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According to current statistics on co-occurring diseases, millions of people in the United States suffer from mental health issues. Substance addiction disorders, sadly, have a strong link to mental health issues. A co-occurring disorder affects around 7.9 million people in the United States. This article will examine why some people develop co-occurring disorders, how they present, and where they can seek treatment.

According to the Substance Abuse and Mental Health Services Administration, an integrated treatment approach that tackles SUDs and other mental disorders at the same time can help individuals with co-occurring disorders enhance their quality of life and health outcomes. Behavioral therapy and medication are usually used to customize treatment to a patient’s particular diagnosis. This guide discusses the incidence of co-occurring mental conditions, how they’re treated, and how to locate treatment for substance abuse disorders that co-occur with mental problems.

When a person has a mental health condition and does not receive sufficient care, they are more prone to turn to drugs and alcohol to alleviate their symptoms. Substance abuse and mental disorders are medically referred to as co-occurring disorders because they generally occur at the same time. Co-occurring disorders necessitate more intensive therapy than single-disorder patients. Drug abuse and psychiatric disease have a tendency to increase each other’s symptoms. Substance abuse disorder (SUD) can also have a negative impact on physical health, making therapy more challenging for this group of patients.

A single or a combination of the following three factors may lead to the co-occurrence of mental disorders.

Self-Medication: Substance abuse can often be used to manage the symptoms of mental illness. There are various causes for self-medication; however, this may be deceiving because self-medication can conceal symptoms while simultaneously exacerbating them over time.

Predisposing Factors: There has been some indication that genetic makeup, hereditary factors, and environmental elements, like trauma, may play a role in the progression of substance abuse problems and other mental health issues.

Drug-Induced Cerebral Changes: Drug abusers are much more prone to acquire mental health illnesses that damage the brain as a result of their continued use of substances, according to research. There are brain regions linked to substance abuse, as well as those linked to behavioral impulsive behavior and impulse control, anxiety issues, mood disorders, and schizophrenia. 

Over a third of the 20.3 million individuals given a diagnosis with SUDs also suffer from mental disorders.

SUD affects over 20 percent of the 42.1 million individuals who have been identified with a mental illness.

Sadly, more than half of the individuals diagnosed with co-occurring illnesses never receive medical treatment for either disorder.

For even more than half of the people who have been diagnosed but do not undergo treatment, the biggest obstacle to therapy is cost.

The differences are somewhat technical, but for the most part, these terms are interchangeable. Though both phrases reflect a situation in which a person has both a mental health issue and a SUD, the concept of dual diagnosis is progressively being substituted by the premise of co-occurring disorders. Each condition would be a comorbidity of the other in this circumstance, while the term comorbidity is also commonly used outside of the behavioral health/mental health professionals to denote the co-existence of various medical conditions.

Moreover, dual diagnosis is a psychiatry phrase that refers to a person who has two or more psychiatric illnesses at the same time, each with its own diagnosis. The phrase “dual diagnosis” was first used in the 1980s to describe people who had both a serious mental disorder and a SUD. The phrase “co-occurring disorders” has been used by the Substance Abuse and Mental Health Services Administration (SAMHSA) ever since the early 2000s to describe the existence of two or more problems. However, Dual Diagnosis Anonymous, which was founded in 1996, is an international organization of support groups for anyone attempting to live a healthy, substance-free life.

As a result, a co-occurring disorder is now most commonly used to describe someone who has a SUD and another psychiatric problem, while it can also apply to someone who has two or even more mental disorders, like comorbid schizophrenia and depression. One or more co-occurring mental illnesses are frequent among patients with SUDs, with roughly half of those who have one also having the other. Co-occurring conditions frequently overlap, and they may arise at the very same time or sequentially.

SUDs as well as other mental health problems have a significant relationship. In fact, over half of the people with one illness will develop at least one other co-occurring mental health disease throughout the course of their lives. Co-occurring diseases can exacerbate the intensity of each other’s symptoms.

The Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) is used to diagnose substance use disorders and mental health. This manual serves as a guide for doctors who are diagnosing substance abuse and mental health disorders based on common symptoms. While substance abuse and mental health difficulties have specific categories, the handbook previously lacked explanations of co-occurring conditions.

This improved with the publication of the DSM-5, the fifth edition of the manual, which was amended to better characterize co-occurring mental health and substance use problems. It was recognized that an individual with a co-occurring disorder will typically have the same psychological symptoms as someone with a mental disorder but no substance use issue. It also considers the fact that a person with a mental health problem does not inevitably have a worse substance use disorder. In essence, the person will show signs of both conditions.

Researchers have recently discovered that Integrated Therapy is the most effective treatment for those with co-occurring disorders.

According to the Substance Abuse and Mental Health Services Administration, combining addiction and psychiatric treatment strategies can prevent flare-ups and suicidal tendencies among rehab grads while also promoting long-term abstinence.

Treatment of co-occurring addiction disorders and mental health is critical for several reasons:

  • An Integrated Recovery Plan attempts to alleviate the negative consequences of mental health illnesses, such as difficulty paying attention, depression, and a reluctance to socialize.
  • When pharmaceutical therapy targets both disorders, you’re more likely to successfully manage your mental health problems and drug-related disorder at the same time.
  • Traditional reservations regarding the use of psychotherapeutic medications in the treatment of co-occurring illnesses are no longer valid.
  • Patients with co-occurring conditions who participate in group therapy expand their support system. This training can also be used to tackle issues like substance abuse.
  • Relapse is less likely when both mental and addiction problems are treated at the same time, like mood swings, depression, or panic attacks.
  • Staff workers with particular training and certifications in Dual Diagnosis treatment work in facilities that focus on treating co-occurring illnesses. Patients with co-occurring disorders encounter unique challenges as a result of their mental illness, according to these addiction professionals.

