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Millions of people in the U.S. suffer from a mental health condition. Unfortunately, mental health disorders put people at high risk of developing a substance use disorder, too. Mental health disorders with comorbid drug addiction used to be called a dual diagnosis, but is now referred to as a “co-occurring disorder.” According to the latest report from the Substance Abuse and Mental Health Services Administration (SAMHSA), 9.5 million American adults have a co-occurring mental illness and substance use disorder.
What is a co-occurring disorder?
When someone suffers from a mental health condition and is not able to get adequate treatment, they are at high risk of turning to either drugs or alcohol to alleviate their symptoms. In clinical terms, this is what’s known as a co-occurring disorder. Treating a co-occurring disorder requires more intense, one-on-one treatment options than if a person was only suffering from one or the other. Substance abuse symptoms and mental health symptoms can make both conditions worse. Drug or alcohol abuse can also worsen a person’s physical health, which can lead to other consequences that make treatment harder for this subset of patients.
Who is most at risk of developing a co-occurring disorder?
9.5 million Americans have a co-occurring mental illness and substance use disorder, and over half of them are men. According to the data, 56 percent of people in treatment for co-occurring disorders are men, making them slightly more common in men than women. Individuals with anxiety and depression are also at increased risk of having co-occurring substance use disorders. In one study, findings show that individuals with a drug addiction are 1.3 times more likely to suffer from depression in a given year. Those who have suffered from addiction at any point during their lives are 1.3 times more likely to have a generalized anxiety disorder.
The increased risk of having both a drug addiction and a mental health diagnosis during a given year was as follows for various other diagnoses:
- Bipolar Disorder: 1.5 times
- Post-Traumatic Stress Disorder: 1.6 times
- Antisocial Personality Disorder: 1.4 times
- Borderline Personality Disorder: 1.8 times
- Schizotypal Personality Disorder: 1.5 times
What are the signs and symptoms of a co-occurring disorder?
There are many combinations of co-occurring disorders, and each one will exhibit different signs and symptoms. They will also require different methods of treatment. Fortunately, mental health clinics are starting to use alcohol and drug screening tools to identify people with co-occurring disorders. Symptoms of a co-occurring substance abuse disorder include the following:
- Sudden changes in behavior
- Social isolation
- Using substances under dangerous conditions
- Risky behavior
- Loss of control over how much they use substances or drink alcohol
- Needing more and more of the substance to achieve the desired effect (tolerance)
- Displaying intense, painful withdrawal symptoms
- Cravings for the substance, and the belief that they need the substance to function.
The symptoms of a mental health condition can also vary from person to person. But several warning signs such as confused thinking, problems with concentration, and suicidal ideation are the most severe warning signs. If someone is displaying these symptoms of a co-occurring disorder, it is crucial that they receive swift medical attention from qualified mental health and drug abuse counselors.
Why would someone with a mental health condition abuse drugs or alcohol?
It can be difficult to determine the exact cause of a co-occurring disorder. As the National Institute on Drug Abuse (NIDA) has explained, mental health conditions themselves are a risk factor for substance abuse. People with mental illnesses may use drugs to self-medicate unpleasant symptoms like anxiety or distress. Unfortunately, drugs may provide temporary relief for symptoms of mental illness, but when a person develops an addiction, their mental health is likely to worsen.
It can be difficult to determine whether the mental health condition or the addiction came first in some cases. Drug use can negatively affect brain functioning, making a person more likely to develop a mental illness. In addition, genetic risk factors and environmental factors like trauma and family patterns can contribute to both mental illness and addiction. In some cases, conditions like addiction and anxiety can simply go hand-in-hand because of shared risk factors.
What type of treatment is effective for people with a co-occurring disorder?
Experts recommend integrated treatment for individuals with co-occurring disorders, which means that both the addiction and the mental illness are treated. Some specific forms of therapy seem to be especially beneficial for people with co-occurring conditions:
- Cognitive-Behavioral Therapy (CBT): This type of therapy helps people to change unhelpful thoughts and behaviors and replace them with healthier ways of thinking and behaving. This may be an especially effective form of treatment for people living with addiction and depression, since researchers consider CBT to be the “gold standard” for treating mental health conditions like depression.
- Dialectical Behavioral Therapy (DBT): Since this treatment is designed to reduce harmful behaviors, such as cutting, suicide attempts, and substance use, it is a suitable option for individuals with co-occurring disorders.
While the specific type of therapy that is most effective will vary from person to person, what is most important to keep in mind is that if a person has co-occurring disorders, it is essential to treat both conditions. If a substance use disorder is not treated, a person’s mental health may never improve, and vice versa. An integrated residential treatment program, that includes mental health care, substance abuse interventions, housing assistance, and other supportive services is a strong option for individuals with co-occurring conditions.
Co-Occurring Disorder Treatment at Mission Harbor Behavioral Health
Mission Harbor Behavioral Health offers several treatment tracks for those living in Santa Barbara or other Southern California Locations, and we are qualified to treat both mental health conditions and substance use disorders. We do not offer residential services, but we have multiple levels of care, including a partial hospitalization program for those who have intensive needs. Contact us today to learn more.
Updated 7/25/21