According to Psychology Today, "Clients with co-occurring disorders (COD) have one or more disorders relating to the use of alcohol and/or other drugs of abuse as well as one or more mental disorders, and a diagnosis of co-occurring disorders occurs 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 the one disorder". It is quite common for these two types of disorders to be active at the same time within one person. In these instances, the disorders are said to be co-occurring. Previously known as dual diagnosis, co-occurring disorders are fairly prevalent in the United States. According to the National Alliance on Mental Health, about half of all people who have a substance abuse disorder also suffer from some type of mental disorder. Men are more likely to develop a co-occurring disorder than women. The other populations which have a higher risk of developing a co-occurring disorder are people of a low socioeconomic status and combat veterans.
Located in the southeastern region of the United States, Mississippi is home to about 2.9 million people. According to a report published by the Substance Abuse and Mental Health Services Administration (SAMHSA) in 2017, about 9.2% of youth and teens in Mississippi, ages 12-17, reported using alcohol in the past month. Another 4% of teens and young people in Mississippi reported using marijuana for the first time in their lives in 2017. In terms of mental health, Mississippi's teens reported experiencing a major depressive disorder within the past year at the rate of 10.7% annually. This works out to be about 10,000 teens each year who report experiencing this mental illness event within the past year. Of the teens who experienced depression, about 34.7% received mental health care from the state of Mississippi.
Mississippi's young adult population reported past-year illicit drug use at the rate of 5% annually, about 17,000 young adults had a substance abuse disorder within the past year in. 23% of young adults in Mississippi reported binge drinking behavior in the past month in the same report from SAMHSA in 2017. Concurrently, the rate of young adults receiving a serious mental illness diagnosis in the past year was 4.1% in 2017.
The most common way that these two types of disorders come to co-occur is through those with untreated mental illness. These individuals may experience unpleasant symptoms such as acute anxiety or hallucinations. In an attempt to find relief from these emotionally painful experiences, people may turn to drugs and alcohol to self-medicate. They may not even realize that they are facing mental illness, they are simply trying to feel better. Self-medication is extremely counter-productive and should be avoided whenever possible. If symptoms of a mental illness appear, medical attention should be sought out.
Researchers have documented that the abuse of psychoactive substances can lead to the development of psychiatric disorders. For example, smoking marijuana has been linked to the risk of developing psychotic disorders. Symptoms of mental illness can also emerge from abusing certain drugs and also from the withdrawal symptoms of a drug. Using drugs can even trigger latent mental illness by affecting a person's genes, causing the disorder to develop when otherwise the illness may never have appeared. Additionally, the mental health complications caused by abusing drugs or alcohol contributes to the development of actual mental illnesses. Although it is clear the mental illness and substance abuse are heavily connected, it is almost impossible to determine if one caused the other. The symptoms of one disorder confounds the symptoms of the other, creating a convoluted amalgamation of symptoms that are difficult to identify.
Due to the many combinations of mental illness and substance abuse disorders, symptoms can wildly vary from person to person. Even with the known difficulties in identifying specific co-occurring disorders within a person, there are some general apparent signs and symptoms to watch for. The following list is not exhaustive, however any of these symptoms or a combination thereof need to be taken seriously.
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The most important aspect of treating co-occurring mental illness and substance abuse disorders is that they be treated at the same time. This method of treatment is known as an integrated treatment approach. Integrated treatment involves coordinating mental health treatment with substance abuse treatment as opposed to handling them separately. The overall goal in treatment of co-occurring disorders is to end dependency on a substance and provide psychological healing so that the individual can productively function within society. Multidisciplinary treatment encompasses different types of psychotherapy, medications and drug abuse education. Individualized plans should be created for each patient so that their unique needs are taken into consideration. Although there are many combinations of disorders and many different life experiences to take into account, there are some tried and true methods of treatment that many of these plans include. These are detoxification, inpatient rehabilitation, transitional housing and continuing care.
For those who have moderate to severe withdrawal symptoms, it is a good idea to start the road to recovery in a medical detox facility. Specialized detoxification facilities offer patients around the clock monitoring, ensuring that patients are completely physically and psychologically safe. Some withdrawal symptoms such as nausea, headache, sweating, vomiting, tremors and seizures require pain managements and other types of medication. In extreme cases, tapering doses of the drug of choice are also required. Highly trained staff administer medication and provide support to patients who are detoxing. The average time it takes to detox from a substance is 3 days, but there are some who require a longer stay of 5 or 7 days.
Inpatient rehabilitation is one of the most effective treatment options for patients with co-occurring disorders. Once patients go through the intake process, they move into the facility and live there for a predetermined amount of time. The average stay in residential treatment is 30 days, however there are 60 and 90 day options available for patients who require an extended stay. The immersive environment provided by residential rehab centers is an advantage to those looking to recover from addiction and mental illness because it completely removes the individual from their environment and places them into a space that is wholly dedicated to their healing. More often than not, people are coming from extremely toxic environments that are not conducive to any type of progress or healing. Completely removing oneself from those types of situations is absolutely the correct decision.
Within residential rehab centers, patients undergo a variety of treatment modalities to address whatever illnesses or disorders they are faced with. One of the most effective psychotherapy treatments for dual diagnosis is cognitive behavioral therapy (CBT). CBT is a type of psychotherapy that enables people to observe the toxic thought patterns that are running their lives. Simply being able to observe these patterns opens a gateway to healing and allows the person to interrupt these patterns and replace them with new, healthy ways of thinking. Coupled with medication, CBT and talk therapy are extremely effective in treating co-occurring disorders.
After completing addiction and mental health treatment, may patients choose to move into a transitional housing unit. This is a wise choice because patients are able to enjoy a certain level of freedom and autonomy while remaining in a supportive environment. The structure provided by transitional housing communities is the perfect way to transition back into one's normal life. Transition housing communities also offer a variety of services for patients including individual and group therapy, occupational therapy, continuing drug and mental health education, transportation to appointments and case management services. During their stay in residential treatment and supportive housing, patients are linked in with a support network of likeminded people who help keep each other on the right path in life.
People in recovery from co-occurring disorders are strongly encouraged to continue their own care once they are finished with treatment. There are a variety of ways to continue one's own care which include attending regular therapy sessions, taking medications, making regular appointments with a primary care provider and getting involved in peer-to-peer support groups. Peer-to-peer support groups provide an unique level of support because everyone within the group has experienced what it is like to face addiction and mental illness. Sharing an experience with another person creates a special bond that cannot be found elsewhere.
References
https://www.nami.org/NAMI/media/NAMI-Media/Images/FactSheets/Dual-Diagnosis-FS.pdf
https://store.samhsa.gov/system/files/mississippi-bh-barometervolume5-sma19-baro-17-us.pdf
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