What are co occurring mental health disorder and substance abuse?
A co-occurring disorder is when a person is battling some kind of mental health issue alongside substance abuse like drugs and alcohol addiction. Both SUDs and mental health issues share a strong link. In fact, it’s estimated that almost half the individuals suffering from one will develop the other at some time or another.
It’s not uncommon for substance abuse to fuel a co-occurring disorder and vice-versa. The severity of both can also increase over time.
The most common mental health issues to co-occur alongside SUD are –
- Anxiety Disorders – Social anxiety and general anxiety share a strong link with marijuana abuse. Almost 19% of people in the US have some kind of anxiety disorder. GAD, social anxiety, and panic disorder can also increase the odds of co-occurring issues.
- Personal Disorders – In terms of the general population, around 10-15% suffer from personality disorders. When we talk about those suffering from addiction and substance abuse, the rate is an astounding 35-70%. The commonest personality disorders in those battling SUD are – borderline, avoidant personality, paranoia, and antisocial behavior.
- Attention-Deficit/Hyperactivity Disorder – Studies tell us that ADHD comes with an increased risk of developing addiction-related issues during adulthood (mainly 20s and 30s.) There is a positive correlation in symptoms of ADHD like impulsiveness, hyperactivity, and inattention with substance use in adults.
- Mood Disorder – Around 30% of people suffering from SUD are likely to suffer from one of the mood disorders such as depression and bipolar.
- PTSD – According to a survey, people with Post-traumatic Stress Disorder are 4x more likely to develop substance use disorder than those without.
What Causes Co-occurring and Substance Addiction?
It is estimated that over half the people with one disorder will eventually develop the other during their lifetime. While the exact set of reasons that can fuel these two conditions might be long, researchers have found the 3 most prevalent reasons as to why co-occurring disorders may take place.
Overlapping Risk Factors
Many of the risk factors behind SUD and mental health issues are overlapping. Generally, these include environmental factors like exposure to drugs or alcohol at an early age, early childhood trauma, and genetics. All of these factors can make a person more susceptible to developing mental health issues and requiring addiction treatment for drugs such as Cocaine or others.
Dealing with a mental illness can be difficult. That’s why many people resort to alcohol and drugs as coping mechanisms. In medical terms, this is called ‘self-medicating’. However, it’s quite misleading as instead of fixing the problems, it only masks them. What’s more, in the long run, it exacerbates the symptoms and worsens the dependency on drugs/alcohol, making it more difficult to detox from alcohol or drugs, often requiring medically supervised detox.
Drug-Induced Brain Changes
Prolonged drug and substance use can change the brains ‘motivation and reward mechanism’. It can give a false sense of wellness causing one to develop a dependence on drugs beyond control. Eventually, it can lead to mental health issues by affecting the brain and neurotransmitters.
Drugs affect the areas of the brain associated with mood, impulse control, anxiety, and schizophrenia.
How to Battle Co-occurring Mental Health and Substance Use
Residential rehab programs begin with an initial assessment to draw an individual treatment plan. This is followed by detox and several other therapies. The patient has to stay in a structured and highly supervised facility. Common inpatient treatment duration for drug addiction is 30 days. Residential programs put the entire focus on recovery as daily triggers and challenges are removed that often lead to relapses.
Outpatient Healing Programs
Under this program, a patient receives all the treatments and therapies as in residential rehab. However, they are not required to live in the facility. This is good for young teenagers, parents, and people with mild addiction who cannot sacrifice work commitments.
This is usually the first step in most addiction treatment programs. Drug detoxification entails medical supervision to get the drugs out of the system. With a clean system, experts can begin further treatment. Generally, therapies and medication cannot begin unless detox is successfully over.
Integrated treatment often includes behavioral therapy and counseling as interventions. Rehab centers in Connecticut and other parts of the United States use integrated treatment coupled with medication. Integrated treatment encompasses several therapeutic techniques with proven results in treating substance abuse and mental health issues. Common integrated therapies are –
- Cognitive-behavioural therapy aka CBT aims to understand negative behaviours, thinking patterns, and self-talk that might be causing addiction and other disorders. It then works on changing them.
- Dialectical behavioural therapy is used for treating borderline personality disorder. It does so by working on negative actions and thoughts like self-harm, suicidal behaviour, and dependence on a substance to cope with daily stressors.
- Contingency management is often used in upscale addiction treatment centres. It reinforces positive changes by utilising incentives for patients who can exhibit positive behaviours such as staying sober and meeting therapy guidelines.
Psychotherapeutic Medications are often integral to treating SUD and co-occurring disorders and are frequently used during alcohol treatment. The commonly prescribed medications include antipsychotics and antidepressants. The latter is used to mostly manage the uncomfortable withdrawal symptoms. Other than that, medications may also be used to lessen the cravings so that relapses don’t happen.
Buprenorphine, naltrexone, methadone, disulfiram, and acamprosate are the common medications used for treating SUD.
Peer Support Clubs
It’s not uncommon for people with psychiatric issues to become antisocial. The withdrawal from social life exacerbates when you throw drugs and alcohol into the mix. By joining peer support groups/clubs like 12-step, Alcoholics Anonymous, and group counseling – patients can find solace in the presence of other people going through similar battles.
They can draw inspiration from their stories and also learn some tips to maintain sobriety. Support groups are highly effective in fostering a long-term, sustainable drug-free lifestyle.
Education and Counselling for Families
Sometimes a toxic family environment or dysfunctional relationships may unknowingly be fuelling a person’s addiction. Family counselling educates people how to create a healthy living environment for a family member to support long-term recovery.
Medical science is embracing the effectiveness and importance of holistic/alternative treatment when it comes to treating drug addiction. Many rehab centres are now adopting a holistic treatment model. Common holistic therapies are – massage therapy, acupuncture, hypnotherapy, yoga, reiki, meditation, and music therapy.
Co-occurring disorders may be a harsh reality in many people’s lives. But, know that if you or your loved one is going through this issue, help is always available.
Holly is a freelance writer who loves to help people who are struggling with a drug or alcohol addiction. Holly knows first-hand what it’s like to deal with substance addiction, and has now been sober for 5 years. Holly is a frequent contributor to many addiction-related blogs and organizations such as the Addiction Treatment Division and Inpatient-Rehab.org.