Mental Health Issues & Addiction

The Substance Abuse and Mental Health Services Administration says that almost nine million individuals experience a co-occurring disorder.¹ For individuals wondering, “is alcoholism a mental illness the answer is yes. Fortunately, there is help, and it usually takes dual diagnosis treatment provided by a professional healthcare specialist.

What is a Dual Diagnosis?

An individual with a dual diagnosis has both mental health issues and addiction. These disorders often occur together. Around half of the individuals who experience a mental health disorder will also struggle with addiction.^² Each can become worse by the other.

What Mental Disorders Can Contribute to a Dual Diagnosis?

Co-occurring substance abuse and mental health conditions can include any combination of two or more mental health disorders and substance use disorders (SUD) that the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) identifies.

Although no specific combinations of substance use disorders and mental health disorders are uniquely defined as co-occurring conditions. Some common mental disorders that can contribute to a dual diagnosis include:

1. Anxiety and Mood Disorders

Anxiety disorders and mood disorders are two prevalent mental health issues. Anxiety and mood disorders occur primarily because of the complex interplay of several factors, including:

Anxiety

Anxiety can result in a person developing feelings of fear, hopelessness, and a few other emotions. It’s normal to experience occasional anxiety. But, individuals with anxiety disorders often experience excessive, intense, persistent fear and worry about daily situations.

They often experience repeated episodes of sudden fear, anxiety, or terror that reach a peak within minutes. This is referred to as a panic attack.

Panic attacks have the following characteristics:

Mood Disorders

A mood disorder is a psychological disorder that disrupts a person’s mood or causes severe mood changes. These changes lead to inconsistent reactions and feelings toward situations. A mood disorder can be characterized by sadness or extreme happiness.

Mood disorders often involve a loss of interest in daily life activities. In situations like these, individuals typically experience overwhelming anxiousness.

Mood disorders are the most common types of psychiatric comorbidities for individuals with substance use disorders.^³

2. Schizophrenia

Schizophrenia impacts approximately 1% of the worldwide population.⁴ While the course of schizophrenia can vary among people, it’s typically persistent and may be both disabling and severe.

SUD commonly occurs in individuals with schizophrenia and dramatically worsens their overall clinical course.

This is a mental disorder marked by interruptions in:

3. Bipolar Disorder

Many individuals with a SUD have a co-existing mental disorder such as bipolar disorder. This condition was once referred to as “manic depression” and causes mood swings between extreme emotional lows and highs.

Research showed of those with bipolar disorder, around 60% had some substance abuse history.^⁵

4. Major Depressive Disorder

Depression is a prevalent condition among individuals struggling with an alcohol or drug addiction. Substance abuse can intensify or trigger feelings of sadness, loneliness, and hopelessness often linked with depression.

Almost a third of individuals with major depressive disorder also have a substance use disorder. This comorbidity yields more significant personal and social impairment and a higher risk of suicide and other psychiatric disorders.^⁶

5. Post-Traumatic Stress Disorder (PTSD)

PTSD is a mental illness caused by experiencing or witnessing a traumatic event. Individuals experiencing PTSD may turn to alcohol or drugs to self-medicate feelings of stress, fear, and anxiety.

Around half of the people seeking substance use disorder treatment meet current PTSD criteria. An estimate more than five times more than the lifetime prevalence rate in the United States.^⁷

6. Attention Deficit Hyperactivity Disorder (ADHD)

ADHD is a type of neurological condition that’s generally diagnosed in children. It can last well into adulthood. It’s usually linked to difficulty:

ADHD and addiction can often co-occur together as well.

ADHD and SUD are inextricably intertwined. Kids with ADHD have a higher risk of developing SUDS than their peers. One study showed that kids with ADHD are more than 2.5 times as likely to experience a SUD overall.^⁸

7. Conduct Disorder

This severe emotional and behavioral disorder can occur in teens and children. When a child has this condition, they may show patterns of violent and disruptive behavior and have issues following rules.

It’s common for kids and teens to experience behavior-related issues during their development. But, the behavior is believed to be a conduct disorder when it lasts a long time, violates other people’s rights, disrupts the child’s or family’s daily life, and goes against accepted norms of behavior.

This disorder has been shown to raise the risk of substance abuse in adolescents — male or female.^⁹

8. Borderline Personality Disorder (BPD)

BPD is a mental health disorder that severely affects an individual’s ability to regulate their emotions. This emotional control loss can:

There are effective treatments available that will help individuals manage their BPD symptoms.

Around 78% of individuals with BPD also develop an addiction or SUD at some point in their life. These individuals are clinically less stable and more impulsive than BPD patients without a dependency on substances.^¹⁰

9. Antisocial Personality Disorder

This is a challenging personality disorder marked by irresponsible, impulsive, and frequent criminal behavior. An antisocial personality disorder will generally be deceitful, reckless, manipulative, and won’t care for other people’s feelings.

There’s a strong link between substance abuse and antisocial behavior.^¹¹ It is still uncertain whether this link is causal so that one condition leads to the other or is explained by shared risk factors and shared symptoms.

Why Mental Illnesses and Addiction are Related

There is a high comorbidity rate between mental health disorders and addiction. However, it doesn’t mean that one condition necessarily led to the development of the other — even if one showed up first.

