Co-occuring disorders and mental health

A co-occuring disorder refers to having a co-existing mental illness and substance use disorder.

Co-occuring disorders are simultaneously seen in the same individual and is also known as a Dual Diagnosis in mental health .

The term can also be used for Substance abuse and an intellectual disability.

Since substance use is often interwined with co-occurring disorders, we should first define what Substance abuse is.

Substance abuse refers to the harmful or hazardous use of psychoactive substances, including alcohol and illicit drugs which often leads to significant impairment or distress. It can manifest in various ways such as health complications, social issues, and legal problems. Individuals struggling with substance abuse may develop a tolerance to the substances they are using, requiring larger amounts to achieve the same effects, which can further exacerbate their situation.

Substance abuse doesn't just affect the person using—it hits families, communities, and society too. It can affect and impact relationships negatively, cost people their jobs, and lead to money problems. It is often linked to mental health issues, making things even trickier for treatment and recovery. To really tackle it, one usually needs a mix of therapy, support groups, and sometimes medications to deal with both the addiction and any mental health issues going on.

Mental health and substance use disorders

When co-occuring disorders and mental health issues are intertwined, the overlap is complicated and can have many layers. It is important to understand why these conditions seem to come up at the same time. The link between mental health struggles and substance use isn’t just by chance; it is shaped by many factors that play into both the start and the ongoing nature of these disorders. Here are some points that highlight the complex ties between mental health issues and substance use disorders:

• First off, some substances can make people with addictions show signs of mental health issues. For example, drinking alcohol or using stimulants or opioids can literally cause mood disorders. It can also ramp up anxiety, or affect how one thinks. These substances might make existing mental health problems worse or even trigger new ones like depression or anxiety disorders. The changes they cause in the brain can seriously adversely affect the brain function, creating a loop where the person keeps using the substance to deal with the heightened symptoms, which just leads to more dependency and a decline in mental health.

  
  

• Secondly, mental health problems can sometimes lead people to use alcohol or drugs. People with these issues might turn to these substances to try and feel better. They are often trying to ease tough symptoms like sadness, anxiety, or stress. For example, someone with anxiety might have a drink to relax, while someone feeling down might use stimulants to get a temporary mood lift. But using substances this way can backfire, leading to more frequent use and potentially a substance use disorder, which makes dealing with the original mental health problem even trickier.

  
  

• Lastly, mental health and substance use disorders share some underlying causes that contribute to their co-occurrence. These shared weaknesses might include changes in the brain, like shifts in neurotransmitter systems that influence mood and behavior. Genetics can also be a big factor. If someone has a family history of mental health issues or substance use disorders, they might be more likely to face both. Also, going through stress or trauma early on, like tough childhood experiences, can really affect someone's mental development and make them more prone to mental health issues and substance use disorders down the line. This mix of biological, psychological, and environmental factors highlights why it's so important to have a treatment approach that tackles both issues at the same time.

  
  

More than one in four adults living with serious mental health issues also has a substance use problem. Substance use occurs more frequently with certain mental health problems, like Anxiety, Depression, Personality Disorder, Schizophrenia (1)

Intellectual Disability is characterized by limitations in intellectual functioning and adaptive behavior, which covers a range of everyday social and practical skills. This condition is typically identified during the developmental period, which spans from birth to age 18. The severity of intellectual disabilities can vary widely, from mild to profound, influencing the level of support individuals may require throughout their lives.

People with intellectual disabilities might find it tough to communicate, take care of themselves, or socialize. These hurdles can make it harder for them to live on their own and fully join in with the rest of the community. Getting help early on is key to helping them build important skills and reach their full potential. Programs focused on education, job training, and community support are intrinsic for boosting their quality of life and making sure they feel included.

Intellectual disability and substance use disorder

It is important to understand that substance abuse and intellectual disabilities can sometimes overlap. People with intellectual disabilities might be more likely to struggle with substance abuse because they often face social isolation, might not fully understand the dangers of using substances, and might not have much access to education about healthy living. Treatment needs to be customized to address both their thinking and behavior.

Treatment for co-occuring disorders.

• Holistic Approaches: Holistic approaches are effective treatments for individuals with co-occurring disorders, focusing on physical, emotional, and spiritual well-being to support comprehensive recovery.

• Therapy: Therapy uses evidence-based methods like cognitive-behavioral therapy (CBT) and dialectical behavior therapy (DBT) to address mental health disorders and substance use. These therapies help individuals develop coping strategies, change harmful behaviors, and effectively manage symptoms.

• Nutrition and Exercise: A balanced diet and regular physical activity can enhance physical health, boost mood, reduce mental health symptoms, increase energy levels, and promote overall well-being.

• Integrated Treatment Programs: Integrated treatment programs are all-in-one plans that tackle both mental health and substance use issues at the same time, combining therapy and medical care for a smooth recovery journey.

• Case Management: Case management involves the coordination of care by professionals who connect individuals with resources. They also monitor progress, and ensure that all treatment components are effectively integrated. This service supports comprehensive recovery by addressing practical and logistical needs.

• Medication Management: This involves the supervised use of medications like antidepressants, antipsychotics, and treatments for substance use disorders (e.g., methadone, buprenorphine) to alleviate symptoms and support recovery, addressing both mental health and addiction issues pharmacologically.

• Support Groups: Support groups are basically peer-led hangouts like Alcoholics Anonymous (AA), Narcotics Anonymous (NA), and Dual Recovery Anonymous (DRA). They offer mutual support and shared experiences for people dealing with co-occurring disorders. These groups help with emotional support, a sense of accountability, and a place where one can truly feel like they belong,

• Behavioral Therapies: Behavioral therapies aim to modify negative behaviors and thoughts related to mental health and substance use by developing healthier coping mechanisms and improving emotional regulation.

• Cognitive-Behavioral Therapy (CBT): Cognitive-behavioral therapy (CBT) helps individuals identify and change harmful thoughts and behaviors related to co-occurring disorders, promoting positive coping strategies, and supporting long-term recovery.

• Dialectical Behavior Therapy (DBT): Dialectical behavior therapy (DBT) teaches skills like emotional regulation, distress tolerance, and interpersonal effectiveness, aiding in managing dual diagnosis challenges.

• Motivational Interviewing (MI): Motivational interviewing (MI) is a client-centered approach that boosts motivation for change by addressing ambivalence about treatment, empowering individuals to commit to recovery, and make informed health decisions..

• Mindfulness and Meditation: Mindfulness and meditation focus on the present moment to enhance awareness of thoughts and feelings. It helps with managing stress, improving emotional regulation, and reducing relapse risk.

• Art and Music Therapy: These creative therapies offer non-verbal ways to express emotions, process trauma, and develop coping skills, aiding those with dual diagnosis.

This topic on co-occuring disorders and mental health covers a wide range of issues, showing just how complicated it can be to tackle substance abuse, mental health problems, and intellectual disabilities. Grasping the details of these conditions is key to creating support systems and treatment plans that really make a difference for those dealing with them.

Do you or anyone you know suffer from co-occuring mental health issues, or intellectual disabilites? Tell us how it was managed.

1. What are Co-Occurring Disorders? | SAMHSA