Grappling with a substance use disorder is already a formidable challenge.
As with any disease that affects the brain, there are often additional complicating factors. Among the most common issue that gets tacked onto addiction is the presence of a mental health disorder. When these two difficult circumstances align in the same individual, this is known as a dual diagnosis or co-occurring disorder.
Facts and Definitions
Dual diagnosis, according to the National Alliance on Mental Illness, “is a term for when someone experiences a mental illness and a substance use disorder simultaneously. Either disorder—substance use or mental illness—can develop first.”
When might someone be diagnosed? Unfortunately, a dual diagnosis can occur at any point in a person’s life. Certain factors during adolescence and the transition to adulthood can contribute to the onset of later co-occurring disorders.
How many people suffer from a dual diagnosis? A 2014 National Survey on Drug Use and Health concluded that as many as 7.9 million people in the United States contend with this diagnosis one-two punch at any given time. As is true in many scenarios pertaining to substance misuse, more men are affected by co-occurring disorders than women, up 4.1 million versus 3.8 million.
Those statistics indicate that dual diagnoses are not altogether uncommon.
In general, how great is the risk? Studies from 2012 and 2013 indicate a risk of around 50 percent. In other words, about 1 in every 2 people who have a mental health disorder will also experience a substance use disorder. Likewise, approximately half of people who suffer from addiction will also develop a mental illness.
The above information paints a scary picture. However, there are tried and true channels to help individuals recover from these trying diagnoses.
Risk for Younger People
The National Institute on Drug Abuse (NIDA) offers a few words of warning concerning youth and co-occurring disorders.
First off, we see that “over 60 percent of adolescents in community-based substance use disorder treatment programs also meet diagnostic criteria for another mental illness.” That is to say that the number discussed earlier—50 percent—increases when we consider a younger population.
Furthermore, a NIDA research report entitled “Common Comorbidities with Substance Use Disorders” points out three other factors to take into consideration when young people are in the picture:
- Between the ages of 18 and 25, additional care needs to be taken when supporting individuals with dual diagnoses. These people are also more likely to be in the midst of large-scale life cycle transitions, e.g. graduating high school, getting a job, moving out of their parents’ house, etc.
- Early substance use can be a predictor for later mental health problems. Children and teenagers who abuse drugs should be aware of their long-term effects on mental health.
- Some studies suggest an increased risk for substance use disorders in youth with untreated ADHD. Many medications used to treat ADHD contain prescription stimulants and should be used with caution.
One piece of that same report indicates that as of 2015, 1 in 4 individuals with a substance use disorder also have a serious mental illness. (Anxiety and depression are not considered “serious mental illnesses” under these criteria.) This statistic draws from a different definition of mental health disorder than the previous 1-out-of-2 stat did, but nonetheless demonstrates a lower overall occurrence rate.
Symptoms
Common signs of substance use disorder are always worth revisiting:
- Withdrawal from friends and family
- Sudden changes in behavior
- Using substances under dangerous conditions
- Engaging in risky behaviors
- Loss of control over use of substances
- Developing a high tolerance and withdrawal symptoms
- Feeling like you need a drug to be able to function
Evaluating a person for a mental health disorder is more difficult and symptoms have a broader range. Whether the problem be anxiety, depression, bipolar disorder, or any number of other possibilities, certain warning signs should be taken seriously:
- Extreme mood changes
- Confused thinking or problems concentrating
- Avoiding friends and social activities
- Thoughts of suicide
If ever symptoms from both of these lists should crop up in your life or that of a loved one’s, it is time to seek help.
Treatment Options
Although the idea of dual diagnoses can be intimidating, there are routes towards recovery. A well-designed treatment plan and support from rehabilitation professionals can make this process a little less daunting.
What is important to keep in mind is that both illnesses must be addressed. Each condition affects the other. Experienced medical professionals are the people best equipped to help you understand the delicate interplay between these diseases.
Bring a professional—like the intervention specialists at DK Solutions—on board to guide you through the process. That process may include some of the following steps:
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- Detoxification. This is the first major step for people with a dual diagnosis. Inpatient detoxification is generally more effective than outpatient care for initial sobriety and safety. To move towards recovery, a person must break the cycle of actively using.
- Inpatient rehabilitation. A person experiencing co-occurring disorders may need access to an inpatient rehabilitation center where they can receive medical and mental health care 24/7.
- Psychotherapy. Many rehabilitation centers offer psychotherapy as a large part of an effective dual diagnosis treatment plan. In particular, cognitive behavioral therapy helps people with a dual diagnosis learn how to cope with their diseases.
Additional Resources
- This is a link to the National Institute on Drug Abuse report about “The Connection Between Substance Use Disorders and Mental Illness,” mentioned above.
- A peer-reviewed scientific study perspective on this topic of dual diagnosis can be found in this journal article.
- Also referenced above, the National Alliance on Mental Illness (NAMI) provides valuable insight on the subject and a great deal more information about mental illness in general.