Dealing with drug addiction, alcoholism or substance abuse is not a simple thing, and when you are struggling with a mental illness as well, it becomes even more difficult. There are treatments, however, than can help. When you have support, medical treatment and self-help strategies, overcoming a dual diagnosis and reclaiming your life within your grasp.
Substance Abuse and Mental Disorders
Mental disorders and addiction together are known as dual diagnosis or co-occurring disorders. This can be mental disorders, prescription drug abuse or illegal drug abuse. It can also involve alcohol addiction in conjunction with a medical disorder.
According to published reports in the Journal of the American Medical Association (JAMA):
- About 50 percent of people dealing with serious mental conditions are affected by substance abuse.
- 53 percent of drug abusers and 37 percent of alcohol abusers also suffer with at least one mental disorder.
- Of all mentally ill diagnosed people, 29 percent abuse drugs and/or alcohol.
The predominance of comorbidity between mental disorders and substance abuse doesn’t necessarily mean that one brought on the other, regardless if one arose first. But, you should consider a few common scenarios:
- Substance abuse can cause you to experience one or more symptoms mental illness. For instance, in some marijuana abusers, there is an increased risk of psychosis.
- Mental disorders can trigger substance abuse. If you have mild, overt or subclinical mental illnesses, you might attempt to self-medicate with drugs or alcohol. For instance, patients with schizophrenia may use tobacco products to improve cognition and lessen symptoms.
- Overlapping factors like genetic vulnerabilities, underlying brain deficits or early exposure to trauma or stress are often causal factors relating to both mental disorders and substance abuse.
All of these scenarios likely contribute to whether and how certain comorbidities develop. Alcohol and drugs don’t treat underlying mental disorder symptoms. In fact, they often generate a totally new set of problems for you, as they also increase the severity of your original mental illness symptoms. Therefore, if you return home without addressing your mental disorders, it could compel you to self-medicate.
In many cases, drug abuse starts when you suffer with depression or other illnesses and look for a solution on your own. In desperate to feel better, you may turn to drugs and alcohol to ease your symptoms. But self-medicating like this doesn’t provide you with any real relief. Whatever temporary relief you get from self-medication goes away quickly, and your symptoms come back even worse than before. You then may find that you need more alcohol or drugs to get relief again.
Symptoms of One Disorder Can Trigger the Other
At times, certain substances can cause problems that trigger mental illness symptoms. Other times, when you’re under the influence, the drugs can cause mental illness symptoms to develop, such as delusions, paranoia or depression. After the drug wears off, if you still have these symptoms, it can mean you have a co-occurring mental illness.
Some examples include:
Increased Traumatic Events
Chronic alcohol and drug abuse increases your risk of becoming a victim of rape or another assault. Traumatic events like these can turn into severe mental disorders such as depression, PTSD, eating disorders and more.
Making poor decisions is quite common when you are under the influence of alcohol or drugs. One poor decision may encourage you to make other related poor decisions, such as breaking the law or stealing money from family members.
Contraction of Disease
Sharing needles or having unprotected sex with others who infected with hepatitis C or HIV can result in you contracting the disease, causing you to struggle with grief and depression over the life-changing consequences.
Feelings of Depression
Alcohol and drugs like crystal meth often lead to depression as they begin wearing off and over time. This depression can turn into a severe mental disorder.
Common Mental Disorders
There are common mental illnesses that are found in dual diagnosis. Some common disorders that co-occur with alcohol or substance abuse include:
Major Depressive Disorder
There are various forms of depression. Your brain has chemical changes that can cause some forms of depression while certain life events can cause others. One particular form of depression that is common is major depressive disorder. This type of depression is diagnosed when you are feeling poorly most days of the week, most of the time.
Some symptoms of major depressive disorder include:
- Loss of pleasure or interest in your activities.
- Feeling sleepy in the daytime or trouble falling asleep.
- Weight gain or loss.
- Feeling guilty or worthless.
- Having little energy and being tired.
- Difficulty making decisions or concentrating.
- Having thoughts of suicide.
- Feelings of being ‘slowed down’ or ‘sped up’.
If you have a few or more of these symptoms, most of the time for a period of two weeks or more, your doctor might diagnose you with this form of depression. Around 20 percent of people in the United States who have a mood disorder like depression also have a substance or alcohol addiction, according to the Anxiety and Depression Association of America (ADAA).
Post-Traumatic Stress Disorder (PTSD)
Not everyone who experiences a trauma will end up with PTSD, but you are more prone to developing this disorder if you:
- Were a witness, victim or directly exposed to a trauma.
- Were hurt severely during the event.
- Experienced a very severe or long-lasting trauma.
- Thought you or a family member were in danger.
- Experienced a severe reaction during a trauma like shaking, crying, feeling apart from your surroundings or vomiting.
- Felt helpless during an event.
- Participating in a war-time event.
