What are Co-Occurring Disorders?
A co-occurring disorder is a condition in which a person has a co-existing mental health disorder and substance use disorder. The other mental health disorders could come in any other form such as intellectual disability, eating disorder, personality disorders, depression, anxiety, or trauma-related disorders.
“Co-occurring disorder” is also referred to as “dual diagnosis,” “comorbidity,” or “dual disorder.” The term dual diagnosis was more prevalent in the past. These terms all mean the same thing – simultaneous diagnosis of both a substance use disorder and mental health disorder.
About 4 million people struggle with a co-occurring drug or alcohol dependency and mental health disorder.
Co-occurring disorders are common. However, the severity of each disorder is likely to change over time. The challenge with co-occurring disorders is that people tend to experience more psychiatric and medical difficulties than those with a single disorder. They may also require a longer period of treatment to address both disorders.
Co-occurring disorders come in different combinations. It could look like, for example: alcohol addiction and depression, anxiety disorder and opioid dependence, marijuana addiction and bipolar disorder, or meth addiction and social anxiety disorder. For most cases of co-occurring disorder, the symptoms and challenges connected to one can degenerate the issues of the other.
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What Are the Symptoms of a Co-Occurring Disorder?
It is difficult to pick out symptoms of co-occurring disorders because they manifest as either mental health difficulties or substance use. The symptoms will also vary depending on the co-occurring conditions. For instance, a co-occurring diagnosis for a mood disorder and methamphetamine (meth) addiction will manifest differently than a combination of anxiety and alcohol addiction. These overlapping symptoms make it confusing for a loved one to identify the issue.
However, there are general symptoms that you can identify with loved ones with co-occurring disorders. These are the indicators you should look for to identify presence of a co-occurring disorder.
Mental and Emotional Symptoms
Depression: if you feel like you can’t remember the last time you felt a positive emotion, have chronic fatigue, or are struggling with irritability, this could be a sign of depression.
Anxiety: extreme stress and anxiety can cause a person to want desperately to find a solution for their suffering. This could lead the person to seek out drugs or alcohol to relieve their symptoms.
Trauma: not everyone who experiences trauma will develop an addiction. However, trauma can be a factor in developing an addiction. Trauma can have severe mental, emotional, and physical side effects that could cause a person to seek relief through drugs and alcohol.
Changes in appetite or weight: depending on the substance of abuse, these fluctuations could go either way. Stimulant drugs would decrease appetite and cause weight loss, whereas marijuana could increase appetite and cause weight gain. Alcohol typically causes weight gain.
Changes in personal hygiene: it is not uncommon for mental health problems and drug abuse to cause poor hygiene habits. Either one could cause a drop in personal hygiene, but together they could be cause for a significant decline.
Health Issues: abusing drugs and alcohol can severely impact the body. Alcohol impairs coordination, leading to falls, broken bones, or bruising. Using drugs intravenously can cause bruising on arms, and some drugs – such as stimulants – can lead to skin picking and scabbing.
Are Individuals with Co-Occurring Disorders More At Risk?
Numerous mental health symptoms are similar to the negative effects of substance use. At a glance, it is then difficult to decide just by observation if the condition is as a result of mental illness or the other way around. Mental health disorders increase an individual’s risk to abuse drugs. Substance abuse increases the risk of developing a mental health disorder. Persons with co-occurring disorders are predisposed to more risks because of the complexity of two disorders with overlapping symptoms. Reputable treatment centers diagnose for both and create treatment plans to treat co-occurring disorders. Individuals with co-occurring disorders are at risk of:
People with co-occurring disorders are likely to experience treatment drop-out when treatment addresses only one disorder. Treatment is more likely to be less effective because the overlapping symptoms are not addressed. Unless there is proper diagnosis and integrated treatment, most individuals experience treatment drop-out because of undiagnosed co-occurring disorders.
“Self-medicating” is defined as a person with mental health symptoms who turns to drugs or alcohol to relieve those unwanted symptoms. While substance use may temporarily provide relief, the long-term effect is damaging. The substance abuse can worsen mental health symptoms, and vice versa. Self-medicating with drugs or alcohol masks symptoms of mental health disorders and makes diagnosis more difficult, leaving the mental health disorder potentially undiagnosed and untreated.
Because two disorders can play off and worsen each other, a person with co-occurring disorders can be at higher risk of relapse than a person without a mental health component. A quality co-occurring disorder treatment facility will help ensure success by providing the individual with a long term treatment plan to manage symptoms.
Require Longer Treatment
Unlike a singular case of substance abuse or a mental health disorder, the process of treating a co-occurring disorder is longer. The treatment for two disorders is done simultaneously, and in some clients the treatment episodes follow one another. This takes a lot of time. Some clients give up out of frustration or fail to follow through with their recommended medication regimen.
While stigma affects all mental health disorders, it is more severe for people with co-occurring disorders. As a result, the persons with co-occurring disorders may isolate themselves to avoid embarrassment. For others, isolation means they avoid treatment altogether. Stigma stops people from seeking treatment.
What Are the Dangers of Having Co-Occurring Disorders?
Due to the risks that people with co-occurring disorders are exposed to, the dangers may be more fatal than with other mental illnesses. Risks such as high rates of treatment drop-out, misdiagnosis leading to lack of comprehensive treatment, and relapse tend to bring more severe and long-term complications to individuals with co-occurring disorders.
Possible complications that may come with co-occurring disorders include:
- Low quality of life due to decreased ability to enjoy work, relationships, and other activities.
- Heightened social isolation and withdrawal from leaning on sober supports for aid.
- According to the Bureau of Justice Statistics report (2017), more than a third of prisoners and half of inmates have a history of mental health disorders. 59% of state prisoners and 63% of sentenced jail mates between 2007 and 2009 had a mental health disorder.
- Poor performance at work or school due to missing time. People with co-occurring disorders are more likely to be expelled from school or dismissed from work.
- A lot of people living with a co-occurring disorder are likely to become homeless. Statistics show that homeless persons have high incidences of co-occurring disorders.
- Due to poor performance at work and relationships, financial difficulties are common.
- A risk of physical harm such as injuries or illnesses as a result of impulsive and risky behaviors.
- Prolonged symptoms may lead to self-harm or suicide attempts.
- Prolonged use of substances, as well as prolonged use of doctor-prescribed medications during treatment, may cause kidney and liver damage.
- Co-occurring disorders lead to medical problems due to various substance abuse issues, such as: overdose, seizures, brain damage, heart disease, collapsed veins, infectious illnesses, and death.
- Prolonged emotional problems such as depression, anxiety, and paranoia could lead to permanent emotional dysfunction that could worsen addiction problems.
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