When one person has a mental illness as well as a substance abuse disorder, the disorders are said to be co-occurring. Co-occurring mental health and substance abuse disorders are prevalent in modern American society. The high prevalence of co-occurrence has been documented with national surveys since the 1980s. These data show that people who are diagnosed with an anxiety or a mood disorder are twice as likely to face an addiction disorder when compared to those who do not have the mental health diagnosis. It is also known that individuals presenting with substance abuse disorders are twice as likely to develop mood or anxiety disorders than people who are not addicted to a substance.
Michigan is a state in the Great Lakes region of the United States and is home to about 10 million people, making it the 10th most populous state in the U.S. In 2017, the Substance Abuse and Mental Health Services Administration (SAMHSA) reported that 10% of Michigan's adolescents and teens aged 12-17 used alcohol for the first time in their lives. This is slightly higher than the nation average of 9.4%. 6.2% of Michigan's teens tried marijuana for the first time in 2017, working out to be about 49,000 young people. In terms of mental health pertaining to Michigan's teens and adolescents, about 96,000 (12.7%) reported experiencing a major depressive episode within the last year. This number increased from 2008, where SAMHSA reported that just 8.4% of teens experienced a major depressive episode in the last year. Of the youth who reported having a major depressive episode in 2017, about 41% received mental health treatment from the state of Michigan.
Michigan's adult population was reported by SAMHSA in 2017 to binge alcohol at the rate of 40.2%. This means that 444,000 adults in Michigan, aged 18 or over, reported binge drinking in the last month. About 14.4% of adults in Michigan reported having a substance abuse disorder. Looking at mental illness among Michigan's adults, about 6% of people 18 and over reported being diagnosed with a serious mental illness in the past year. This is higher than the prevalence of serious mental illnesses in 2008, which was 4.7% of Michigan's adult population. Of those with a serious mental illness in 2017, only 47.7% of these individuals received treatment for their illnesses.
The fact that mental illness and substance abuse have a tendency to occur at the same time within an individual does not mean that one caused the other. It is difficult to diagnose mental illness because many symptoms do not reach the standards within the medical community to warrant a solid diagnosis, yet these symptoms can trigger drug abuse behaviors. On the other hand, drug abuse can cause one or more symptoms of a mental illness. For example, there is an increased risk of psychosis among marijuana users who previously had no mental health issues. Mental illness can lead to drug abuse because the symptoms of a mental illness cause the individual to abuse drugs in order to self-medicate. For instance, in studies involving schizophrenia and tobacco, patients believed that smoking tobacco alleviated some of their cognitive symptoms, reporting that they felt more mentally clear after smoking. Both psychological disorders and substance abuse are caused by damage or anomalies in the same areas of the brain. They also share many of the same genetic risk factors meaning that stressors or chemicals that affect certain genes may trigger both types of disorders within an individual.
It is important to be informed of the signs and symptoms that you or a loved one may be suffering from co-occurring mental illness and substance abuse. Although it is difficult to determine causality or even diagnose the disorders that are present, it is still possible to identify that co-occurring disorders may be at play. The following signs and symptoms may indicate co-occurring disorders.
Any of these symptoms are a warning sign that a person may be experiencing a mental illness as well as an addiction. It is best to err on the side of caution and seek out medical assistance as soon as possible if any of these symptoms are present within yourself or a loved one.
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There are treatment options available for those who are suffering from co-occurring disorders. Through research, it has been determined that the best treatment for mental illness and addiction disorders is based on an integrated approach. An integrated approach would mean that all disorders present within an individual are treated simultaneously, by a multidisciplinary staff of professionals working together. Using an integrated approach as a basis for treatment, individualized treatment plans will be created for each patient based on their specific needs. Most plans include detoxification, inpatient rehabilitation, transitional housing and continuing care.
In some addiction cases, withdrawal symptoms are so severe that patients need to be medically removed from the substance. Even moderate withdrawal symptoms are extremely unpleasant and potentially harmful for the body to tackle on its own. For these reasons, it is wise to seek out a qualified detox center to assist with removing the substance from the body. Common symptoms of withdrawal include nausea, sweating, high blood pressure, anxiety and irritability. More severe symptoms include suicidal ideation, hallucinations or delusional thought, tremors and seizures. Within a detox facility, patients will be administered drugs to alleviate pain and allow a more peaceful detox experience. Patients may even need tapering doses of their drug of choice to safely detox. The best method for detoxing an individual will be decided during the intake process.
Inpatient drug rehabilitation centers offer the highest level of care for those suffering from addiction and a mental illness. These facilities are able to provide 24/7 monitoring and support for their patients. Inpatient rehabilitation centers are residential facilities where patients live for a period of time and undergo an individualized treatment plan for their illnesses. The average length of stay in rehab centers is 30 days, but there are 60 and 90 day options for those who require a longer period of recovery.
Treatment plans usually include some form of psychotherapy, including talk therapy and cognitive behavioral therapy (CBT). There are also options for family therapy where relationships can be mended and trust rebuilt. Some facilities offer more alternative methods of therapy such as art, yoga, music, mindfulness, acupuncture, and equine therapies. Many inpatient rehabilitations also use exercise as a healing modality, moving the body in order to heal the mind. Medication is also an imported treatment for those with co-occurring disorders. There are many pharmaceutical therapies available for mental illness and addiction, these have been proven to be very effective for patients facing both disorders.
There are handful of options for patients who have completed their rehabilitation programs. One of these is moving directly into a supportive housing community. The goal of transitional housing is to provide patients with a greater level of freedom and responsibility while providing support to deal with the stressors of daily life. Transitional housing gives patients a chance to apply the skills they learned in rehab to daily life without risking a relapse in addiction or mental health. Patients are provided with many types of services while living in transitional communities. Services include occupational therapy, group and individual talk therapy, transportation to important appointments, and case management. The variety of services available will differ depending on the community that is chosen. Whichever community is chosen, the decision to move into transitional or supportive housing after completing rehabilitation is a sure step toward full recovery.
Individuals who have gone through a rehabilitation program and supportive housing will have already been connected in with peer support groups such as Alcoholics Anonymous or mental health support groups. Peer support groups meet regularly and support one another in their shared experience of addiction and mental illness. These programs are sometimes overseen by trained facilitators who will moderate the meetings as members share their experiences and struggles with one another. Individuals in these groups gain a sense that they are not going through things alone, and that they have a friends and a sport network to rely on in hard times. These spaces are judgement free so people are more likely to open up and express their true thought s and feelings which can be an extremely healing experience.
References
https://www.drugabuse.gov/sites/default/files/rrcomorbidity.pdf
https://store.samhsa.gov/system/files/michigan-bh-barometervolume5-sma19-baro-17-us.pdf
https://www.drugabuse.gov/publications/research-reports/common-comorbidities-substance-use-disorders/part-1-connection-between-substance-use-disorders-mental-illness
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