Substance abuse is defined as a pattern of harmful use of any substance for mood-altering purposes. Mental illness refers to disorders generally characterized by dysregulation of mood, thought, or behavior, as recognized by the Diagnostic and Statistical Manual, 5th edition, of the American Psychiatric Association (DSM-5).
When a person is suffering from both a substance abuse and a mental health disorder, it is called a co-occurring disorder. Some people refer to this as “dual diagnosis.”
According to the National Alliance on Mental Illness (NAMI), approximately 50 percent of individuals with severe mental health disorders are affected by substance abuse. NAMI also estimates that 29 percent of all people diagnosed as mentally ill abuse alcohol or other drugs.
Some of the most common mental health disorders among those with co-occurring disorders include mood disorders, anxiety disorders, personality disorders, and psychotic disorders.
Dealing with either can be difficult, but it is often more difficult to deal with both. Each disorder has its own unique symptoms that can impair one’s ability to function and often interact with each other. For example, when mental health disorders are left untreated, substance abuse is likely to increase. One may try to self-medicate with substances to reduce mental health symptoms. One may also increase substance use as a result of stress and inability to cope with issues or situations.
On the other hand, when substance abuse increases, mental health symptoms often increase as well or new symptoms may be triggered. This could also be due to discontinuation of taking prescribed medications or the contraindications for substance use and mental health medications. When taken with other substances, mental health medications can become less effective.
It can be difficult to recognize co-occurring disorders or determine which comes first. Substance abuse often causes side effects which mimic symptoms of depression, anxiety, and mood disorders. If one is genetically predisposed for mental health issues, or more susceptible to mental health issues due to trauma history or stress, substance abuse can increase the risk of or exacerbate symptoms that may be mild initially. Individuals with co-occurring disorders are more vulnerable to relapse and worsening of mental health issues.
The best treatment for co-occurring disorders is commonly referred to as an integrated approach. This method of treatment simultaneously combines the treatment of both mental health and substance abuse disorders. This type of treatment may be offered at one treatment facility; however, separate facilities can work together to address both problems. Treatment often includes education regarding both substance abuse and mental health diagnoses and how they are related. It also teaches healthy coping skills.
According to the Substance Abuse and Mental Health Services Administration (SAMHSA), treatment for co-occurring disorders does the following:
Recovery for individuals with co-occurring disorders often is difficult, but not impossible. These individuals may require longer treatment than those who have a single disorder because they often experience more crises and progress is generally slower. The road may be rough, but it can be traveled. It takes time and commitment from the individual, treatment team, family members, and support networks to make it work. Finding the right type of treatment is the key and with hard work and dedication there is hope.