Co-Occurring Disorders

Co-occurring disorders affect many struggling addicts and alcoholics. But, what is exactly is a co-occurring disorder, and how to I overcome this?

What Are Co-Occurring Disorders?

Known commonly as dual diagnosis, co-occurring disorders are a state in which a person suffers from a mental illness along with a substance use disorder. For example, alcohol and depression, anxiety and prescription painkiller abuse, etc.

In 2016, National US survey on drug use and health estimated that around 3.4% of all adults with a mental illness also had a coexisting substance use disorder.

Antisocial personality disorder has been associated with the greatest risk (15.5%) of developing a substance use disorder according to mental health America (MHA).

Co-occurring disorders are extremely challenging to diagnose owing to the signs and symptoms produced by both morbidities that obscure each other. For instance, it is harder to make out if the psychiatric symptoms in a drug addict are due to his use of substance or are because of a primary psychiatric illness and vice versa. Even when diagnosed, CODs are even harder to treat because of overwhelming mental and health issues as compared to patients suffering from a single disorder and so, these patients require intensive integrated therapy for longer durations.

People with dual diagnosis are likely to suffer from a great deal of problems concerning themselves such as frequent symptomatic relapses, financial issues, hospitalizations, imprisonment, sexual victimization, etc.

Their social and personal life is also profoundly affected and therefore it becomes harder for them to live every day and deal with every day stressors. This is the reason of high suicide rate in such individuals.

Man with Co-Occurring disorders

What Causes Dual Diagnosis?

There are a multitude of reason a person with a psychiatric illness will develop an addiction or vice versa. One of the reasons is genetic makeup of an individual. Certain individuals are more likely to suffer from coexisting illnesses compared to others. This is due to increased propensity to develop one condition if they have the other. In addition to this, a person’s environment can also make significant contribution in making a person suffer from co-occurring disorders.

Whether one illness predates the other is a question asked by many. The answer to this is different for every unfortunate individual because some people suffer from one condition before they suffer from the other. It’s all about variation.

As specified by the NIDA (National Institute on Drug Abuse), approximately 50 percent of people with a mental illness or substance use disorder are likely to develop the other condition at some period in their life.

For example, according to DSM-5, people with psychiatric illnesses like schizophrenia, bipolar disorder, and antisocial personality disorder are more likely to abuse alcohol and become alcoholics at some point in their life.

How To Spot Someone With Co-Occurring Disorders

A person with a co-occurring disorder will exhibit signs and symptoms according to the mental illness they have along with addiction. Signs and symptoms of addiction include:

  • Can’t stop using the drug
  • Taking the drug becomes essential to deal with every day matters
  • Using the substance even though it’s affecting the health badly
  • Trying to find ways to obtain the drug no matter what the means
  • Increased tolerance

Signs and symptoms of COD’s are distinctive. An individual with dual diagnosis will show classic signs of a mental illness combined with addiction. For example, an anxious patient will look restless and irritable and fearful and you’ll find him addicted to one of many substances for instance, meth or heroin. Information from close relatives and friends can be really beneficial in this context. It is important to be exceptionally observational when it comes to identifying a COD patient.

Types Of Co-Occurring Disorders

Some of the common types of co-occurring disorders include:

  • Major depression with cocaine addiction: effects of both illnesses represent the opposite ends of the spectrum. Depression makes the person feel low while snorting cocaine makes them feel high. So, this is no hard math that a depressed person will be more likely to opt for drugs like cocaine to get out of their low and feel amazing. On the other hand, researches have shown that primary cocaine users can also ultimately become depressed owing to changes cocaine causes in the brain when used chronically.
  • Alcoholism and anxiety disorders: anxiety disorders have a drastic effect on the person’s life making day-to-day life very hard and affecting the persons overall well-being. Many people with anxiety disorders turn to the consumption of alcohol to break through their wall of fears. This makes them a chronic alcohol user to alleviate everyday stress and feel better. Contrarily, according to SAMHSA (the substance abuse and mental health services administration) persistent alcoholism can actually result in anxiety rather than relieving it.
  • Schizophrenia and addiction: schizophrenia is one of the most common psychiatric condition and is characterized by psychotic symptoms (disorganized thought, delusions and hallucinations) leading to functional impairment. Many schizophrenics engage in substance use to decrease their feelings of anxiety and depression. Substance use can also act as environmental trigger to cause schizophrenia.
  • Antisocial personality disorder and substance use: researches conducted at Marquette University concluded that approximately 90 percent of ASPD patients abuse drugs.
  • Bipolar disorder and substance use: people with BPD experience drastic mood swings ranging from hypomanic episodes, manic episodes, major depressive episodes and mixed episodes. These mood swing make the person resort to drugs to lessen their symptoms and make them feel good. Vice versa, some drugs actually have the potential to cause symptoms similar to BPD in users by changing their brain chemistry in such a way.

Treatment & Beyond

Treatment of CODs can be exceedingly burdensome. Prompt correct diagnosis is the first step on the road to success. This can be hard owing to a myriad of intricate symptoms of both morbidities in the same person who is unaware of it. Sometimes, a person with dual diagnosis is treated for one condition and not for the other which is associated with a high relapse and failure rate.

Therefore, it is of major importance that the person should be diagnosed correctly keeping in mind all the signs and symptoms by talking to the patient extensively and to his/her friends and family. This can save money, time, and effort and will prove fruitful for the patient.

Following the diagnosis, treatment of a dual diagnosis patient should be integrated. This means that both the disorders should be treated by the medical team simultaneously. This requires immense patience from the health care staff and the patient. This is in most cases associated with the best outcomes.

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