Integrated treatment aims to teach persons with co-occurring illnesses how to stay sober or significantly decrease their substance use while also managing their mental disease symptoms.

This is achieved through the use of efficient counseling and behavioral therapy methods, as well as drugs in some cases. Integrated treatment may include a variety of therapeutic strategies that have been shown to be successful in the treatment of substance use disorders and mental health, such as:

CBT or Cognitive behavioral therapy is a type of treatment that looks into a person’s beliefs and thoughts in order to modify their behavior.

DBT or dialectical behavioral therapy is a treatment for borderline personality disorder that focuses on reducing negative behaviors such as self-harm, substance abuse, and suicidal conduct.

Patients who display appropriate and positive behaviors, like clearing a drug test or avoiding self-harm, are rewarded with tiny incentives through contingency management.

Motivational enhancement is a technique that can help people become more motivated to make positive changes during their therapy.

Mutual-support groups for individuals with co-occurring conditions, like Narcotics Anonymous and Dual Diagnosis Anonymous meet on a regular basis.

Integrated therapy for SUDs can occur at any point throughout the continuum of care, including:

Detox, or Withdrawal Management: Detox, also known as withdrawal management, is a type of medically controlled detox that entails medical supervision 24 hours a day, seven days a week. Staff is on-site 24 hours a day, seven days a week, and clinicians may write prescriptions as needed to guarantee safety while detoxing from narcotics and alcohol.

Inpatient Care or Residential Treatment: Individuals enrolled in residential or inpatient therapy live at a rehab facility 24 hours a day, seven days a week for the duration of their treatment. While clients learn to control their drug use and manifestations of any co-occurring illnesses, medical and mental health experts are always available or on call to give support, medication, and other services.

Outpatient Treatment: Outpatient treatment allows patients to get similar (if not identical) care as inpatient treatment, but with the added benefit of being able to stay at home while still getting treatment for co-occurring conditions.

Although most emotional concerns, such as low self-esteem, sadness, guilt, and anger management problems, can have a big impact on a person’s addiction troubles, these concerns are often deemed as symptoms rather than disorders. When we talk about disorders, we’re talking about the real diagnosis that causes the above-mentioned symptoms.

Some of the most common co-occurring disorders in people who abuse substances are as under:

1. Generalized anxiety disorder

Individuals with repeated, regular panic and anxiety attacks, as well as symptoms like sleep difficulties, agitation, and impaired functioning, are diagnosed with generalized anxiety disorder. Individuals who suffer from frequent anxiety may turn to alcohol and drugs for a variety of reasons. While some people abuse prescribed anxiety medicines like Xanax, others use illicit drugs or alcohol to improve their social skills or deal with anxiety symptoms.

2. Eating problems

Individuals in need of addiction therapy are frequently diagnosed with eating disorders like bulimia and anorexia. To suppress hunger and boost confidence, people frequently utilize medicines like diet pills and stimulants, as well as alcohol. These issues frequently coexist with body dysmorphic disorder, a condition in which a person is hypercritical of their own looks and agonizes over perceived imperfections in their own body.

Eating disorders are more common among young adults, but they can affect anyone at any age.

3. Bipolar disorder

Bipolar illness patients are more vulnerable to alcohol and drug abuse and addiction. A biochemical disequilibrium in the brain produces this mental disorder, which leads the individual to have uncontrollable, intense episodes of sadness and mania. Some people with bipolar disorder self-medicate in order to decrease the severity of their episodes, which causes an increase in bipolar episodes and serious addiction.

4. Post-traumatic stress disorder

After a person goes through situations that create tremendous stress and, in some situations are life-threatening, post-traumatic stress disorder (PTSD) evolves. Violent crimes, car accidents, and war are only a few examples. Individuals with PTSD frequently have night terrors and flashbacks. Some of these persons seek relief from their symptoms through the use of drugs and alcohol, which can contribute to further emotional and sleep disturbances.

5. Mood disorders and personality disorders

Personality and mood disorders including borderline personality disorder (BPD)  and obsessive-compulsive disorder (OCD) have a wide range of symptoms. BPD is one of the most frequent of these diseases, and it can cause impulsive behavior, significant mood changes, and emotional instability. These individuals frequently struggle to sustain interpersonal relationships and some resort to alcohol and drugs as a coping method.

6. Schizophrenia

Schizophrenia is a serious mental illness that involves hallucinations, delusions, psychosis, and disordered thinking in patients. Most schizophrenics lose their ability to discriminate between reality and fiction, and it’s not unusual for them to turn to alcohol or drugs to cope with their feelings.

7. Attention deficit hyperactivity disorder

Children and young adults with attention deficit hyperactivity disorder (ADHD) are frequently diagnosed. It’s characterized by a lack of concentration, impulsivity, and hyperactivity. Prescription drugs, particularly stimulants, are usually administered to patients suffering from this illness. We routinely find young adults who are misusing their prescriptions, and those who are self-medicating and suppressing their symptoms with alcohol or other substances.

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