You’ve heard the old saying, “when it rains it pours?” Unfortunately, this often is the case with mental health concerns.
Nearly a third of people with mental health disorders and almost half of those with severe mental illness also suffer from addiction, giving them co-occurring disorders.
If you are one of those people, getting healthy means treating the mental health disorder and the addiction.
Defining Co-Occurring Disorders
A co-occurring disorder (also known as comorbidity, dual disorders, or dual diagnosis) is the term used when you have both a mental health issue and an addiction. More than nine million people in the United States have co-occurring disorders, which appear simultaneously or just overlap.
Co-occurring disorders can present themselves at any age but often develop during the transition into adulthood (ages 18-25) when mental health issues typically appear for the first time.
Co-occurring disorders include a combination of two or more substance use disorders and mental health disorders, according to the American Psychiatric Association’s (APA) Diagnostic and Statistical Manual of Mental Disorders (DSM-5).
Common mental disorders with dual diagnosis are:
- Anxiety, depression, bipolar, or other mood disorders (affect one in 10 adults each year)
- Personality disorders
- Conduct disorders,
- Eating disorders (affect 30 million Americans in their lifetimes)
- Post-traumatic stress disorder
- Attention deficit hyperactivity disorder
People treated for these disorders often also misuse alcohol, tobacco, and/or drugs, either prescription or otherwise. About 8% of the population age 12 or older are diagnosed with a substance use disorder each year. Substance abuse can happen to anyone, but the median age of diagnosis is 20 and men are twice as likely to experience this type of addiction. The more severe the mental illness is, the more likely you are to have a substance abuse disorder.
When you have more than one disorder, you need treatment for the causes of all of them to get well. The disorders often exacerbate each other. If one disorder is treated, but others are not, you will continue to have problems with the untreated issues.
Symptoms of Co-Occurring Disorders
It can be difficult to diagnose co-occurring disorders because the symptoms of mental health issues and addiction overlap. A mental health professional can most easily diagnose dual disorders in person and when you aren’t using any substances.
Some general symptoms of mental illness include:
- Changes in Basic Functioning. Major changes in eating or sleeping habits, either eating and/or sleeping too much (i.e., you can’t seem to get out of bed) or not enough (binge eating, for example).
- Lack of Interest. No longer finding interest in hobbies or activities that once were important and brought you joy.
- Mood Swings. You experience extreme emotional highs and/or lows, often within a short timeframe. Or you feel afraid without a legitimate cause. You are increasingly irritable and just can’t seem to get along with others or pull out of your “bad mood.” Or maybe you just feel like you’re in a fog and can’t focus or think clearly.
- No Self-Awareness. Sometimes those with mental illness can’t see changes in their behavior that are clear to others. You may even become angry or aggressively deny these changes when others point them out to you.
- Withdrawal. You isolate yourself from friends or family. This may occur after they mention changes in your personality or behavior, although that’s not always the case.
- Physical Changes. You may have an increased or decreased libido. You also may just physically not feel well, even though you have no reason not to. Possibly you stopped performing personal hygiene routines like brushing your teeth or showering regularly.
- Behavioral Changes. You may start participating in risky behaviors that are out of character for you, like substance abuse. You also could experience hallucinations, paranoia, or delusions, or consider suicide.
Substance use symptoms depend somewhat on the substance used.
Here are some general substance use disorder symptoms:
- Inability to Quit. You can’t stop using the substance, even though you’ve tried. You may even have tried to quit because it’s worsening your other symptoms. When you try, you experience withdrawal symptoms like sweating, vomiting, muscle aches, and/or restlessness.
- Difficulty Functioning. You feel like you can’t function or cope with your regular life without the substance. As an alternative, you can’t complete regular tasks because of your substance use. You also may be in danger of disciplinary action because of tardies or absenteeism from school or work.
- Withdrawal. You isolate yourself from friends or family or spend time with different types of people. In other words, you spend time with people who support your substance use and avoid those who don’t.
- Risky Behavior. You participate in risky behaviors that are out of character for you, like driving under the influence. You may even get into legal trouble or be arrested because of these behaviors, but you still can’t stop.
- Increasing Need. You experience an increased tolerance, which means you need more of the substance to get the same feeling you did initially. This increased need could result in you spending a lot of time getting, using, or recovering from the effects of the substance. It also may cause financial difficulties.
