Co-occurring disorders, also known as dual diagnosis, are said to be present when a person is diagnosed with a mental illness and substance abuse problem at the same time. Many Georgians find themselves in this complicated situation. Georgia is a southeastern U.S. state whose terrain spans coastal beaches, farmland and mountains and many consider it to be the birthplace of the Civil Rights Movement. However, Georgia's statistics pertaining to co-occurring disorders show a more troubled side to the state. Georgians are not alone in this. It has been estimated that more than half of the people in America with a serious mental illness also have a substance use disorder.
In the past year alone, about 1.3 million adults living in Georgia reported a mental illness within the past year. This number makes up about 17% of the population on Georgia. This number only encompasses the cases that are diagnosed. Untold numbers of people with mental illness go undiagnosed each year. More generally, about 32% of Georgian adults reported feeling poor mental health in 2016. These people are not necessarily diagnosed with a specific illness and are self-reporting about the state of their mental health. Even so, this is a large percentage of the state's population who feel their mental health is suffering for one reason or another. On a much darker side, drug overdose deaths in Georgia have increased annually since 2012. The number of drug overdose deaths increased by about 35% in a span of four years, from 2012 - 2016, with about 70% of these deaths being related to opioid abuse.
Although causation has not been established, the co-occurrence of mental illness with substance abuse is attributed to several factors. Drugs and alcohol are often used by mentally ill individuals as a means of symptom relief. They may be unaware of the fact that they are indeed self-medicating, they may assume the substance abuse is a standalone issue. The fact is, an undiagnosed mental illness is harmful to an individual because they will attempt to self-medicate using harmful substances and/or exhibit harmful behaviors the origin of which remains unknown. Seeking help for mental illness is the first step to recovery. A problem which is unknown cannot be resolved.
Another factor contributing to co-occurrence of substance abuse and mental illness is that substance abuse increases the risk for mental illness. Despite the fact that research has not been able to show the true cause of many mental disorders, it has been able to show that mental illness stems from a combination of genetic predisposition, environmental and other outside forces. If a person is genetically susceptible for developing a mental illness, then often times environmental or other outside factors are the catalyst that causes the disorder to develop. Substance abuse is an example of an outside factor that acts as a catalyst for dormant mental illness. This is especially applicable to those who have the genetic predisposition for schizophrenia and depressive disorders. Often times patients did not experience symptoms until they began using drugs and/or alcohol.
Lastly, research has shown that drug and alcohol abuse can make symptoms of a mental illness worse. If a person is experiencing mind symptoms that they may not even notice while sober, the effect of a drug or alcohol can magnify and underline these symptoms. There are certain drugs that even interact with medications that are meant to treat mental illness. These effects include neutralization of the therapeutic effect of the drugs, meaning that the drug's efficacy is greatly diminished effectively rendering the mental illness untreated and exacerbated.
What is clear from research and reports from clinicians is that the relationship between a mental illness and a substance abuse disorder is convoluted. Even trained professionals have difficulty picking out which symptoms are tied to which disorder. Sometimes it is even impossible to know, the symptoms are so interconnected. That is what makes diagnosing these cases so difficult.
The relationship described in the previous section shows the difficulty that can exist when attempting to diagnose or even identify the different disorders that are present within an individual. It is not absolutely necessary for the lay person to identify the different mental illness or substance abuse disorders that are co-occurring within themselves or a loved one to effectively help the person. There are signs and symptoms one can easily identify that may indicate that an individual is experiencing co-occurring disorders.
Any of these signs and symptoms or a combination of these may indicate that an individual is suffering from co-occurring disorders. If you identify any of these symptoms, medical assistance should be sought out immediately. With these cases, it is better to be safe than risk leaving these issues undiagnosed. Undiagnosed mental illness and substance abuse disorders not only wreak havoc on the individual and their immediate family units, the ramifications thereof cost communities a great financial burden. The long term effects may mean that an individual never joins society and always will require the use of public resources to survive.
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It is widely agreed upon in the medial industry that an integrated approach is best when treating co-occurring conditions. An integrated approach means that all of the disorders present within an individual are treated at the same time. It used to be common knowledge that the substance abuse issue would be treated first followed by the mental illness. Clinical outcomes have shown that this method is deeply flawed and does not work. With an integrated approach as the underlying theme of the treatment, individualized plans are created with the patient's specific needs in mind. These plans often include detoxification, inpatient or outpatient rehabilitation, transitional housing and continuing care.
If an individual will suffer harmful effects if they stop taking a drug, then detoxification is required. Specialized detoxification centers exist only for this purpose, to safely bring a human being off of a harmful substance in a supportive environment. Highly trained staff are authored to provide tapering doses of a substance if that is what is required to ensure safety for the body's systems. Patients are monitored around the clock to further protect their safety.
The individual will then begin the rehabilitation process. Inpatient rehab centers provide the most comprehensive and structured treatment, as the individual will live at the facility for a time. Outpatient programs have also been found to be effective for certain individuals who thrive in a less structured environment. It depends entirely on the individualized treatment plan that is put into effect. Within these programs, healing is found through psychotherapy, art therapy, abstinence, and medication. A combination of these proven techniques works well to heal psychological and physical damage done by co-occurring disorders.
Transitional housing in an invaluable tool in one's recovery. Often times, an individual is not quite ready to join their normal life and require a more structured and supportive way of living in order to maintain their new sobriety and continue to thrive. Transitional housing allows a person to live on their own, but with those who are going through the same types of hardships and are walking the same path of recovery. The healing properties of being surrounded by those who are going through the same issues is unmatched.
It is often said that recovery is a life-long journey. Inpatient or outpatient rehabilitation deals with the immediate and acute symptoms of mental illness and drug abuse. It allows a person to get back on their feet and back on the path to a productive and full life. However, the work does not end there. Steps must be taken in order to ensure that the feet do not falter from this path. One must continue to go to therapy and enlist in self-help support groups. There is a plethora of groups available for all walks of life and all preferences. From women's groups to drug specific groups, there is something for everyone and anyone can find their niche. Once a group is found, a support network is put in place that is integral to maintaining sobriety and mental stability.
References
https://www.kff.org/other/state-indicator/adults-reporting-any-mental-illness-in-the-past-year/?currentTimeframe=0&sortModel=%7B%22colId%22:%22Location%22,%22sort%22:%22asc%22%7D
https://www.samhsa.gov/data/sites/default/files/2015_Georgia_BHBarometer.pdf
https://www.hhs.gov/ash/oah/facts-and-stats/national-and-state-data-sheets/adolescent-mental-health-fact-sheets/georgia/index.html
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