PTSD and Substance Use Disorders (SUD) both involve debilitating symptoms. A large number of people are affected by these disorders individually. However, a large number also are affected by the simultaneous occurrence of both disorders. When combined, these disorders can be hard for your physicians to treat and for you to cope with. PSTD affects about eight percent of the U.S. population at some point in their lives, reports the National Center for PTSD.
Prevalence estimates for PTSD and SUD dual diagnosis have been extensive. In fact, recent estimates show that 22.4 percent cocaine dependent individuals receiving treatment also suffered with PTSD.
Schizophrenia is a disabling and very severe psychiatric disorder characterized by:
- Persistent delusions
- Disorganized behavior
- Disorganized speech
Other indicators of this disorder are negative symptoms that include a a lack of initiative or motivation or an absence of emotional expression. One of the most typical co-occurring disorders in individuals with schizophrenia is Alcohol Use Disorder (AUD). Both psychosocial and biological factors contribute to this co-occurrence. If you have both AUD and schizophrenia, you are more likely to have legal, social and medical problems than if you were to suffer with schizophrenia alone. AUD often complicates the treatment of schizophrenia.
There is undoubtedly a connection between the widespread abuse of alcohol in people with schizophrenia (as well as the general population) due to it being legal and easily obtained. A study conducted by the Epidemiologic Catchment Area (ECA) showed that 33.7 percent of people with a schizophrenia diagnosis also met AUD diagnosis criteria at some point in their lives.
The National Institute on Drug Abuse reprinted a survey from the National Epidemiologic on Alcohol and Related Conditions that showed about a 20 percent high predominance of drug dependence and abuse among people who had anxiety disorders.
Common symptoms and signs of anxiety include:
- Feeling jumpy or restless
- Excessive worry and tension
- Trembling, dizziness or nausea
- Feeling ‘on edge’ or irritable
- Headaches, muscle tension
- Difficulty concentrating
- Shortness of breath or racing heart
Both clinical experience and research revealed that when substance abuse disorders and anxiety co-occur, they intertwine functionally in both the maintenance and development of comorbidity. A culmination of studies has suggested there are three primary pathways to comorbidity, which include:
- A self-medication pathway where your anxiety leads to drug abuse
- An anxiety disorder pathway that is substance-induced
- An anxiety sensitivity, genetics or other variable pathway
Bipolar disorder often co-occurs with alcoholism. This disorder, formerly referred to as manic depressive disorder, can be a hazardous combined with alcohol or drug abuse. Each can worsen your severity and symptoms of the other. When you have both disorders, you increase your risk of depression, extreme mood swings, suicide and violence.
Common symptoms and signs of bipolar disorder include:
- Grandiose or unrealistic beliefs
- Feelings of extreme irritability or euphoria (i.e. extreme mood swings)
- Increased energy
- Reduced need for sleep
- Racing thoughts and rapid speech
- Rage or anger
- Impulsivity and impaired judgment
- Suicide thoughts and behavior.
Although you can get bipolar disorder at any time in your life, typically onset of this disorder is at the average age of 25. Around 2.9 percent of Americans are diagnosed with bipolar disorder each year and almost 83 percent of cases are considered severe. This disorder affects both men and women equally.
Bipolar disorder can be a long-term and chronic condition, but it’s controllable with psychological counseling (psychotherapy) and/or medication. Because suicidal thoughts and behaviors are common among individuals with bipolar disorders, it is imperative to seek local emergency help by calling 911 if you or a loved one is experiencing suicidal thoughts.
Other Mental Disorders Seen with Dual Diagnosis
Other mental disorders often seen with dual diagnosis include:
- Mood disorders
- Anti-social personality disorders
- Panic disorders
- Obsessive compulsive disorders
This is not an exhaustive list of disorders that occur with drug abuse or addiction. They are just some of the most common.
Signs and Symptoms of Dual Diagnosis
So, how do you know if you have a dual diagnosis? Determining if you are suffering with dual addiction problems can be difficult as there is not one definitive way to make that determination. In some cases, you develop the mental disorder first which can then lead you to use drugs or alcohol to help you feel better. In other cases, you might develop the drug abuse first and it leads to mental or emotional issues over time.
Identifying characteristics of a dual diagnosis is essential as well. An American Journal of Drug and Alcohol Abuse study found that people who received a dual diagnosis typically had:
- A police report and arrest history
- Living arrangements that were undesirable
- Poor social and familial relationships
- A psychiatric hospitalization history
- A multiple drug abuse history
The symptoms and signs of dual diagnosis can vary greatly since there are many combinations of illnesses and disorders than can occur.
Signs and symptoms of substance abuse could include:
- Withdrawing from your family and friends
- Using drugs under hazardous conditions
- Sudden changes in your behavior
- Doing things you normally would not do to maintain your habit
- Engaging in behaviors that are risky when you are high or drunk
- Loss of control over substance use
- Feeling like you have to have the substance to function
- Developing tolerance and symptoms of withdrawal
At the same token, there are also standard symptoms and signs that could indicate that you would benefit from a dual diagnosis therapy-based facility and other related treatment services. These include:
- You already received a diagnosis for OCD, depression or another mental disorder that is or isn’t receiving treatment.
