Dual diagnosis cases (also called “co-occurring disorders”) are extremely common, especially among certain groups. In fact, there’s reason to believe that there’s a causal relationship between many mental disorders and substance abuse disorders.
For example, according to a study published on substance abuse among veterans, 11 percent of veterans who visited a VA treatment facility for the first time met the criteria for a substance abuse disorder. Veterans are also more likely to suffer from mental disorders such as post-traumatic stress disorder (PTSD), which can lead to alcohol abuse and opioid prescriptions that lead to substance abuse.
Overall Prevalence of Dual Diagnosis
According to the Substance Abuse and Mental Health Services Administration (SAMHSA), 7.9 million adults suffered from co-occurring disorders in 2014. The administration assessed the following groups as being at the highest risk of dual diagnosis:
For the populations who are homeless or in the criminal justice system, the causal relationship may be different than with veterans, and it should be noted that there is some significant overlap in these three groups.
A report published by the National Institute on Drug Abuse suggested that there is a reason why people with mental disorders are up to two times as likely to develop substance abuse disorders:
Simply, people who struggle with mental health disorders either seek clinical medication or self-medicate with drugs and alcohol. People that get prescriptions for their condition are less likely to develop abuse disorders, but often the medications that they get access to have a high abuse potential, creating more risk.
People that self-medicate for their mental illnesses often start early, and the use of drugs or alcohol as a way to escape becomes a natural part of life.
The reverse order can also be true, in which a mental disorder is caused or worsened by the use of drugs or alcohol. For example, some common pairings:
The original development of an addiction may have come about as a response to a mental health issue. Without proper diagnosis many seek to control their disorders by self-medicating—alcohol or tranquilizers for anxiety, amphetamines or cocaine for depression, etc.—and the short-term relief or distraction makes the experiment look like a success. Repetition can then lead to dependency, and a substance abuse disorder is formed when one previously might not have been. The substance abuse can exacerbate the mental illness, and the mental illness impede long-term sobriety. This cyclical affect of dual diagnosis makes it difficult to treat without the proper support.
Alternatively, a person relatively free from mental health problems can experiment with drugs and continue past “recreational use” to dependency; then secondary mental health issues can emerge. Untreated, these can in turn exacerbate the ongoing drug abuse. Also, certain drugs, like amphetamines and PCP, can cause psychotic episodes that may repeat themselves—these flashbacks can be triggered by stress even in the absence of drug use.
At Holistix Treatment Centers, we believe that if the client can identify the underlying issue and treat it simultaneously with their treatment for addiction, the client’s chances of a successful, relapse-free recovery are much improved. In fact, once we can identify and properly begin treatment on the underlying issue that’s driving or co-occurring with the dependency on alcohol or other drugs, clients will have reached a major milestone and will be that much closer to long-term sobriety.
At Holistix Treatment Centers, we do not believe that long term recovery comes in a one-size-fits-all program. For this reason, each client, upon arrival at our drug treatment center, will undergo an extensive and comprehensive physical and psychological exam with our team of physicians, mental health specialists, spiritual advisers, and nutritionists. Together, we will determine what the client’s underlying issues are so we can then customize an individualized approach and, when appropriate, provide integrated dual diagnosis treatment. The symptoms of the multiple disorders that can occur alongside addiction can present complex and similar symptoms. Proper diagnosis requires a highly trained professional staff with years of experience.
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Bipolar disorder is a treatable brain disorder marked by extreme shifts in a person’s mood and disposition. Periods of intense mania are followed by bouts of severe depression, often with periods of normalcy in between. While on either end of the spectrum, sufferers of bipolar disorder often find it difficult to concentrate and maintain functionality sufficient for leading a productive life. Bipolar disorder, which is also known as manic depression, can be managed with medication. It is characterized with intense manic or “high” periods in which the individual becomes overly enthusiastic or optimistic and may begin tasks or plans that are not feasible. These high periods are followed by crashes and intense “lows”, which can involve sleeping all day, feeling hopeless, suicide attempts, and other symptoms shared with depression.