Instead, there are still various factors that should be considered, such as:

Drug abuse can lead individuals to experience one or more symptoms or signs of another mental disorder. For instance, there's a higher risk of psychosis in people who use marijuana.^¹²
Mental health disorders can result in alcohol or drug abuse because some individuals use substances to self-medicate.^¹³ For example, nicotine can sometimes reduce specific schizophrenia symptoms and may improve cognition.
Evidence also shows that mental health disorders and addictions are caused by genetic influences, underlying brain deficits, and exposure to trauma earlier in life. For example, it's estimated that 40% to 60% of an individual's vulnerability to addiction can be due to genetics. A few human genome regions have also been associated with a higher mental illness and substance abuse risk.^¹⁴
Another common factor between addiction and mental health disorders is the individual's age when symptoms first appear. During the teenage years, individuals are still growing, maturing, and developing. Because of this, substantial brain changes occur during adolescence. For example, teens are more prone to act impulsively and take risks.
Finally, emotionally or physically traumatized individuals are at a much greater risk of SUD. This connection is especially problematic for veterans coming back to the country.

Is a Dual Diagnosis Hard to Get?

A dual diagnosis is challenging to treat. It can be challenging for family members to know where their loved one’s mental health disorder symptoms end and their substance abuse disorder begins. Because of this, it can be hard to determine what is causing the symptoms that a loved one is experiencing. To receive a proper diagnosis, the individual should see a healthcare professional trained and experienced in dual diagnosis treatment.

Some individuals begin using alcohol and drugs to cope with their mental health disorder symptoms. They may not understand what’s happening to them when symptoms start showing up. As a result, they may use different substances to self-medicate.

In other situations, the SUD exists first, and the mental disorder appears afterward. Alcohol or drug abuse can lead to or trigger mental illness in some individuals. Depression symptoms can be brought on by excessive or long-term alcohol or drug use.

Some individuals turn to drugs or alcohol when they’re feeling depressed to try and make themselves feel better. They may obtain a temporary lift, but the substance makes them feel worse. If a person with a dual diagnosis receives treatment in a program that’s not suited well to their needs, they may not recover.

Some problems that can arise when healthcare professionals don’t correctly address dual diagnosis include the following:

Individuals are more likely to leave the alcohol or drug treatment program early
Individuals can be quickly discharged following treatment without the follow-up care necessary to sustain long-term sobriety.
Individuals' mental health symptoms can make it harder to engage and interact with others during educational sessions and group therapy.
Individuals have a greater risk of relapse.

If both the mental health disorder and addiction aren’t worked through, an individual may not be able to achieve full recovery.

How to Treat Dual Diagnoses

Typically, it’s better to treat the co-occurring mental illness and SUD together instead of separately. Individuals seeking treatment for a mental health disorder and a SUD need a healthcare professional to evaluate them.

Overlapping symptoms can make it challenging to come up with an accurate diagnosis. Therefore, the healthcare professional will need to use comprehensive assessment tools. This will decrease the risk of missing the diagnosis and help provide targeted treatment.

It’s also essential that the treatment, which can include medications and behavioral therapies, is tailored to the person’s specific combination of:

The person will want to speak with their healthcare professional to decide on the best treatment. People who are struggling should allow the treatment time to start working effectively.

Treatments may include:

1. Detoxification

The first hurdle individuals with a SUD need to go through is detox. Inpatient detoxification is typically safer and more effective for initial sobriety than outpatient treatment.

During inpatient detox, the individual will be monitored 24/7 by trained medical staff. The process will last up to seven days while the individual’s body eliminates the drugs and toxins from itself. Individuals will generally receive tapering amounts of the substance they were using or a medical alternative. This is to help wean them off the drug and lessen the withdrawal effects.

2. Medications

Medications are available and are effective for treating alcohol, opioid, and nicotine addiction. These medications can reduce the symptoms of various mental health disorders. In some cases, multiple conditions can be treated with certain medications.

3. Residential Treatment

This type of treatment is also called inpatient rehabilitation. Individuals will live in a home-like, sober environment onsite. Although outpatient treatment programs are still available, residential treatment programs are preferred for people new to recovery.

The programs provide the individual with complete immersion in their pursuit of recovery. Inpatient treatment programs remove individuals from their triggers. This will enable them to start working through their cravings and urges at the beginning of sobriety.

The individuals will receive one-on-one work with licensed clinicians. They will also participate in group sessions that will provide them with a supportive environment. These therapies are designed to create healthy coping skills and lasting recovery. Also, the staff can offer individuals 24/7 medical support if they are in need.

4. Behavioral Therapies

Several behavioral therapies help treat people with co-occurring mental health disorders and SUD. Healthcare professionals may recommend these therapies by themselves or in combination with medication.

Some types of behavioral therapies for people with co-occurring mental health disorders and SUD include:

Cognitive Behavioral Therapy (CBT): This talk therapy is designed to help individuals learn how to better cope with complex situations by changing behaviors and challenging irrational thoughts.
Dialectical Behavior Therapy (DBT): This form of therapy uses concepts of being attentive and aware or mindful and accepting of the present emotional state and situation. It also teaches the individual skills that help reduce self-destructive behaviors (i.e., self-harm, suicidal thoughts or attempts, drug use), control extreme emotions, and improve relationships.
Therapeutic Communities (TC): These are a common type of long-term residential treatment focusing on helping individuals create new and healthier attitudes, values, and behaviors.
Assertive Community Treatment (ACT): This type of mental health care is based on community and emphasizes community outreach and a treatment approach tailored to the individual.
Contingency Management (CM): The principles of CM promote healthy behaviors by providing rewards or vouchers for desired behaviors.

Consider Help with Inland Detox

To effectively manage mental health disorder symptoms in recovery, the SUD and the mental health disorder should be treated together. Combining mental health care and addiction treatment for an integrated intervention is considered the best for recovery. A treatment plan can be customized to fit individual needs and diagnoses.

Inland Detox in Riverside County, California offers dual diagnosis treatment for individuals struggling with mental health and substance use disorders.

References

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