A co-occurring illness, also known as a dual diagnosis, is when someone has a substance use disorder (SUD) and a mental illness. According to the National Institute on Drug Abuse, close to 50 percent of people with a mental illness or SUD will have a co-occurring disorder at some point. Dual diagnoses are common, but that does not mean one causes the other.
Most mental illnesses have to do with abnormal brain chemistry. A lot is happening in the brain, and a small deviation in one or two neurons or neurotransmitters can change brain functioning. Adding drug abuse to the mix, which also alters brain chemistry, will just compound the problems in the long run.
Often, a SUD can start with someone’s desire to self-medicate their way through their mental illness. Mental illness often comes with emotional pain and confusion that can be mitigated temporarily with psychoactive drugs. It is important to understand that treatment of mental illness with mind-altering substances only provides temporary relief — it is never a viable, long-term solution. Self-medication will only lead to worsened mental health problems and the potential for addiction.
How It Happens
It is possible to become addicted to anything that causes unnatural spikes in dopamine, but it will take time. In the case of drugs that flood the brain with dopamine, the addiction comes very quickly because the brain is hardwired to want to repeat pleasant experiences, and the high you get from something like cocaine is exponentially more intense than the joy you’d get from, say, smelling clean laundry.
It makes sense, then, that depression is a significant problem for long-term drug users and vice versa. Since drug users’ positive moods have been artificially induced for so long, their brains are not prepared to produce pleasure and happiness on their own. On the other side of the equation, people with depression have a hard time producing their dopamine, so something that can artificially manufacture that chemical will be appealing. With time and treatment, the brain can heal and regain its ability for positive thinking, but the longer the drug use goes on, the harder it is to recover.
Depression is not the only mental illness with a high instance of a co-occurring SUD. People with anxiety, attention-deficit hyperactivity disorder, bipolar disorder, schizophrenia, and many other mental illnesses are more susceptible to addiction. Bear in mind that the development of both SUD and mental illnesses has plenty of risk factors, heredity being a key one, as well as environmental factors and generational trauma.
People with co-occurring disorders face more obstacles to recovery. Dual diagnoses mean higher instances of additional problems, like homelessness, relapse, hospitalization, isolation, victimization to violent crimes, and incarceration. It can be a hard road if you’re facing both mental illness and SUD. Fortunately, there is hope. There are ways to recover and stay recovered.
What Can Be Done?
Mental illnesses need to be. In the presence of addiction, the mental illness cannot be adequately assessed until the drugs are removed from the system. Hence, a patient needs to “dry out” fully before an accurate analysis can be made. Brain chemistry is too complicated to diagnose in the presence of brain-altering substances.
Both mental illness and SUD often present significant threats to the patient’s wellbeing and must be treated concurrently. Each disorder needs to be treated by a professional because overlapping symptoms can make the individual issues harder to diagnose.
Behavioral therapy, like Cognitive Behavioral Therapy and Dialectical Behavioral Therapy, is often part of the treatment program. Medications are typically the other piece of the equation. When prescribed and regulated by a qualified professional, they can be used in treating mental illnesses and SUD. This integrated strategy of treating the SUD and the mental illness together is the recommended approach for medical and mental health professionals today. There is often a collaboration between multiple types of professionals, creating a team to help combat all the problems at once.
This is our approach to help you recover from your addiction and manage your mental illness. Our team of experienced professionals works together to give you the best chance of lasting recovery. The education we provide about your disorders and preventing relapse will help prepare you for when you leave treatment. Reach out to us to talk to our team about how we can help get you on the path to recovery.