What are Co-Occurring Disorders?
A co-occurring disorder is a condition in which a person has a co-existing mental illness and substance use disorder. It is commonly defined as the combination of substance use and other mental disorders. The other mental disorders could come in any other form such as intellectual disability, eating disorder, personality or trauma-related disorders.
Co-occurring disorder is also referred to as dual diagnosis or dual disorder. The term dual diagnosis has been more prevalent in the past. Dual diagnosis goes with the same definition – simultaneous diagnosis of both a drug abuse disorder and mental health disorder. Comorbidity is also a commonly used term to describe the co-occurring disorder.
About 4 million people struggle with a co-occurring drug or alcohol dependency and mental health disorder.
Co-occurring disorders are common. However, their cases differ in severity, and the severity of each case is likely to change over time. The challenge with dual-diagnosis is that the affected tend to experience more severe psychiatric and medical difficulties than those nursing 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 be alcoholism and depression, anxiety disorder and opioid dependence, marijuana and bipolar disorder or meth and social anxiety disorder. For most cases of dual 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 a mental disorder or substance abuse. The symptoms will also vary depending on the co-occurring conditions. Take for instance, a dual diagnosis for mood disorder and meth addiction will manifest differently from a combination of anxiety and alcohol addiction. These overlapping symptoms can be confusing for a loved one to identify.
However, there are general symptoms that you can pick with dual diagnosis patients. Experts recommend that these are the indicators you should look for first 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 happy, or satisfied with life, this could be a sign of depression. Self medicating symptoms of depression using drugs or alcohol can be dangerous and lead to addiction.
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 major factor in developing an addiction. Trauma can have severe mental, emotional, and even physical side effects that could cause a person to seek relief through drugs and alcohol.
Physical Symptoms
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, and where as marijuana could increase appetite, and alcohol can cause weight gain.
Changes in personal hygiene: it is not uncommon for mental health problems as well as 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 can impair 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 Dual Diagnosis Individuals More At Risk?
Numerous mental health symptoms are similar to the negative effects of addiction. 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 round. Mental health disorders increases an individual’s risk to abuse drugs. Substance abuse increases the risk of developing a mental 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 come up with treatment plans to treat comorbidity. Dual diagnosis individual are at risk of:
Treatment Failure
People with co-occurring disorders are likely to experience treatment failure especially when it is addressed with one disorder. For instance, when a person is offered treatment for substance addiction alone, it is likely to fail because the overlapping symptoms are not addressed. Unless there is proper dual diagnosis and integrated treatment, most individuals experience treatment failure for comorbidity.
Self-medicating
When trying to escape mood disorder or anxiety most people will turn to self-medicate. While it may temporarily provide relief, the long term effect may be more damaging. The side effects of the substance abuse can worsen mental health symptoms, and vice versa. The complexity with self-medication is that it can mask dual diagnosis and leave it undiagnosed and untreated.
Relapse
Because these two disorders can play off and worsen each other, a person can be more at risk of relapse than a person without a mental health component. A quality dual diagnosis 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 addiction or a mental illness, the process of treating a co-occurring disorder is longer. It is done co-concurrently, and in some patients the procedures follow one another. This takes a lot of time. Some patients are likely to give up or fail to follow through with drugs as required.
Stigma
While stigma cuts across all mental health disorders, it is more severe for people with co-occurring disorders. As a result, the victims may isolate themselves to avoid embarrassment, and for others, to avoid treatment altogether. Stigma stops people from seeking treatment.
What Are the Dangers of Dual Diagnosis?
Due to the risks that people with co-occurring disorders are exposed to, the dangers are more fatal than with other mental illnesses. Risks such as high rates of treatment failure, misdiagnosis and hence lack of comprehensive treatment, and relapse tend to bring more severe and long-term complications to suffering individuals.
A more serious issue that spills over to serious dangers is that comorbidity can go undiagnosed and untreated. Possible complications that may come with dual diagnosis include:
- Low quality of life in general due to decreased ability to enjoy work, relationships and other activities.
- Heightened seclusion, social isolation and withdrawal from social events.
- According to Bureau of Justice Statistics report of 2017, more than a third of prisoners and half of inmates have a history of mental illness. 59 percent of state prisoners and 63 percent of sentenced jail mates between 2007 and 2009 had a mental health illness. People with co-occurring disorders are likely to run into legal difficulties.
- Poor performance at work or school due to missing time. They are likely to be kicked out of school or dismissed from work.
- A lot of people living with a co-occurring disorder are likely to become homeless. Statistics also show that most people homeless persons have high incidences of co-occurring disorders.
- Due to poor performance at work and relationships, they often run into financial difficulties.
- They are at risk of physical harm such as injuries or illnesses as a result of impulsive and risky behaviors.
- Prolonged symptoms lead to self-harm and suicide attempts.
- Prolonged use of substance addiction as well as protected use of drugs during treatment such as serious kidney and liver damage.
- Co-occurring disorders lead to medical problems due to various substance abuse such as overdose, seizures, brain damage, heart disease, collapsed veins, infectious illnesses, overdose, 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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Treatment for Co-Occurring Disorders
Partial Hospitalization Treatment
A Partial Hospitalization program will allow for intensive daily therapy that will be able to treat both substance abuse and a mental health condition. This involves supervision from a medical staff and daily therapeutic groups. During treatment, the individual will learn how to manage their mental health, while also staying sober from substances. They will also receive a transitional plan for after treatment.
Intensive Outpatient Treatment
In Intensive Outpatient Treatment, the individual will still receive daily therapeutic care, but they will receive fewer hours. Their therapy will help them to learn to stay sober while also balancing normal aspects of life- such as work, school, and family obligations. During this level of care the person can live at home, or couple the treatment with a sober living environment for more accountability.
Sober Living
A sober living environment provides a safe and sober place for an individual to stay while they attend treatment, as well as afterwords if they feel they need continued accountability. In a Sober Living environment the individual would undergo regular drug testing, and have certain expectations such as curfew and be required to attend outside recovery groups, such as AA or SMART recovery.