Understanding Dual Diagnosis, Co-Occurring Disorders, and Integrated Treatment

The Substance Abuse and Mental Health Services Administration (SAMHSA) reports that 8% of the United States adult population has a mental health disorder. If you look at half of those people, they also live with a co-occurring substance use disorder (SUD) or alcohol addiction.

Only 16% of those 4 million individuals have sought treatment. On the one hand, you might say that any help is better for a person than going without help. Still, on the other hand, if the illnesses included in a person's dual diagnosis or co-occurring disorders aren't approached simultaneously with integrated care, then the quality and effectiveness of such an unbalanced and inadequate dual diagnosis program are questionable.

What Is the Difference Between Dual Diagnosis and Co-Occurring Disorders?

Among the population of people with substance use disorders, the Journal of the American Medical Association reports that nearly 50% of them have equally prominent symptoms of a severe mental health condition. When speaking of dual diagnosis, it is a matter of a person having a solitary diagnosis of substance abuse disorder alongside a separate diagnosis of some mental or behavioral health issue. While the two distinct disorders could affect each other, they are still essentially different illnesses. Regarding co-occurring conditions, the terminology refers to a person who has developed one or more mental health conditions because of drug abuse. Reversibly, co-occurring conditions could also refer to a person's substance use being responsible for generating one or more mental health illnesses. This is also called comorbidity or comorbid conditions. 

In the past, people with a dual diagnosis or co-occurring disorders were treated for one illness at a time. For example, a person would go into treatment for anxiety at a psychiatric center. They would then have to go to another facility to treat substance use disorder. This practice was highly impractical as that one illness left unmanaged would often worsen and probably undermine any successful progress for the treated condition. It could create one big ineffective cycle. 

Personality Disorders, Mood Disorders, and Psychotic Disorders Vs. Substance Use Disorders

The most common mental health conditions fall under one of three categories. Mental disorders are most problematically and prominently marked by symptoms involving issues with thinking, like delusions or hallucinations. Mood disorders are mood disturbances, such as having limited emotional scope and exaggerated or inappropriate feelings. Personality disorders are symptomatic when a person's characteristics create personal distress and impair their thoughts about the world, others, and themselves. They lack emotional control, impulsiveness, and dysfunctional interpersonal skills.

For optimal, long-lasting results in terms of recovery and better relapse prevention, there is a need for an integrated approach when a person has a mental health issue and substance abuse problem. Whether one is the causation or another ailment causes one, it doesn't mean that treatment shouldn't include an entire team of professionals who can provide the care needed for all areas that prevent a person from functioning and making healthy decisions for their life. These are a few other mental health conditions that could easily contribute to substance abuse issues or be caused by it:

  • Post-traumatic stress disorder (PTSD)
  • Attention-deficit hyperactive disorder (ADHD)
  • Schizophrenia
  • Clinical depression
  • Bipolar disorder
  • Eating disorders
  • Obsessive-compulsive disorder
  • Generalized anxiety disorder (GAD)
  • Borderline personality disorder
  • Social anxiety
  • Panic disorder

What Causes Co-Occurring Conditions?

Even if one condition, substance use or mental illness, came before the other, it isn't an implication that the first condition to become symptomatic and apparent caused the co-occurrence. Although establishing which disease came first or the reason either of the disorders manifested in a person could be helpful knowledge, it shouldn't prevent or delay a person from getting the treatment best suited for them and their recovery as a whole individual. Nevertheless, researchers have come up with a few possible reasons why comorbidity happens:

  • The abuse of illicit substances or the excessive consumption of alcohol could cause alterations in the brain that makes a person more susceptible to developing a psychiatric disorder.
  • To compensate for a treatment's inefficacy, some people diagnosed with a mental health disorder turn to drugs and alcohol to self-medicate instead of legitimate medication management by a treatment provider, which can eventually lead to addictive disorders. For some people, self-medicating rids the individual of the undesirable symptoms of their mental illness. However, for others, substance use has adverse effects and, in many instances, aggravates the very symptoms the person was trying to mitigate. Research has revealed that upon developing a mental health condition, there are changes in the brain's reward sensory, which could aggrandize the effects of substances and "hook" the person into continued use of drugs or alcohol. 
  • Genetic predisposition could put a person at risk for developing both a mental health problem and substance use disorder. Researchers have found a specific gene that could create a peculiar reaction to a drug—regardless of whether a person has a euphoric feeling. Science has also discovered a particular gene that puts adults at risk of developing a mental condition if they were chronic marijuana users as a child. It's been observed that stress, trauma, and other environmental factors are impactful enough to alter genealogy and, through generations, pass down the susceptibility to developing substance use disorder or a mental disorder. 

The key to successful and sustained recovery for a person with a dual diagnosis or disorders co-occurring is to get integrated treatment from a provider that approaches care without preferential treatment for the one that came first or for one being worse than the other. Cognitive behavioral therapy is often part of integrative care. It is used in mental health clinics, inpatient rehabs, and partial hospitalization programs to treat an individual with a dual diagnosis disorder. If you or a loved one needs help treating substance use disorder and one or more mental health conditions, most experts will agree you can get the best comprehensive care at a specialty inpatient rehab program. If you want a dual diagnosis treatment center capable of providing synchronous care to help you become the best version of yourself, then it's time you discover Wish Recovery. We have licensed physicians, psychiatrists, psychologists, and other health care and social work professionals. Our dedicated staff knows how to care for a person holistically with a personalized treatment plan that addresses each of your needs in our luxurious, resort-like facility. Contact us today for a confidential consultation at 844-222-8808.

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