If you spend much time around people with mental health diagnoses or substance use disorders, you have likely noticed that there is a great deal of overlap between the two groups. It is extremely common for people who experience one to also experience the other. Around 8 million adults in America have both a mental health condition and a substance use disorder. At Safe Harbor Recovery Center in Portsmouth, Virginia, we offer treatment that addresses mental illness and addiction together.
Why Addiction and Mental Illness Occur Together
When a person has both a mental illness and a substance use disorder, these are referred to as co-occurring, comorbid, or dual diagnosis disorders. There is sometimes a tendency for people to place blame on people with dual diagnosis for “causing” their own mental illness by using drugs. The reality, however, is far more complex.
- Shared risk factors – Environment, stress, trauma, and genetics all contribute to the development of addiction and to the development of mental illnesses, so it’s not surprising that being high risk for one also makes a person high risk for the other.
- Self-medication – People who struggle with mental illness sometimes turn to alcohol and drugs to manage their symptoms. Because this coping strategy makes mental illnesses worse, people often use more and more substances in an effort to control symptoms.
- Triggering events – Sometimes, people will develop new mental illnesses after using alcohol or drugs. They may or may not have had an existing mental health disorder before using.
Warning Signs of Dual Diagnosis Disorders
It’s not really possible to make a comprehensive list of the signs a person with co-occurring mental health and substance use disorders could display, since the combination of different mental illnesses and substances could have a wide range of results. On the other hand, if you see the following symptoms, it is generally a good idea to discuss your concerns with the person you’re worried about:
- Withdrawing from friends and family
- Big changes in behavior, particularly if the new behavior is impulsive and/or dangerous
- High tolerance for substances
- Withdrawal symptoms when substances are not available
- Being unable to function without the drug in question
- Confusion or difficulty focusing
- Indications of suicidal thoughts or plans
Treating Co-occurring Disorders
In the past, many treatment programs would only address mental illness or substance use disorders, but integrated interventions are now recommended for the most effective treatment. This may look like a person going through detox, then engaging in therapy for their mental health, while attending groups related to addiction, participating in recovery meetings, and possibly taking medications that address both issues.
The integrated approach is often more effective than the old strategy of only treating one problem at a time because people who are mentally well are better able to focus on their addiction recovery, and people who are sober are usually better able to progress in their mental health. Treating one at a time sometimes limits a person’s ability to make progress in either domain. Sometimes, it can even result in one condition being made worse, if medication is used without regard for how it might affect the untreated disorder.
Some of the therapy options that are most effective for adults with dual diagnosis disorders are:
- Cognitive behavioral therapy (CBT)
- Dialectical behavior therapy (DBT)
- Assertive community treatment (ACT)
- Therapeutic communities (TC)
- Contingency management (CM)
Substances Commonly Misused in Dual Diagnosis Disorders
The drugs that are most likely to be misused by a person with a mental illness and a substance use disorder include:
- Alcohol
- Tobacco
- Opioids
- Stimulants
- Marijuana
- Hallucinogens
- Prescription medications
Recovery Groups
In addition to treatment programs that address mental illness and addiction together, some self-help and support groups are tailored to this group, such as Double Trouble in Recovery. While AA, NA, and SMART Recovery are also often able to address the needs of this population, some people like to have a network of people who are living with both conditions.
At Safe Harbor Recovery Center, we meet each client where they are, developing individualized care plans that meet their unique needs in an evidence-based, trauma-informed manner. Our residential, partial hospitalization, and intensive outpatient programs offer different treatment levels based on the requirements each patient has at a given time.