Consequently, much less time is wasted trying to coordinate care across fundamentally different medical bureaucracies.
As part of an integrated approach, clients often get to decide what their individual treatment goals are. For example, if you’re diagnosed with both anxiety and alcoholism, you get to choose which of those is most distressing to you, and in what ways. If you feel that alcoholism is your way of self-medicating your anxiety disorder, you might be inclined to focus on the root causes of your anxiety.
Alternatively, if you feel that family problems are at the core of both disorders, you might choose to concentrate on treatment that empowers you to cope with interpersonal relationships and family boundaries. Of course, treating both disorders together is important, but the best way to do that varies based on the individual. In addition, programs that encourage clients to be involved in their treatment decisions tend to have better outcomes.
Treatment for Mental Health and Addiction: Co-Occurring Disorders
Integrated treatment for a dual diagnosis looks a little different than traditional substance abuse treatment. An effective program has at least four parts:
- Medications: Not only are medications effective in treating mental health disorders, but they are increasingly used in the management of substance use disorders, particularly in detox. For example, here at Opus Health we specialize in offering Medication-Assisted Treatment (MAT). Treatment of co-occurring disorders with medications can be complicated: clinicians are acutely aware of safety concerns, drug interactions, addiction triggers, and the potential for abuse. For this reason, it’s crucial that the care providers at your treatment facility be properly educated and professional when it comes to addictionology.
- Individual therapy and addiction counseling: integrated treatment facilities teach coping skills for both addiction recovery and mental health. Furthermore, counselors usually attempt to discover which came first: mental disorder, addiction, or a third variable.
- Support groups for mental illness, addiction, and/or both.
- Relapse prevention/aftercare plan and resources.
Accurate diagnosis and integrated treatment of co-occurring disorders is crucial to recovery if you’re struggling with both mental illness and addiction. Treating one without the other, or treating them both separately has been shown to be much less effective.
Need help finding an integrated treatment facility? Call us today at Opus Health if you’re in the southern California area, as we are a fully-licensed IMS treatment center who understands the relationship between mental health and addiction through recovery.