Observation alone can reveal a connection between substance use disorders and mental health conditions. Evidence supports this connection: many people who have SUDs also have mental health disorders, and vice versa. “Co-occurring disorders” or “dual diagnosis” are the terms commonly used to describe this phenomenon. At Carolina Dunes Behavioral Health in North Carolina, we offer our teen, adult, and senior patients who have co-occurring disorders treatment that addresses both issues simultaneously.
More Than Just Overlapping Causes
Some of the risk factors for developing both mental illness and addiction include genetics, stress, and trauma. In addition, research seems to indicate that one disorder can trigger the other. Some people with substance use disorders first started using alcohol or other drugs in an attempt to self-medicate their mental health symptoms, and some people with mental illnesses didn’t manifest symptoms until after they began using substances.
Treating Both Types of Conditions Together
More than 21.5 million adults in America meet the criteria for dual diagnosis, but only 10 percent of those adults received treatment for both disorders in the past year. There are several reasons why this could be:
- It can be difficult to find treatment programs that treat both mental health and substance use disorders.
- Many treatment programs are limited in what forms of payment they will accept.
- Overlapping warning signs may complicate assessment and lead to missed or inaccurate diagnoses. For example, people who are struggling with addiction may experience sudden changes in behavior, make impulsive decisions, and struggle to meet personal, professional and academic obligations. These can also be hallmarks of several different mental health conditions, and it can be difficult to untangle all of the possible reasons for symptoms. For this reason, it is important that people be thoroughly screened for mental illness and substance use disorders together when they show indicators of either.
In the past, it was far more common to treat mental illness and substance use disorder separately, but evidence shows that treating both simultaneously yields better results. Certain therapies are especially effective in treating co-occurring conditions in adults:
- Cognitive behavioral therapy (CBT)
- Dialectical behavior therapy (DBT)
- Therapeutic communities (TC)
- Contingency management (CM)
In children and adolescents, these therapies are often used to treat co-occurring mental health and substance use disorders:
- Brief strategic family therapy (BFST)
- Multidimensional family therapy (MDFT)
- Multisystemic therapy (MST)
Conditions That Co-Occur Frequently
Some of the mental illnesses that are most often experienced by people with substance use disorders are:
- Anxiety disorders
- Depression
- Attention deficit hyperactivity disorder (ADHD)
- Bipolar disorder
- Schizophrenia
- Post-traumatic stress disorder (PTSD)
Challenges Associated with Co-Occurring Disorders
It can be more challenging for people who are struggling with both substance use disorder and mental illness to recover from their conditions not only because of incorrect or missed diagnoses but because of opposing needs of known conditions. For example, some of the medications that are used to treat substance use disorders should not be used at the same time as some anxiety medications.
In addition, people with dual diagnoses are 12 times more likely to become involved in the criminal justice system than people without either type of diagnosis and 6 times more likely to get arrested than people who only struggle with mental health conditions. Time spent in jail can delay treatment, and having a criminal record can make it harder to find jobs and housing.
The high rates of arrest among people with dual diagnosis were especially prevalent among women, who were 20 times more likely than women without SUD or mental illness to be arrested; and also among Black adults, who were more likely to be arrested than non-Black adults who also had dual diagnoses.
At Carolina Dunes Behavioral Health, we take a whole-person approach to mental health and substance abuse treatment and also seek to include our patients’ support systems whenever we are able to do so. Our trauma-informed approach and evidence-based practices make our hospital an effective and compassionate place to receive care during a mental health or substance use crisis.
