Individuals with a Substance Use Disorder along with a Mental Health Disorder are diagnosed as having Co-Occurring Disorders, also known as Dual Disorder or Dual Diagnosis. Co-Occurring Disorders are often times difficult to diagnosis, as someone’s substance use, abuse, or dependence may mask the symptoms of a Mental Health Disorder. Additionally, the symptoms of a mental health illness may be perceived as symptoms of a substance use disorder. Many times, individuals with mental health issues do not discuss their substance use believing it to not be relevant when the reverse is true; it’s not only relevant but important in order to receive the proper treatment.
A Substance Use Disorder includes abuse of drugs or alcohol, or dependence/addiction to drugs or alcohol. It’s important to understand that drugs include illegal, non-prescription, and prescription drugs. Just because someone may have a valid prescription for medications/drugs such as opiates (i.e. Vicodin/Hydrocodone, Percocet, Oxycodone) or benzodiazepines (i.e. Valium, Xanax) does not mean they are immune from being diagnosed with a substance use disorder. A proper evaluation with an Addiction Professional, therapist, or counselor is vital in determining whether or not someone is misusing or has lost control of the use of their medications.
Some of the most common Mental Health Disorders found in individuals with an addiction issue include mood and anxiety disorders. Mood-related disorders include Major Depression and Bipolar Disorder. Anxiety-related disorders include Post-Traumatic Stress Disorder (PTSD), Panic Disorder, Social Anxiety, Generalized Anxiety Disorder, and Obsessive Compulsive Disorder (OCD). Individuals with severe mental illnesses, such as Schizophrenia and Schizoaffective Disorder, have an even higher rate of having a co-occurring Substance Use Disorder. Common examples of co-occurring disorders are major depression with cocaine addiction, and alcohol addiction with panic disorder.
These two entwined problems, co-occurring disorders, do exhibit some typical patterns. Mental health symptoms can worsen, even while in treatment for the mental health issue, as individuals may use drugs to make themselves feel better, self-medicating their mental health symptoms. Someone feeling anxious may use to calm themselves or make themselves more comfortable around others while someone experiencing emotional pain may use in order to escape and feel numb. People that are depressed sometimes use in order to feel better about themselves or their situation. Drug or alcohol use in these situations not only have the potential to mask the symptoms of a mental health issue but that substance use will fail to make the mental health issue better; needed coping skills will not be obtained, satisfying relationships will not be developed, and developing strong self-esteem will not happen. Also, the use of alcohol while on medications to treat a mental health issue can interfere with the medication’s ability to be effective. In short, drug and alcohol use can worsen mental health symptoms.
The other pattern seen is substance use problems that are resistant to treatment efforts. Individuals may stop their drug or alcohol use but struggle as the symptoms of an untreated mental health issue persist or worsen. They may struggle to recognize or accept there is a mental health issue while also fearing treating that mental health issue with medications may negatively affect their substance use treatment. This is further complicated with the fact that many substance use treatment facilities may not be equipped to treat the co-occurring disorder at the same time or place.
The symptoms of co-occurring disorders can vary in severity and complexity as both substance use disorders and mental health issues may have biological, psychological, and social components. It is imperative, however, that both mental and substance use disorders are treated.