The dual disorders result in more problems than a single disorder. The more either or both disorders increase in severity, the greater these concerns will become and the more difficult treatment will be. Therefore, it’s important to seek help as soon as you identify concerns.
Co-Occurring Disorders and Substance Use
There is a strong relationship between substance abuse disorders and other mental health disorders. Half of the people with one disorder eventually develop at least one co-occurring disorder. These disorders can worsen each other’s severity.
Mental health researchers identified three reasons co-occurring disorders are so prominent.
- Overlapping Risk Factors. Common risk factors for substance abuse disorders and other mental health conditions frequently overlap. These factors include genetics (40-60% of vulnerability for a substance abuse disorder is genetic) and environmental factors, like exposure to trauma.
- Self-Medicating. Some people try to cope with mental illness on their own by self-medicating to lessen the symptoms of the mental illness. The problem is that you aren’t a trained professional and often cause further harm to yourself while temporarily reducing symptoms.
- Self-Induced Brain Changes. Substance abuse can change areas in the brain, increasing your likelihood of developing a mental health disorder. These brain changes correlate with impulse control, mood, and anxiety disorders, to name a few.
Benefits of Dual Diagnosis Treatment
Co-occurring disorders require integrated dual diagnosis treatment to help you fully heal. Mental health professionals need to treat the disorders together or the untreated issues will worsen over time. You need to receive treatment for the root causes of your disorders, not just the symptoms.
Four Signs of Co-Occurring Disorders
There are often signs that indicate mental health disorders and substance abuse. If someone you are close to struggles with alcohol or marijuana abuse as well as a bipolar disorder, they may behave even more erratically than someone with a substance abuse disorder alone.
In general, those living with co-occurring disorders have difficulty functioning on a day-to-day level. Common signs include the following:
- Inability to hold down a job
- Difficulty holding functional friendships
- Legal and financial problems
- Extreme mood swings
You probably cannot rely on a loved one caught in this situation. Unstable emotional ups and downs can interfere with regular family life. If you concentrate on taking care of a family member with co-occurring disorders, you may find it difficult to meet your other family obligations. So, what can you do?
When you see signs of chronic intoxication, drug abuse, and poor judgment, you may wish to refer your loved one to Integrative Life Center in Nashville. For co-occurring disorders, we may recommend a residential addiction recovery program. We offer gender-specific treatment options for men and women that make it easier to concentrate on recovery without distractions.
Who Has Co-Occurring Disorders?
Mental Health America reports that certain clients have an increased risk of developing a co-occurring substance abuse disorder:
- Antisocial personality disorder: 15.5%
- Manic disorder: 14.5%
- Schizophrenia: 10.1%
- Panic disorder: 4.3%
- Depression: 4.1%
This means that those with personality disorders have a high likelihood of turning to drugs and alcohol to numb the symptoms of their disorder. Fortunately, a reputable depression or anxiety treatment program and similar therapies provide a better solution.
Treatment for Co-Occurring or Dual Diagnosis in Nashville, TN
Integrative Life Center provides treatment for co-occurring disorders including:
- Cognitive-behavioral therapy. Perhaps the most common type of therapy, CBT helps you and your therapist identify harmful ways you think and behave. You then work together to determine how to respond to those thoughts and actions in a healthier way.
- Dialectical behavior therapy. Uses mindfulness to help you learn how to observe your emotions in stressful situations instead of reacting to them. This type of therapy then helps you recognize triggers and avoid undesirable actions.
- Experiential Therapy Programs. Uses movement, action, and activity (kayaking, for example) to create a mind-body connection and encourage you to recognize and address suppressed issues.
- Relapse Prevention Therapy. Addiction is a chronic disease, which means you have to be prepared to prevent relapse. This type of therapy equips you with skills to recognize, cope with, and control relapse triggers.
At ILC we use the transformative approach to treatment, which means we focus on restoring your physical and emotional self. That means we help you strengthen your mind, body, and soul. We will help you identify and address the root cause of your issues, not just the symptoms. Then we will help you treat the causes and control the resulting negative behaviors.
Co-occurring disorders are common. The cause of these dual disorders must be treated simultaneously to help you address your mental health concerns and overcome your addictions. ILC can help you heal your mind and body from co-occurring disorders. Contact us today to get started on a treatment plan.