- You believe you have a psychiatric condition or mental illness like depression, anxiety or bipolar disorder.
- You have other people in your family who have already received a dual diagnosis.
- Your attempt at receiving substance abuse treatment, whether at a center or on your own, was unsuccessful. You don’t understand why you didn’t succeed in recovery and think there might be an underlying cause.
Mental disorder symptoms can also vary greatly. By knowing what the warning signs are, such as confused thinking, extreme mood changes, avoiding social activities or friends, problems concentrating or thoughts of suicide, you can determine if you have a legitimate reason to look for help.
Keep in mind, if you receive a dual diagnosis, you have to have both conditions treated. You also have to stop using drugs or alcohol for your treatment to be effective.
Treatment for Substance Abuse and Mental Health Problems
How is dual diagnosis treated? When you get a dual diagnosis of both a substance abuse problem and a mental disorder, it’s important that you go into a treatment program that will address both of these issues simultaneously. This is because your mental disorder symptoms can make it almost impossible to stay sober and clean and your untreated drug or alcohol abuse problems can render mental disorder treatments ineffective.
There are various methods of treatment in a dual diagnosis. Therefore, treatment is different for everyone and is custom-tailored to your unique circumstances.
Some forms of treatment may include:
Detoxification is the first hurdle you will have to pass with dual diagnosis. When you go in for your inpatient detoxification, a trained medical professional will monitor you seven days a week, 24 hours a day. They may administer small amounts of the drug you were on to taper you off it slowly, which lessons your withdrawal effects. For initial sobriety, inpatient detoxification is usually more effective than trying to go through outpatient detox. This is because the inpatient process removes you from exposure to places and people you associate with use and are placed in a consistent environment while you battle your addiction.
If you are dealing with dependent or dangerous abuse patterns and a serious mental disorder, your chance of recovering successfully will increase by going to an inpatient rehabilitation center where you can get focused mental and medical care 24 hours a day, 7 days a week. You will receive support, medication, therapy and health services designed to treat your addiction and its underlying cause.
Sober houses, group homes and other supportive housing options can also be helpful if you are newly sober or avoiding a relapse. You still get the round-the-clock care, but have a little more freedom.
Medications are effective for treating many different mental disorders. Medication can be an important tool in your recovery depending on your mental disorder and its symptoms. There are also medications to help you through your substance abuse addiction. These types of medications help to lessen your withdrawal symptoms while you are in your detoxification stage. They work by producing the same effects in your body as certain drugs that are addictive.
Typically, a big part of a successful treatment plan for dual diagnosis is psychotherapy. This is where you are educated on your particular illness and how your behaviors and beliefs influence your thoughts. Many studies have shown psychotherapy to improve the symptoms of both substance abuse and mental illness.
Cognitive-behavioral therapy is a very effective treatment for dual diagnosis in particular. If you have a dual diagnosis and, the therapy will help you learn how to cope, as well as change your patterns of thinking that are ineffective. Cognitive-behavioral therapy (CBT) includes a number of set sessions whereby you learn to “unlearn” preconceived beliefs about your life and decisions. The premise behind CBT is that your behaviors and decisions are based on the way you perceive situations around you.
Self-help and Support Groups
While being treated for a dual diagnosis, it can leave you feeling isolated and challenged. Support and self-help groups are a great way to share your frustrations as well as your successes. You can also tap into community tips and resources; get referrals for specialists and other benefits that work best when you are trying to recover. You can also gain friendships and feel more encouraged and motivated to stay clean.
If you are struggling with a less complex addiction history, seeking help from an outpatient program where you can still live at home and receive care could be a good option. However, if you have a more serious dual diagnosis problem, inpatient rehabilitation is what you need since you have that more intensive, round-the-clock help to keep you sober and clean.
You will have well-trained physicians by your side to help you through any mental disorders and substance abuse issues you are dealing with. You not only receive dual diagnosis services in your treatment plan, but you also receive the education so you know what you are fighting. This will leave you better equipped to achieve your sobriety goals.
Just remember, mental disorders and addiction don’t go away by themselves and are likely to get worse if ignored. You don’t have to go through your dual diagnosis alone and you can stop feeling this way. The first step to your recovery is admitting that you have a problem and then taking the baby steps you need through an effective rehabilitation treatment plan. Only then can you begin your life again, sober and clean.
Partnering with JourneyPure Emerald Coast in Panama City, FL for Dual Diagnosis
JourneyPure Emerald Coast in Panama City, FL is one of the leading treatment centers in Florida for dual diagnosis. We specialize in treating individuals who have a dual diagnosis — or a mental illness and substance addiction simultaneously. We use a number of successful therapeutic techniques to treat dual diagnosis, including cognitive behavioral therapy.
To learn more about dual diagnosis treatment at JourneyPure Emerald Coast, please contact us at (800) 493-5253.