Dual Diagnosis: Substance Abuse and Mental Health

It's hard to argue with the numbers. Addiction and mental illness often coexist. Over 9 million people suffer from a co-occurring disorder, reports the Substance Abuse and Mental Health Services Administration. In spite of this, only 7 percent of individuals with both conditions receive treatment. Even more troubling is the fact that almost 60 percent go without treatment.

Comorbidity: An Overview

It can seem quite terrifying to hear the term comorbid if you're unfamiliar with it. After all, there is a sense of fatality associated with it. However, these are two conditions that coexist and are separate from one another. In almost every case of substance abuse, the addictive tendencies involved are compensatory tendencies that are themselves symptomatic of trauma or being deeply unsatisfied emotionally. There is no direct link between one and the other, but they often interact and exacerbate each other's symptoms.

The key to understanding comorbidity, however, is to recognize that not only substance abuse but also other mental health disorders are chronic brain diseases.

Because of the behavioral aspects and the substance itself, addiction causes permanent changes to the brain's wiring. Just as people suffering from physical conditions, such as diabetes, must manage their health for the duration of their lives, so must people suffering from addiction. Relapse can still occur even if habits are broken because the programming that triggers relapses remains intact.

Similarly, depression, anxiety, bipolar disorder, schizophrenia, and other conditions affect specific areas of the brain. Therefore, it should not come as a surprise that mental health conditions and addiction are closely connected. The weight of anecdotal evidence clearly corroborates the notion that mental health issues and addiction are related. As a coping mechanism, many people with underlying mental health problems turn to drugs or alcohol.

Addiction and Mental Illness: Why They Co-occur

Despite the high rate of comorbidity between addiction and mental illness, neither necessarily causes the other-even when one arises first. According to the National Institute on Drug Abuse, a number of factors must be considered, such as:

• It is possible to experience one or more symptoms of another mental illness due to drug abuse. Those who use marijuana may be at a greater risk of psychosis, for example. As a result of mental disorders, some people use drugs or alcohol to self-medicate. For instance, nicotine in tobacco products can ease certain symptoms of schizophrenia and improve cognitive function.

• It is also believed that addictions and mental illnesses are caused by underlying brain deficits, genetic influences, and/or childhood traumas. Genetics, for instance, is believed to account for 40 to 60 percent of the vulnerability of a person to addiction. Additionally, some regions of the human genome have been linked to mental illness and substance abuse.

Addiction and mental health issues are also commonly associated with early onset ages. A person's development, maturation, and growth continue during the teenage years. This leads to considerable brain changes during adolescence. Teenagers, as an example, may act impulsively and take risks more often. In addition to being common among teens, these behaviors can increase the risk of addiction and other mental health issues.

Last but not least, people who have been physically or emotionally traumatized are much more likely to develop substance use disorders. There is a particular concern about this connection among returning veterans. Military service members returning from Iraq and Afghanistan have reported PTSD or major depression symptoms in one out of five instances.

Treatment for Dual Diagnosis

It is best to treat co-occurring disorders in an integrated way that addresses both substance abuse and mental disorders at the same time. In order to achieve long-term recovery, it is essential to be treated by the same treatment provider or team for both mental health and substance abuse disorders. You may need to consider the following depending on your specific issues:

• Medications, counseling, lifestyle changes, and peer support may be used to treat your mental health problem.

• In order to maintain sobriety, you may need detoxification, withdrawal management, behavioral therapy, and support groups.

Finding the Right Treatment Program

Research the treatment methods, ensure the program is appropriately licensed and accredited, and look for an aftercare program that prevents relapse. Furthermore, you should ensure that the program has experience with the mental health issue you are dealing with. As an example, depression and anxiety may be treated in some programs, but schizophrenia and bipolar disorder may not.

There are a number of approaches to treatment, but there are a few basics to look for in a successful treatment program:

• During treatment, both your substance abuse problem and your mental health problem will be addressed.

• As a member of the decision-making process, you are actively involved in setting goals and implementing change strategies.

• You will receive basic education about your disorder and related issues as part of your treatment.

• The program teaches you healthy coping skills and how to handle stress, challenges, and upsets in life.

Self-Help for a Dual Diagnosis

Apart from getting professional treatment, you can also take self-help steps to address your mental health and substance abuse issues. The journey to sobriety is only the beginning. Sustained recovery requires both continued mental health treatment and better coping strategies and decisions when faced with life's challenges.

• Learn how to manage stress through healthy coping skills like deep breathing, meditation, and mindfulness.

• Connect with others such as spending more time with friends and family. You may also want to join a support group or get therapy.

• Make healthy lifestyle changes, such as getting enough sleep, exercising regularly, and adopting healthy eating habits.

• Discover new meanings in life. You can do this by taking up a new hobby, getting involved in a volunteer activity, or finding a job that you enjoy.

Final Words of Advice

For a patient's success, it's crucial to make the right diagnosis of both addiction and mental health issues. As a result, their chances of recovering increase. To achieve this, however, there must be an increased awareness of comorbidity. Too often, one of those conditions goes undiagnosed and untreated. People will be more likely to seek treatment for their co-existing conditions if the recognition and treatment for them improve.