Co-occurring disorders are defined as when at least one psychological disorder is present in an individual with a substance abuse issue, or vice versa. Co-occurring disorders were also referred to as dual diagnosis in the past, but that term is considered outdated due to the fact that it is possible for a person to have more than one mental illness in combination with the addiction.
Over 125,000 people were treated in state run hospitals and clinics in 2015, according to the Substance Abuse and Mental Health Services Administration (SAMHSA). Of these people 6% were adults who presented with co-occurring mental health and substance abuse disorders. 1% of those treated in state facilities were teens with co-occurring mental health and substance abuse disorders.
Illinois is a state in the Midwest of the United States and is located in the Great Lakes Region. According to a report by a division of SAMHSA, over 1 million people in the metropolitan areas alone above the age of 12 used illicit drugs in the past year. Drugs and alcohol have a greater effect on teens than on adults. Many teens simply don't realize the long-term damage drugs have on their bodies. The same report also noted that 790,000 metropolitan residents were diagnosed with substance abuse issue in the past year. Concurrently, 414,000 adults experienced a major depressive episode within the past year. It is no secret that the prevalence of addiction and mental illness exists on a large scale.
The most common drugs that are abused in Illinois are cocaine, heroin, marijuana, prescription drugs and methamphetamines. Concurrently, the most common mental illnesses to co-occur with the abuse of these drugs are PTSD, anxiety disorders, depression, personality disorders and schizophrenia. In 2018, the governor of Illinois signed a bill which would broaden access to mental health and substance abuse treatment for the citizens of Illinois. This bill was in response to the growing opioid epidemic within the state. With the increased awareness and budget allowed for these treatment programs, the state is in a much better position to handle the increase in cases of co-occurring disorders.
No causation has been established for these types of disorders. However, researchers have been able to correlate mental health issues and substance abuse in multiple ways. The first is that undiagnosed mental illness leads to substance abuse. Often times, symptoms of an undiagnosed mental disorder drive people to self-medicate in order to alleviate some of the unpleasant symptoms of their illness. For instance, a person might be experiencing an intense anxiety due to a clinical disorder and this causes them to seek out a drug like marijuana to attempt to quell it. While sometimes people may be unaware they are self-medicating, it is nonetheless harmful and leads very quickly to dependency and then finally addiction. Next, an individual's genetic makeup plays a role in developing these types of disorders. There are genes that, when present, predispose a person to develop an addiction. Simultaneously, there are instances where people have the genetic predisposition to develop certain mental illnesses. One person could possess both of these markers. Environmental factors such as drug use and other stressors dictate whether or not the illnesses develop. For example, a person may be predisposed to develop schizophrenia and when they begin to abuse drugs they begin seeing symptoms of schizophrenia such as delusions and hallucinations. The appearance of the symptoms then causes the person to use even more of the substance to compensate. Another explanation as to why these conditions may co-occur is a person's early exposure to drugs and alcohol. The earlier a person is exposed to a drug or drink, the more likely it is that that person will develop an addiction and a mental illness. The damage that is done to brain tissue creates irreparable harm and opens the door to addiction and psychological disorders. It is clear that these two types of disorders share many risk factors, and so therefore they tend to co-occur within the same individual regardless of which appears first.
The physical and psychological symptoms of co-occurring mental health and substance abuse disorders differ from person to person. No two people are alike so it would hold that no two people would exhibit the exact same symptoms. There are some common themes, however, that hold true when attempting to identify the presence of these disorders. Although the presence of some of these signs and symptoms does not necessarily mean that a person is mentally ill or addicted, they are still red flags and should be examined more closely.
The symptoms of a mental illness often look like the symptoms of an addiction. It will be tough to tell which signs are caused by which problem. Regardless, these signs and symptoms are indicative of a psychological or addictive disorder and should be flagged immediately. Medical professionals will be able to accurately diagnose the individual once they are evaluated. The important thing is to get this person help, fast.
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Although a dual diagnosis certainly poses a challenge, recovery is absolutely possible. This is especially true in light of recent developments in treatment methods. Through research it was determined that an integrated approach is the optimal method for recovery for these people. The best outcomes are achieved when medical professional work together as a team and tackle both disorders at the same time. Instead of treating the addiction before the mental illness, both disorders are treated simultaneously. Although an individualized treatment plan will be created for each case, many treatment plans follow a similar path. There are some cases that will require the patient to be assisted in coming off their drug or drink of choice. They will be referred to a detoxification center. From there, patients will check into a residential rehabilitation center and eventually graduating to transitional housing. After the appropriate time is spent in transitional housing, the patient must continue on the path of recovery through self-help and community support.
Certain addictions require the patient to be under medical supervisions when coming off their drug of choice. These cases are delicate and require specially trained staff to oversee their detox. Patients are continually monitored as they slowly remove the toxic substances from their body. They may even require tapering doses to ensure the safety of their vulnerable bodily systems.
The most effective treatment available for addiction and mental illness is residential or inpatient rehabilitation. These programs require that the patients live at the facility and be monitored at all times. For instance, their behavior is documented and they are monitored to ensure their own safety as well as the safety of those around them. Within these programs, individuals will follow the plan that was created for them upon intake. These plans usually include individual psychotherapy, group therapy, physical exercise, art therapy and medication. One of the most effective therapies to treat addiction is cognitive behavioral therapy or CBT. This type of theory addresses learned patterns of behavior and allows an individual the chance to interrupt these toxic patterns and create new pathways to success.
Once a person completes their rehabilitation program, it is wise for them to move into a supportive housing unit. These housing communities are often times connected with the rehabilitation facility so moving in is arranged easily. Patients are guided and supported every step of the way. Transitional housing is a very effective tool for integrating a recovering addict and patient back into society. It is a step down in structure when compared to inpatient programs allowing for more liberty of choice, giving people the opportunity to more safely apply the coping skills they learned.
Often times, patients are able to create a network of peer support through meeting people in their supportive housing units. This community is invaluable in helping a person to maintain their sobriety and mental wellness. Along with peer support, there are more formal support groups available to recovering addicts. Many choose to join 12-step groups, but there are other, differently formatted groups that are just as effective. In addition to peer support and self-help groups, patients are strongly encouraged to keep attending psychotherapy sessions and take the medications that were recommended to them in rehab. If the therapy and medication is stopped, so will the recovery. Recovery is a path one must walk for the rest of their lives.
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