Mental health disorders can come in a variety of forms, as can substance use disorders. When they occur together in the same person, medical professionals use the term “co-occurring”, “co-morbid”, or “dual diagnosis”.
Many people have co-occurring disorders—in fact, some statistics say that as many as 1 in 5 American adults dealt with a mental health problem in 2014, while about 8 million adults had co-occurring disorders. Some common mental health disorders include depression, anxiety, bipolar disorder, and schizophrenia. However, feeling depressed and anxious—or having delusions or hallucinations, which is a common symptom of schizophrenia—are hallmark symptoms of addiction, too.
Dual diagnosis is a broad category. Many people use drugs and alcohol to self-soothe mental health problems like depression and anxiety, but drug use can also trigger temporary symptoms that mimic a more serious mental health condition. In some cases, drug abuse can cause a latent mental health disorder to emerge.
One of the first steps of co-occurring disorder treatment is correctly identifying an underlying mental health condition from what is actually an effect of drug abuse. “It’s often difficult to ascertain what’s the chicken and what’s the egg,” says Dr. Levi Kahane, Medical Director at Cornerstone Recovery Center. “Is the person depressed because they’re using cocaine and coming off it, or are they using substances to medicate the depression or suppress the voices they’re hearing?”
In treating a co-occurring disorder, a client goes through detox before being assessed for a mental health disorder. “It takes time for the substances to clear out of a person’s system,” Dr. Kahane says. “You don’t want to give them a medicine to stop hearing voices if the voices are only caused by excessive drug usage.”
Dr. Kahane emphasizes the role that trauma—and post-traumatic stress disorder (PTSD)—can play in influencing addictive behavior. “The clients themselves sometimes don’t realize the abuse they endured as a child has made them angry, irritable, frightened, and sad—and being able to be in a place for a couple of weeks with a psychiatrist evaluating them really helps to get the right diagnosis and treatment.” Educating clients about the connection between their substance use and mental health issues is an important aspect of true healing and recovery.
Many people with mental health disorders can be successfully treated with medications, but often, this population is noncompliant—“psychiatry speak” for, they don’t take their medications regularly or stop taking them entirely. There are many reasons patients are noncompliant: they forget, or they can’t afford them, or they simply decide that they’re not working well or fast enough. Dr. Kahane believes that instead of daily pills, injectable medications might work better for some clients. One such drug is Vivitrol, which is an injectable form of naltrexone that blocks the effects of opioid drugs. It can be used to treat heroin or prescription painkiller addiction instead of other medications that must be taken daily.
Cornerstone Recovery Center is one of few South Florida addiction treatment centers that offer a co-occurring services program. With a diverse staff of therapists, addiction professionals, and certified behavioral health technicians, our program aims to treat each client with an individually customized program. If you or a loved one needs help for both addiction and a mental health disorder, please contact our admissions counselor online or call 1-888-711-0354 today. All communications with our staff are confidential.