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Dual Diagnosis

Comorbidity: Addiction and Other Mental Disorders

Dual diagnosis is a term for when someone experiences a mental illness and a substance abuse problem simultaneously.

 

dual diagnosis at Destin RecoveryA unique characteristic of Destin Recovery Center is its ability to work with dual diagnosis individuals, that is, those who not only suffer from alcohol or drug addiction but also a mental or psychological disorder.

Psychological disorders such as depression, anxiety, bipolar, PTSD and others may be present before or because of the addiction. This can cause serious havoc when it comes to addiction treatment. No ordinary rehab facility will do. Treatment for both issues must occur simultaneously or else treatment will not be effective. We will help you to manage your symptoms like no one else has ever been able to do!

The Destin Recovery Center staff is equipped to handle varying levels of addiction and disorders in their various combinations. We are aware that each individual’s experience is unique and, therefore, so is their treatment. Every recovery experience in our Program is as varied as the people who join us.

Roland Reeves, MD

What is Dual Dignosis / Comorbidity

The term “comorbidity” describes two or more disorders or illnesses occurring in the same person. They can occur at the same time or one after the other. Comorbidity also implies interactions between the illnesses that can worsen the course of both.

Dual diagnosis is a very broad category. It can range from someone developing mild depression because of binge drinking, to someone’s symptoms of bipolar disorder becoming more severe when that person abuses heroin during periods of mania. Either substance abuse or mental illness can develop first. A person experiencing a mental health condition may turn to drugs and alcohol as a form of self-medication to improve the troubling mental health symptoms they experience. Research shows though that drugs and alcohol only make the symptoms of mental health conditions worse. Abusing substances can also lead to mental health problems because of the effects drugs have on a person’s moods, thoughts, brain chemistry and behavior.

Is Drug Addiction a Mental Illness?

Yes. Addiction changes the brain in fundamental ways, disturbing a person’s normal hierarchy of needs and desires and substituting new priorities connected with procuring and using the drug. The resulting compulsive behaviors that weaken the ability to control impulses, despite the negative consequences, are similar to hallmarks of other mental illnesses.

How Common Are Comorbid Drug Addiction and Other Mental Illnesses?

Many people who are addicted to drugs are also diagnosed with other mental disorders and vice versa. For example, compared with the general population, people addicted to drugs are roughly twice as likely to suffer from mood and anxiety disorders, with the reverse also true.

About a third of all people experiencing mental illnesses and about half of people living with severe mental illnesses also experience substance abuse. These statistics are mirrored in the substance abuse community, where about a third of all alcohol abusers and more than half of all drug abusers report experiencing a mental illness.

Why Do These Disorders Often Co-occur?

Although drug use disorders commonly occur with other mental illnesses, this does not mean that one caused the other, even if one appeared first. In fact, establishing which came first or why can be difficult. However, research suggests the following possibilities for this common co-occurrence:

  • Drug abuse may bring about symptoms of another mental illness. Increased risk of psychosis in vulnerable marijuana users suggests this possibility.
  • Mental disorders can lead to drug abuse, possibly as a means of “self-medication.” Patients suffering from anxiety or depression may rely on alcohol, tobacco, and other drugs to temporarily alleviate their symptoms.

These disorders could also be caused by shared risk factors, such as—

  • Overlapping genetic vulnerabilities. Predisposing genetic factors may make a person susceptible to both addiction and other mental disorders or to having a greater risk of a second disorder once the first appears.
  • Overlapping environmental triggers. Stress, trauma (such as physical or sexual abuse), and early exposure to drugs are common environmental factors that can lead to addiction and other mental illnesses.
  • Involvement of similar brain regions. Brain systems that respond to reward and stress, for example, are affected by drugs of abuse and may show abnormalities in patients with certain mental disorders.
  • Drug use disorders and other mental illnesses are developmental disorders. That means they often begin in the teen years or even younger—periods when the brain experiences dramatic developmental changes. Early exposure to drugs of abuse may change the brain in ways that increase the risk for mental disorders. Also, early symptoms of a mental disorder may indicate an increased risk for later drug use.
How Are These Comorbid Conditions Diagnosed and Treated?

The high rate of comorbidity between drug use disorders and other mental illnesses calls for a comprehensive approach that identifies and evaluates both. Accordingly, anyone seeking help for either drug abuse/addiction or another mental disorder should be checked for both and treated accordingly.

Several behavioral therapies have shown promise for treating comorbid conditions. These approaches can be tailored to patients according to age, specific drug abused, and other factors. Some therapies have proven more effective for adolescents, while others have shown greater effectiveness for adults; some are designed for families and groups, others for individuals.

Effective medications exist for treating opioid, alcohol, and nicotine addiction and for alleviating the symptoms of many other mental disorders, yet most have not been well studied in comorbid populations. Some medications may benefit multiple problems. For example, evidence suggests that bupropion (trade names: Wellbutrin, Zyban), approved for treating depression and nicotine dependence, might also help reduce craving and use of the drug methamphetamine. More research is needed, however, to better understand how these medications work, particularly when combined in patients with comorbidities.

Other Information Sources

or more information on comorbidity between drug use disorders and other mental illnesses, visit:

 Source: National Institute on Drug Abuse; National Institutes of Health; U.S. Department of Health and Human Services.

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