Many individuals are challenged with more than one physical or mental health disorder simultaneously. When one of these conditions is the addiction to drugs or alcohol, the other(s) are considered co-occurring disorders.
These conditions may be interdependent and require comprehensive treatment programs to allow individuals to recover fully and prevent relapse. They are also very common, with as many as 8.2 million Americans suffering from both a substance use disorder and a mental illness. Of those diagnosed with drug addiction, 53% also have a mental health condition.
What is a co-occurring disorder and how is it diagnosed and treated as part of dual-diagnosis programs? Let’s look into these interwoven conditions and discuss the comprehensive treatment approaches that offer the best supportive therapy for you or a loved one who is dealing with several challenges at once.
Recognizing Co-Occurring Conditions
Addiction itself is a recognized mental disorder with a spectrum of severity. This can make it difficult to recognize symptoms that are blended together with other disorders like depression, anxiety, or PTSD. Substance abuse disorders can also be combined with physical diseases, including HIV, heart disease, kidney disorders, and chronic pain from a variety of conditions.
Some of the signs and symptoms of co-occurring disorders include:
- A belief that the substance is necessary for the person to function
- Sudden changes in behavior, including risky behaviors
- Cycles of euphoria or high energy followed by periods of depression or exhaustion
- Withdrawing from family, friends, and support groups
- A slow or sudden loss of control surrounding substance use
- Hiding substance use or lying about it
- Using increasingly greater amounts of a substance as tolerance develops
- Showing signs of physical withdrawal when the substance is not available
- Disordered thinking, difficulty concentrating, problems with memory
- Thoughts of suicide or self-harm
- Lack of self-care and avoidance of treatment
- Declining physical health
What Causes Co-Occurring Disorders or Dual Diagnosis?
While the causes of addiction and some other mental disorders are still the subject of much study, some of the reasons that individuals develop co-occurring disorders are:
- Genetics or biology. Certain people are pre-disposed to develop an addiction based on their genetics and body chemistry. Some of these factors may be developmental while others are part of a person’s genetic code.
- Environmental influences and learned behavior. Being exposed to drug or alcohol use in early childhood leads to learned behavior which may lack appropriate coping skills and normalizes substance use.
- Traumatic life experiences. Experiencing trauma (or multiple traumas) can lead to mental conditions as the mind attempts to shut out painful memories or numb them with drugs or alcohol. Experiences like physical or sexual abuse, a natural disaster, military combat, or a serious accident can trigger depression, PTSD, and substance use disorders.
- Chronic pain or illness. Enduring chronic pain or dealing with a serious physical condition can lead to self-medication, anxiety, and depression.
Which Types of Disorders Typically Occur Together?
Every individual has a unique path into and out of addiction; however, there are some common associations between certain substances and specific mental disorders, which include:
- Borderline personality disorder and use of any intoxicating substance which is available
- Antisocial personality disorder and alcoholism
- Schizophrenia and alcoholism or unbiased drug use
- Panic disorders and cocaine addiction
- Depression and heroin addiction
- PTSD and opioid addiction
Successful Integrated Treatment for Co-Occurring Disorders
Often these conditions develop together because of a lack of treatment. When treatment is not sought or is not available for mental or physical trauma or illness, individuals may turn to drugs or alcohol in an effort to alleviate their symptoms. They may also face some antiquated views that suggest delaying treatment for one disorder until the other one is under control.
Innovative and comprehensive dual diagnosis treatment is a more effective way to achieve complete recovery, using the whole-body or holistic healing approach. This type of treatment needs to directly address the risk factors those with co-occurring disorders face, being that they are:
- Less likely to complete a treatment program
- More likely to experience homelessness
- Potentially involved in legal issues
- Often in poor physical health
- Likely to lack vocational, career, relationship, or life skills
- More likely to relapse
Recommended Treatment Strategies for Co-Occurring Disorders
Entering a comprehensive dual diagnosis drug rehab program is often the best first step for someone with co-occurring disorders. In such a program an individualized treatment program can be designed to provide access to all types of therapy in order to address the underlying causes and contributing factors of addiction.
Therapy options which may be part of an effective integrated approach include:
- Medically supervised detox. The first days or weeks of sobriety may involve managing withdrawal symptoms under the 24/7 supervision of a compassionate healthcare team.
- Therapeutic medications. Not only are these necessary for the treatment of the co-occurring mental or physical conditions that may be present, but there are also medications available that can help limit cravings and reinforce sobriety.
- Residential Treatment. Following detox, some individuals benefit greatly from 24 hour supervised residential treatment to continue their early recovery and learn about their addiction and mental health conditions and to develop appropriate coping skills.
- Cognitive behavioral therapy (CBT). This type of therapy allows individuals to reverse negative or destructive thought patterns, which is beneficial in treating many mental disorders, including depression and substance use disorders.
- Dialectical behavioral therapy (DBT). This treatment was developed to treat suicidal thoughts in those with borderline personality disorder, and it is also helpful therapy for depression, eating disorders, PTSD, and addiction.
- Seeking safety. This evidence-based therapy is focused on healing trauma, which is often a cause, and sometimes an effect, of substance use. It was developed under a grant from the National Institute on Drug Abuse and focuses on coping skills to achieve safety in the present, rather than delving into details of past traumas.
- Inclusive group therapy. Using a supportive approach to build confidence and rebuild self-esteem, group therapy plays an integral role in recovery. Family therapy helps repair relationships and builds better communication and coping skills which, in turn, heal support systems.
- Integrated ongoing care for all disorders. Communicating and working together with other medical professionals as a united team, the treatment provided should include continuing support for all aspects of health throughout the recovery process.
- Aftercare and relapse prevention. Before leaving an intensive outpatient or inpatient treatment program, those with co-occurring conditions are especially in need of a detailed aftercare and relapse prevention plan. This should be a written plan to provide continued outpatient services for all conditions and detail what steps the individual will take if a relapse seems likely or occurs.
Choosing the Best Dual Diagnosis Treatment Program
Finding the right program is extremely important for you or a loved one who may need treatment for co-occurring conditions. A professional team that offers a wide range of services and medical expertise may be needed to fully support you to the best possible outcome. Waiting to seek treatment or focusing on treating an incomplete picture of the person may delay or prevent recovery.
At Dedicato Treatment Center in Sierra Madre, California, our staff is dedicated to providing a holistic and complete approach to co-occurring disorders treatment. Clients join us from across the country to experience JCAHO-accredited, comprehensive, compassionate, and supportive treatment for dual diagnosis. We offer supervised detox, inpatient programs, residential, and intensive outpatient services for every step of the journey.
Contact us today to find out more about the broad and inclusive range of services, therapies, and activities available at the Dedicato Treatment Center. Seeking a source of support and healing is the bravest step forward when faced with multiple challenges. Let us be the starting point to a full recovery of mind, body, and spirit.