PTSD is a condition brought on by a traumatic event or period in one’s life. As the name implies (post traumatic-stress disorder) fits of stress come, often triggered by a stimuli that relates to their trauma, delivering a surge of emotions and unpleasant memories associated with the event. PTSD patients report that sometimes they are suffering from uncontrollable anxiety, sleepless nights, and unrealistic dreams by nature. This can lead to short-term memory loss, which may cause long lasting psychological issues. It is recommended to treat the victim as early as possible in order to avoid complications. When it is confirmed that the affected person is behaving in a dangerous way, it is important to address the issue so the victim will no longer be affected by the traumatic event. To deal with the bouts of stress brought on by PTSD, many patients begin self-medicating with depressants to numb their pain, or any other drug that allows them to find an ‘escape’ from their experiences.
Fear is your body’s natural reaction to a lot of outside stimuli. It is normal for the body to react in such a way as to become anxious or fearful because this often protected our ancestors from a lot of problems and harm. It is not normal, however, for our bodies to be overtaken with fear to the point that physical symptoms begin to arise because of it. When this happens, it is usually the sign of a larger problem. Panic attacks are unique from a normal fear in that there is no real danger the body is protecting the sufferer from. Most people experience a couple panic attacks in their lifetime, without recurrence. If, however, panic attacks are more regular, it may debilitate the person and alter their behavior in anticipation. Sufferers may try to self-medicate their condition using depressants, rather than seek proper medical help.
Depression is another mental illness that is very common in young adults. It is characterized by feelings of extreme helplessness, hopelessness, and is not nearly the same thing as “feeling blue” or being “down”. Depression is a serious mental condition that affects millions of Americans, and can cause suicidal thoughts as well as over, or under-eating, over, or under-sleeping, and a change in moods. Depression is not something that people can just “get over” or “snap out of”, and may in fact require medication or therapy or a combination of both before the individual begins to see a lifting of their symptoms. The symptoms of depression can come and go, and are similar but slightly different from the symptoms of bipolar disorder.
While addiction, once fully formed, becomes an insidious disease in the mind, it doesn’t start that way. If we view it, instead, as a symptom, we can trace it back it’s origin. Substance abuse may have begun as a remedy for esteem issues, for improving social status, or a may to self-medicate previous burdens. Some of these origins are circumstantial, but some may have to do with a pre-existing chemical imbalance. Many mental disorders, like addiction, are better treated when you fully understand what you are suffering from. Similarly, understanding diabetes, it’s causes and symptoms are necessary for safely living with the disease. Understanding PTSD, depression, and other disorders and their effect on you goes a long way to recognizing your own treatment needs.
While you likely seek to live a life free from the bonds of substance abuse, it may be necessary for some patients to utilize medication for certain mental disorders. These medications are rarely addictive or high-inducing in their quality. They may be needed to improve the quality of your life dramatically increase the chances of long-term recovery.
It can be difficult to accept that you may be living with a mental illness, but once it is properly diagnosed and treated, treating the presenting case of substance abuse can be magnitudes easier. Only a properly trained medical professional can diagnose these underlying conditions, if you believe you are suffering from a disorder alongside addiction, seek a qualified center, such as Holistix Treatment, today.
A good drug treatment program and drug addiction therapy facility needs to be able to treat both conditions without treating one as the sole cause of the other. Addiction is a complicated disease and no one thing is to blame for it. There are various options available to handle drug addiction therapy. A good drug treatment program will offer several levels of therapy as well as multiple treatment options. This allows the rehabilitation facility to meet the individual needs of their patients.
Most programs begin with a detox process to remove the physical dependence on any substances then a residency program. This type of program can last as long as two months and is designed to provide intensive focused therapy in a controlled environment to help you get over the first hurdle and give you the tools necessary to face the cravings and temptations of everyday life. During the inpatient treatment process dual diagnosis cases are identified and treatment begins. The next step is an intensive outpatient drug treatment program that provides drug addiction therapy by meeting at the site several times a week for intensive therapy that can help you deal with what occurs in daily life. Finally, a standard outpatient therapy program provides continued support necessary to maintain a sober condition.
As the addiction treatment community begins to realize that addiction is itself a mental disorder, the relationship between substance abuse and mental disorders becomes more complicated. Because the greater treatment community largely lacks a proper understanding of dual diagnosed conditions, these conditions are still treated separately or worse, not diagnosed at all.
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