People who are said to have co-occurring disorders have one or more disorders relating to the use of drugs or alcohol in addition to one or more psychological disorders. Previously referred to as dual diagnosis, co-occurring mental illness and substance abuse disorders are fairly common in American life. About 50% of people with a serious mental illness also have or will develop a substance abuse disorder in their lives. The many adverse effects that substance abuse has on mental health has been studied, and the research has shown that the drug abuse often results in non-compliance with treatment, poor prognosis, and higher rates of use of costly care services.
Maine has a population of about 1.4 million people and is the northernmost state in the United States. Untouched forests and pristine snow covered mountains define this relatively low populous state. Amid this natural glory, Maine's population faces mental health and substance abuse disorders simultaneously. The Department of Health's special report for Maine in 2015 showed that 1 in 5 adults in Maine reported having any type of mental illness and that adults with mental illness were three times more likely to engage in addictive behaviors. Adolescents in Maine were twice as likely to develop a drug or alcohol addiction if they had experienced a major depressive episode previously. The same report shows that almost 60% of all people who received substance abuse treatment in Maine also had a previously diagnosed mental health disorder. Maine's teen population were also more likely to have experienced a major depressive episode than the adult population in Maine.
Psychological disorders and substance abuse are connected in many ways. Drugs and alcohol affect the brain dramatically, even changing the way the brain operates. Therefore, it is not surprising that prolonged use of a drug or drink can cause symptoms that mimic a mental illness.
Individuals with a mental illness also often use drugs or alcohol to address unpleasant symptoms they are experiencing. The use of drugs in this manner pay provide temporary relief but it soon leads to addiction and even more damage to the brain. The drugs interact with the brains chemistry and the result is a worsening of the original mental illness. The drugs may also induce scary or harmful side effects within the person, mimicking an even more serious mental illness. Self-medicating in this way is dangerous and complicates a person's diagnosis significantly.
Drug and alcohol abuse increases the risk for developing a mental illness. Researchers have not been able to determine the true cause of mental illness; however, they have been able to identify factors that contribute to their development. Psychological disorders are caused by a combination of genetics, environmental stressors, and other outside forces. If a person is genetically predisposed for developing a mental illness, it is possible that a combination of drug use and stress or trauma will cause the illness to develop. If the person leads a completely different life and never picked up a drug or drink, or managed to avoid that traumatic experience, they may never develop a mental illness.
For mentally ill individuals, the use of drugs and alcohol will likely cause their mental illness to worsen. Substance abuse can even cause new symptoms of the mental illness to manifest. If the individual is treating their mental illness with medication, the use of drugs and alcohol can completely negate any healing from the medication and cause harm to body systems due to drug interaction.
A diagnosis of co-occurring mental health and substance abuse disorders happens when at least one disorder of each type can be established independent of the other and is not simply a cluster of symptoms resulting from one type of disorder. The average lay person will be ill equipped to identify the complex interplay of disorders present within a person. Accuracy is not necessarily required when identifying whether or not co-occurring disorders are present. Observing some general and common signs and symptoms is what is important in taking the first steps to recovery.
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Treatment and recovery for those with co-occurring disorders is possible thanks to recent advancements in the field. Modern treatment methods are rooted in observations made by clinicians in the 1970s. These observations made way for large scale system changes which were made to serve the many people suffering from co-occurring disorders. Now, people with both types of disorders are treated using an integrated approach. This means that all disorders present will be treated at the same time. Using an integrated approach, a multidisciplinary team of professionals will create an individualized treatment plan for each patient that comes through their doors. These individualized plans for treatment often include detoxification from the substance, residential treatment, half-way housing, and continuing self-care.
For those who require it, detoxification centers are the first stop on the road to recovery. Specialized detoxification centers are equipped to handle harmful and painful withdrawal symptoms for the severely addicted. Patients may require tapering doses of a substance as opposed to full abstinence in order to safely come off their drug of choice. Along with careful dosing, patients are administered pain management medication to alleviate the more acute symptoms of coming off a toxic substance. Patients are monitored around the clock for their own protection and safety. A caring and highly trained staff of professionals are able to provide medical care and emotional support for those going through the detox process. Although there is not an universal timeframe for detoxing, most people stay at these centers for two weeks.
Once safely detoxed, patients then are admitted into the actual treatment program where they can begin to tackle their addiction and mental illness issues. Inpatient rehabilitation provides a completely immersive environment that is most conducive to changing a person's life. Residents' behavior patterns are completely interrupted as they adjust to life in treatment, allowing for new patterns to be adopted. Along with the dramatic change of environment, rehabilitation centers use treatment modalities to address underlying causes of addiction and mental illness. These modalities include cognitive behavioral therapy (CBT), individual or group talk therapy, biofeedback technology, acupuncture or massage and medication therapies. Certain programs may use different methods; however, these are some commonly used methods.
CBT is a type of therapy in which patients become able to observe their own harmful thought patterns they use in their life. The ability to observe the patterns makes way for change, and patients will eventually be able to replace the harmful thought patterns with new and healthy patterns that allow for healing in their life. Talk therapy is available for those who have experienced trauma and have not addressed it. Airing out one's trauma under close guidance is an extremely healing experience. Group therapy has its uses also because witnessing another's pain can be a healing experience. Alternative therapies such as acupuncture and massage help patients to overcome the physical symptoms they are experiencing due to their addiction. Many people take advantage of these types of treatments. Finally, the pharmaceutical option currently available for treating mental illness are wonderful. Countless individuals have found healing and relief for their mental illness by using these types of medications.
When treatment is complete, patients are encouraged to move into transitional housing rather than go back to their normal lives. It could also be that the patient was homeless before entering treatment, so often times these housing communities are a life-line for newly sober individuals. Transitional housing communities provide a level of support that is not found in the outside world. The types of services offered within these communities include psychotherapy, medication management, occupational therapy, and case management.
Research has shown that outcomes improve when patients take their care into their own hands when treatment is over. Continuing care is critical and involves the patient attending therapy sessions, continuing to take their medication, and seeking out support groups of like-minded individuals. Usually patients are connected into these peer support groups during their stay in residential treatment or while they are living in a supportive housing community. Although the connection was made for them, it is up to the patient to participate in the peer support groups in order to enjoy the benefits of doing so. Peer support has been shown to be invaluable for those in recovery because it is in the helping of others that people find the most healing.
References
https://ps.psychiatryonline.org/doi/pdf/10.1176/ps.50.11.1427
https://www.maineseow.com/Documents/Mental%20Health%20in%20Maine_SEOW.pdf
https://store.samhsa.gov/system/files/sma13-3992.pdf
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