Welcome to the Co-occurring Disorder Workshop
In this workshop, ABTRS will discuss co-occurring disorders when seeking substance abuse treatment. The medical community uses the term “dual diagnosis” for patients who have been diagnosed with more than one chronic health condition such as cancer and diabetes. Until recently, this term was also used to refer to addicted people with a co-occurring mental health condition. Instead, we now use the term “co-occurring disorders” for people with these diagnoses.
A co-occurring disorder describes patients who suffer from an addiction and an additional psychological condition simultaneously. Co-occurring disorders require integrated treatment for long-term recovery from both conditions. Co-occurring disorders are more common than you may realize:
- 65 percent of addicts have a co-occurring disorder.
- 22 percent of mental health patients have an addiction.
- 50 percent of alcoholics suffer from major depressive disorder.
During treatment, feelings of sadness, anger and irritability may come and go, but this doesn’t constitute a diagnosis of co-occurring disorders. Symptoms that indicate a deep-rooted psychiatric disorder lead mental health professionals to consider whether an addicted person has a co-occurring disorder or not. When a patient is diagnosed with a co-occurring disorder, the therapist develops a comprehensive treatment plan that addresses both conditions and is designed to heal our patients’ bodies and minds for a lifetime to come.
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Comprehensive Care Means Addressing Co-occurring Disorders & Addiction
Trauma and Active Addiction: How They Go Hand in Hand
A traumatic experience can trigger several physiological and psychological responses that make up our innate survival instinct, more commonly referred to as the “fight or flight” reflex. Whether one is afraid of heights and is on the top floor of a skyscraper or comes across an angry rattlesnake on a desert hike, the brain is prepared to activate in one way or another to come out of the threatening circumstance unharmed.
It generally takes 20-60 minutes for the response to diminish and dissipate once the event is over. It can often leave behind a dysfunctional psyche that may need psychiatric or psychological attention; frequently both if the event was traumatic enough for the individual.
While victims of trauma can begin to start feeling better without help in a few months, it can take much longer to heal for some. For others, real healing is often out-of-reach until professional help is attained. Some very common reactions to trauma include fear and anxiety, avoiding reminders of the trauma, depression and grief, devolving of self-image, relationship difficulties and increased physical expressions of agitation such as jumpiness, trembling, insomnia, nightmares and more. These symptoms of a recent trauma may also signal the presence of post-traumatic stress disorder (PTSD).
Drugs and alcohol are best known for their numbing effects on adverse feelings and their enhancement of happy, confident feelings. These effects can numb the aftermath of sensations caused by a trauma or PTSD, but they also tend to build and strengthen the symptoms of an active addiction. Experts agree that one should immediately seek guidance from a psychiatrist or psychologist for effective, long-term treatment of PTSD.
When Self-medicating with Drugs and Alcohol Becomes an Addiction
Substance Use Disorders (SUDs) generally manifest by the self-medication theory of addiction. This theory entails an individual experiencing severe depression, trauma, PTSD, social anxiety, various severe and mild anxiety disorders and/or undiagnosed mental health disorders and utilizing drugs or alcohol to alter the affects of those symptoms.
For example, a person with severe depression or PTSD may drink everyday to overcome the feelings associated with those problems. Those with a bipolar disorder may choose to do cocaine when they experience depressive episodes and smoke marijuana to handle the hypomanic episodes.
What is common for both of these examples is they turn to mood-altering substances to handle the symptoms instead of seeking medical help and proper diagnosis. By self-medicating with addictive substances, the person develops a substance abuse addiction because they become dependent on those substances to solve their problem. Unfortunately, where there is continued use and abuse there will always be tolerance and unpredictable results.
Take a person who is self-medicating their trauma with alcohol. They may find this coping mechanism to be very effective one week but not as effective the following weeks as their tolerance increases. As tolerance continues to increase, the person may explore other drugs to cope with alcohol as it no longer solving their anxiety associated with trauma.
Self-medicating with addictive substances is a slippery slope to a Substance Use Disorder. Based on the National Center for Biotechnology Information (NCBI), 65 percent of addicts that seek treatment find that they have a co-occurring disorder that influenced the severity of their addiction.
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Self-medicating with Addictive Substances are a Temporary Relief, Not a Way of Life
Many mental health disorders are due to serotonin and dopamine deficiencies in the brain. Drugs and alcohol create a rush of these chemicals, relieving the burden of negative feelings such as depression, anxiety, guilt, shame and emotional pain and replaces them with feelings of euphoria and confidence, while simultaneously boosting a desire for social interaction and excitement.
Marc Lewis, Ph.D. explained in Psychology Today, “That traumatized amygdala keeps signaling the likelihood of harm, threat, rejection, or disapproval, even when there is nothing in the environment of immediate concern. In fact, this gyrating amygdala lassos the prefrontal cortex, foisting its interpretation on the orbitofrontal cortex (and ventral ACC) rather than the other way around (which we might loosely call emotion regulation). The whole brain is dominated by limbic imperialism—making it a less-than-optimal neighborhood in which to reside.”
Drugs and alcohol temporarily relieve the discomforts related to PTSD by relocating one’s attention from reoccurring pains and worries to peace, resolve and happiness. Stressors due to trauma and PTSD compel addicted people to sacrifice whatever is necessary to obtain the superficial comfort the effects of consuming substances can bring. While this method may serve the individual’s intentions at the moment, the risk of addiction rapidly increases and he or she is ensnared in dependency without realizing what was happening.
If those friends come around and attempt to pressure your loved one to abuse drugs and Alcohol again, then a line has to be drawn. Ultimately, that decision can only be left up to your loved one. Your loved one should speak up and create a boundary for themselves. Give him or her the opportunity to take responsibility.
Getting Treatment for Co-occurring Disorders in Rehab Encourages Long-lasting Recovery
When at least one mental health disorder accompanies an addiction, evidence has shown that integrated treatment for each disorder is the most effective strategy for long-term recovery. The National Institute on Drug Abuse (NIDA) acknowledges that many individuals suffering from an addiction also struggle with other mental health disorders, which exacerbates the severity of substance dependency, making efforts to overcome the active stage of addiction rather futile.
NIDA explains, “Because drug abuse and addiction-both of which are mental disorders-often co-occur with other mental illness, patients presenting with one condition should be assessed for the other(s). And when these problems co-occur, treatment should address both (or all), including the use of medications as appropriate.”
Several symptoms of multiple mental health disorders are consistent with those of substance abuse disorders. In addition, every individual responds to addiction and mental health disorders differently, therefore treatment strategies are tailored specifically for our patients and their families and remain flexible to accommodate fluid needs and progress made in treatment.
NIDA also notes that long-lasting recovery is achieved through “varying combinations of services and treatment components during the course of treatment and recovery. In addition to counseling or psychotherapy, a patient may require medication, medical services, family therapy, parenting instruction, vocational rehabilitation, and/or social and legal services.
For many patients, a continuing care approach provides the best results, with the treatment intensity varying according to a person’s changing needs.”
Our network of treatment recovery centers embrace the potential each of patients has for long-lasting life in recovery and this emboldens patients’ families to do the same.
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