What are Co-Occurring Disorders?
This past year hasn’t been easy. While our backs were turned, COVID-19 was the unexpected wave that took us all down. Its powerful impact sucked the world into an undertow of uncertainty, loss and distress. The emotional and financial effects have been detrimental, and despite 2021 showing promise, many are still struggling to tread above water.
The self-isolation, job instability, illness and death throughout the world has taken its toll on everyone. It has been particularly challenging on those plagued with substance use disorders (SUDs) or mental health issues. And even more so for individuals who suffer from both.
Known as co-occurring disorder, this dual diagnosis is more common than people realize.
Half of the population who suffer from mental disorders are affected by SUDs, according to a recent article published by HelpGuide.org. And although it is difficult to pinpoint what comes first, the SUD or the mental health issue, it is known that these co-occurring disorders have a symbiotic and toxic relationship, where – if left untreated – one can exacerbate the other.
According to the National Institute on Drug Abuse (NIH), the rates of comorbidity among SUDs and anxiety disorders; and SUDs and mental disorders are very high. And there is a major overlap with SUDs and serious mental illnesses (SMIs), as well. In fact, one in four adults living with a serious mental health problem also have a substance use problem, according to MentalHealth.gov.
- SMIs include major depression, schizophrenia, bipolar disorder and other disorders that cause serious impairment on one or more major life activities.
- Anxiety disorders include generalized anxiety disorder (GAD), panic disorder, and post-traumatic stress disorder (PTSD).
- Mental disorders include depression, bipolar, attention-deficit hyperactivity disorder (ADHD), psychotic illness, borderline personality disorder, and antisocial personality disorder.
But What Comes First – Mental Health Issues or SUDs?
Even though the link between SUDs and mental health issues are highly prevalent, establishing causality is challenging for several reasons. The severity of emotional or behavioral problems may not be enough for a diagnosis. The symptoms – known as subclinical symptoms – exist, but they do so without being identified. So the subclinical mental health issues continue without detection, and they can eventually prompt drug use. It can also be difficult for people to recall the first time their mental health issue or drug problem began.
Of course, there are contributing factors in the development of co-occurring disorders. Risk factors such as genetics, environmental influences, brain involvements, stress, and trauma and adverse childhood experiences. Furthermore, mental illness may contribute to substance use and addiction. And conversely, substance use and addiction can contribute to mental illness.
Escaping reality is not uncommon within our society, and oftentimes, people turn to drugs or alcohol to cope with difficult emotions. But, in the long run, it’s an exercise in futility.
Have you ever felt a surge of anxiety the day after drinking? Paranoid after taking an amphetamine? More depressed after smoking marijuana? Substance use and mental health disorders, such as depression and anxiety, are closely linked. So self-medicating may seem like a good idea at the time, but it can increase the very symptoms you were trying to drown.
Alcohol and drug use can also increase the underlying risk for mental disorders. It’s no secret that genetics and environmental factors play a role in who we become and what we’re susceptible to, so it’s difficult to say if abusing substances ever directly causes the mental disorders that lie within us. But if you are at risk for a mental health disorder, it may just push you over the edge.
Identifying a Co-Occurring Disorder
It is not easy to recognize a dual diagnosis. The signs and symptoms vary depending on the mental health issue and the alcohol or drug being consumed. The signs of depression and marijuana use could look very different from those of alcohol use and depression.
Here are some warning signs of co-occurring disorders:
**Information pulled from HelpGuide.org
- Do you use alcohol or drugs to cope with unpleasant memories or feelings, to control pain or the intensity of your moods, to face situations that frighten you, or to stay focused on tasks?
- Have you noticed a relationship between your substance use and your mental health? For example, do you get depressed when you drink? Or drink when you’re feeling anxious or plagued by unpleasant memories?
- Has someone in your family grappled with either a mental disorder or alcohol or drug abuse?
- Do you feel depressed, anxious, or otherwise out of balance even when you’re sober?
- Have you previously been treated for either your addiction or your mental health problem? Did the substance abuse treatment fail because of complications from your mental health issue or vice versa?
Treatment for Co-Occurring Disorders
An integrated approach, where both the substance use problem and mental disorder are treated simultaneously, is the best form of treatment. This can include counseling, self-help measures, lifestyle changes and peer support for your mental health problem. And detoxification, managing withdrawal symptoms, behavioral therapy and support groups to treat SUDs.
It’s also important to learn healthy coping skills for life’s stressors and challenges, and equally vital that you are actively involved in setting goals and developing strategies for change.
We are at the start of a new year, but we’re still facing problems of the past. So don’t be discouraged because help and hope is always within reach.