Co-occurring Disorders: What Are They and How Are They Treated?

Years ago, mental health was separate treatment from drug or alcohol addiction. The facilities for treatment were not the same and even the approach to therapy was different. This was not helpful to those who had issues from the opposing side. A person treated for bipolar disorder would not receive help for their substance abuse and someone with substance abuse issues was not receiving treatment for their mental health issues.

Now, co-occurring disorders have treatment in their own right. The U.S. Department of Health and Human Services shows that severe psychiatric disorders affect around 5 percent of people in the United States. And around 7 million have effects of substance abuse from drugs or alcohol. Without dual diagnosis care, people on either side would miss out on effective treatment.

Here is more on co-occurring disorders. What they are, statistics, treatment options, and more.

What Are Co-occurring Disorders?

The definition of a co-occurring disorder is also known as a dual diagnosis. What it means is that a person has both a substance abuse disorder as well as a mental health disorder.

This is however, a more recent discovery when it comes to addiction treatment. In fact, it wasn’t until the 1990s that this diagnosis had treatment as such. Before then, people had treatment for each disorder separately. As mentioned before, if someone had both, they were either treated for one or the other – and never in the same facility.

This was problematic because a person with both disorders was only receiving treatment for one. So either their substance abuse disorder suffered or their mental health suffered. A person would have had to choose the worst or their therapist or doctor would have made the decision.

The problem with that treatment plan we will go over in the next section.

Which Comes First?

This is a difficult question to answer since every person is an individual, with individual diagnoses. The important thing to know is that sometimes one is part of the causation of another.

For example, if a person has mental health issue they may try to self-medicate with other substances. Take for instance someone with untreated post-traumatic stress disorder or PTSD. If that individual is not receiving care from a professional for their PTSD, they may self-medicate with drugs or alcohol. On the flip side, a person with a substance abuse problem can trigger a dormant mental health issue. Both can feed each other’s symptoms and escalation.

According to Behavioral Health Evolution:

Those diagnosed with mental health disorders often use substances to feel better. People who are anxious may want something to make them feel calm; people who are depressed may want something to make them feel more animated; people who are fearful of others may want something to make them feel more relaxed and less inhibited; and people who are in psychological pain may want something to make them feel numb.

The problem with this is that using substances to medicate does not fix the problem and it may even hinder healing. This is because turning to drugs or alcohol interferes with the person’s coping skills. If the person is taking medication for their mental health issue then alcohol can also disrupt how the medicine is working.

Another issue with not treating these disorders together in the past is this. Let’s say a person stops their substance abuse in order to focus on their mental health issues. The person may find it difficult to continue with treatment if the symptoms are not masked by drugs or alcohol. Many treatment centers in the past insisted a person be “clean” and stop all types of substance use.

This did not treat the substance abuse at all and sometimes makes treatment for the mental health issues more difficult. The point is, treating one disorder doesn’t make the other go away. For a full spectrum treatment plan, both substance abuse disorders and mental health disorders needs addressing at the same time. The treatment has to happen simultaneously, which is where co-occurring treatment comes in.

Why Do Co-occurring Disorders Develop?

According to the National Institute on Drug Abuse, when two disorders or illnesses occur in the same person, simultaneously or sequentially, they are described as comorbid. Comorbidity also imples that the illnesses interact, affecting the course and prognosis of both. This research report provides information on the state of the science in the comorbidity of substance use disorders with mental illness and physical health conditions.

There are a few things that contribute to a co-occurring disorder. And while this is not a comprehensive list and everyone is unique, some of these are contributory.

Genetics

A person’s heredity may, in some cases, play a role in if they tend to develop the same issue. In these cases, having a family member with a mental health issue or a substance abuse disorder may increase the risk of that person developing the same.

Biology

This one is more complex. For some, it is simply something that seems more hardwired into the brain. This may also happen due to factors such as an injury or accident. In some, it is due to prenatal development. There are any number of things that may lead to a propensity in having a mental health issue or a substance abuse issue.

Environment

Our environment is an area that can and does sometimes affect a person’s chances of substance abuse – especially in homes where there is heavy drug abuse.

Trauma

Traumatic experiences sometimes lead to both substance abuse disorders and/or mental health issues. Whether it’s a natural disaster, war, or sexual abuse – these all affect the psyche and can have a direct effect. The substances are often used to mask the pain or feel numb. And trauma can lead to disorders like PTSD, depression, and anxiety.

Life Experience

Between significant life experiences and heavy substance abuse, this can sometimes lead to the development of mental health issues.

How Are Co-occurring Disorders Treated?

As mentioned, it is crucial that both mental health disorders and substance abuse disorders have treatment together. Treatment should include:

• Dual care by a professional for both disorders so that treatment runs parallel.
• Treatment strategy that includes the patient’s loved ones. Spouses, children, and other familial members of the household should has to have inclusion. This is for someone to get an all-encompassing treatment that includes support from those closest to them.
• Medication needs validation as acceptable forms of helpful treatment. Pharmaceuticals such as anti-anxiety medications or antidepressants are helpful in treating co-occurring disorders.
• A support system that helps build confidence, self-esteem, and coping mechanisms.

There are specific needs when it comes to integrated treatment options. These include:

Medical Detoxification

If a person has an addiction to drugs or alcohol, medical detox is important. This is so that the patient has the ability to get help with things like withdrawal symptoms.

An Evaluation

No treatment plan is going to work best without a professional evaluation of the patient’s needs. This allows the professionals to gauge better what issues may cause problems or what course of action is needed to proceed.

Diagnosis

Once an evaluation is made, this allows the professionals to make an educated diagnosis. This is important so that the patient can learn more about what is best to plan for a better recovery.

Treatment Plan

A treatment plan is the very thing that is imperative to help the patient know what comes next. This includes things like learning coping mechanisms, getting on the right medication, dealing with mental health issues, healing from addiction, and dealing with the things that may have led to the disorders in the first place such as trauma.

Therapy

The therapy for co-occurring disorders include group therapy, family therapy, and individual therapy. Group therapy is important so that the person with the disorders has support from people like them. Often, there are specific things that each person can share with the other. Whether it’s finding work while having a disorder or learning how to deal with family. Family therapy allows the support of family members. It helps the family member better understand what is going on so that they can be supportive and helpful to recovery. And individual therapy gives a safe place where confidential information can be shared without judgment. The therapist works one-on-one to ensure that the patient can discuss problems, goals, triggers, and even past experiences.

Aftercare

Aftercare is integral to any type of treatment program. This includes things like transitioning into outpatient services or learning to cope with triggers that happen when you’re on your own.

We Can Help You or Your Loved Ones

Whether it’s you or a loved one, Transformations has a wealth of treatment options that include everything mentioned. We know that no one plan fits all and that is why we create individual treatment plans based on your (or your loved one’s) needs. If you or someone you care about needs help with co-occurring disorders, contact us – we are here for you.