Up until the mid-1990s, mental illness and substance abuse were treated separately. Those suffering from mental health issues were frequently instructed to “sober up” if they had simultaneously been using chemical substances. Those with substance use disorders were told that they could receive the necessary drug or alcohol addiction treatment in a residential facility, but that they would need to visit a psychiatric hospital if they required further assistance. An in-depth study conducted in 1995 and published in Comprehensive Psychiatry detailed the correlation between substance abuse and mental health. The study is called, “Prevalence and patterns of “dual diagnosis” among psychiatric inpatients,” and it was intended to bring about a better and more thorough understanding of comorbidity. The findings were conclusive – it was determined that out of 435 carefully studied psychiatric patients, 55.9% simultaneously struggled with substance abuse. Over half – 53.6% – of dually diagnosed patients had not shown symptoms of mental health disorders (or had not been officially diagnosed) before using substances. The correlation became even more clear. Another study, titled “The Challenge of Dual Diagnosis” and published in 1996, focused on the connection between alcohol abuse and mental health. The introduction to the study reads, “Improved diagnostic criteria are available, and research has demonstrated that both disorders must be addressed if the dually diagnosed patient is to have the best chance for a good outcome. The best type of treatment program is an integrated approach, assuring that treatments will be coordinated for best effect.” What does this mean? Essentially, it means that in order for one treatment to be successful long-term, all existing disorders must be treated at the same time.
More on Dual Diagnosis Disorders
Integrated treatment refers to treatment that thoroughly addresses addiction and mental illness, regardless of what the addiction or the mental illness is. There are many different combinations when it comes to comorbidity, and many struggle with more than two disorders. One individual might suffer from a gambling addiction and alcoholism, for example, while another might suffer from schizophrenia, post-traumatic stress disorder and prescription painkiller addiction. Symptoms will vary significantly on a person-to-person basis. There are several different types of addictive disorders that could be considered comorbid. These include:
- Drug addiction – Some of the most commonly abused chemical substances include opioids (like prescription painkillers of heroin), stimulants (such as amphetamines or cocaine), and sedatives (such as prescription sedatives like Xanax and Valium). Those with drug addictions often initially begin using the drug to help cope with untreated mental health symptoms, such as depression or anxiety.
- Alcohol addiction – Because alcohol lowers inhibitions and acts as a sedative, those who are experiencing untreated symptoms of anxiety-related disorders very frequently turn to this specific substance. Of all addictive substances or behaviors, alcoholism is the most common.
- Gambling addiction – Compulsive gambling is an addictive disorder, one characterized by an inability to stop gambling despite serious, negative personal consequences. While the types of gambling vary – and can include gambling at a casino, betting on sporting events, compulsively buying scratch off lotto tickets, and more – the symptoms are generally the same. Symptoms often include interpersonal problems, job loss, and severe financial distress.
- Eating disorders – Eating disorders are very common amongst individuals that struggle with substance abuse and addiction. In many instances, sufferers of eating disorders will turn to drugs and alcohol as a means of quieting obsessive thoughts about food and eating. Eating disorder can include anorexia nervosa, bulimia, compulsive overeating, or a number of others.
- Sex or love addiction – Sex addiction is characterized by compulsive engagement in sex with multiple partners, compulsive masturbation, or any other type of obsessive/compulsive sexual act. Psychology Today defines love addiction as, “A ‘pattern of behavior characterized by a maladaptive, pervasive and excessive interest towards one or more romantic partners, resulting in lack of control, the renounce of other interests and behavior, and other negative consequences.’ In love addiction, immature love—love that is uncertain, external, blind, and beyond one’s control—permeates one’s life.” (3).
When it comes to mental illness, substance abuse (alcohol or drug addiction) is by far the most common comorbid disorder. Some symptoms of substance use disorders include:
- The building of a physical tolerance/requiring more of the substance in order to experience the same physical and psychological effects
- Psychological cravings that are so intense that they disrupt day-today life, and lead to obsessive drug-seeking behavior
- Anxiety when the substance can not be easily accessed, or when it is not readily available
- Interpersonal issues, like issues amongst family members or strained friendships/romantic relationships
- Repeated efforts to quit using/only being able to stop using for a brief period of time
- Making a noticeable shift away from activities that were previously enjoyed/a lack of motivation or interest
- Withdrawal symptoms with ceased use
- Increase in risk-taking behaviors, like driving while intoxicated or engaging in promiscuous sex
Common Comorbid Mental Health Disorders
Some mental health conditions that often coincide with substance abuse disorders include:
- Anxiety disorders
- Depressive disorders
- Bipolar disorder
- Trauma-related disorders, like post-traumatic stress disorder (PTSD)
- Attention deficit hyperactivity disorder (ADHD)
As previously discussed, the majority of individuals who struggle with an addictive disorder will simultaneously struggle with a mental illness – either undiagnosed and untreated, or previously diagnosed. In 2014, the Substance Abuse and Mental Health Services Administration found that a staggering 7.9 million American adults struggled with a dual diagnosis disorder. When it comes to how and why dual diagnosis disorders come to be, pinpointing an exact reason can be difficult. It has been repeatedly found that dual diagnosis disorders interrelate with one another; though determining which preceded the other can prove to be difficult. Drug and alcohol use affect brain chemistry, and can worsen and exacerbate the symptoms of pre-existing mental health conditions. On the contrary, some drugs can actually cause mental health issues. For example, excessive alcohol use has been known to lead to depression, and methamphetamine addiction has been linked to schizophrenia and other types of psychosis. When it comes to dual diagnosis disorders, there are three major risk factors that contribute to their potential development. The first of these is genetic predisposition, which has been linked to mental health and substance abuse. This essentially means that if either disorder runs in your family, you are more likely to develop it at some point down the line. The second contributing factor is disorders that develop during adolescence, and the third concerns exposure, like environmental factors such as continuous stress, ongoing trauma or persistent feelings of fear.
Guardian Recovery Network & Dual Diagnosis Disorders
At Guardian Recovery Network, we cater to those who struggle with dual diagnosis disorders. Our team of experienced and compassionate professionals is made up of licensed therapists and psychiatrists, who work together in ensuring the most comprehensive, integrated and quality care available. If you have been diagnosed with a mental illness in the past – or if you believe you are struggling with the symptoms of an undiagnosed mental illness – we are available to help. We specialize in comorbid disorders, and provide a wide range of services all geared towards paving the road of a lifetime of meaningful recovery. For more information on our personalized program of dual diagnosis addiction treatment, give us a call today.