Nearly 21.5 million Americans have co-occurring mental health and substance use disorders. This is also sometimes referred to as “dual diagnosis,” “co-existing” or “co-morbid” conditions. Knowing the shared causes of these conditions can make it easier to understand why so many people experience them together. At Palms Behavioral Health in Harlingen, Texas, we treat patients who experience mental illness, substance use disorders, and both together.
Which Develops First?
For some people, symptoms of mental illness occur first, followed by substance use. This may be the result of a person trying to self-medicate their symptoms. For others, substance use develops before mental illness or may trigger additional mental health issues beyond what already exists. Sometimes, it is difficult to determine which occurred first.
What matters more than which condition developed first, is that people with co-existing conditions receive effective treatment for both disorders. Without proper care that is tailored to treat both of their conditions, patients with dual disorders are at higher risk for:
- Relapses (mental health and addiction)
- Hospitalizations
- Money problems
- Isolation
- Homelessness
- Incarceration
- Victimization
Shared Causes of Addiction and Mental Illness
While it would be easy to blame people for causing their own mental health and/or substance use disorders and this happened quite often in the past, this is counterproductive. People with these conditions often struggle with an abundance of guilt and shame, which can make it harder for them to recover. It is more helpful to show them compassion, empathy, and support. By recognizing underlying factors that can lead to mental illness and addiction, we can better prevent and treat both disorders.
Shared causes for these conditions include:
- Stress
- Trauma
- Genetics
- Brain differences
Mental Illnesses Frequently Found Alongside Addiction
The mental health disorders that are most often seen in people who struggle with substance use disorders include:
- Anxiety and other mood disorders
- Schizophrenia
- Bipolar disorder
- Major depression
- Conduct disorders
- Post-traumatic stress disorder (PTSD)
- Attention deficit hyperactivity disorder (ADHD)
Substances Most Often Misused by People with Mental Illness
The drugs people with mental health disorders are most likely to use include:
- Legal drugs such as alcohol, tobacco, and prescriptions
- Opioids
- Stimulants
- Marijuana
- Hallucinogens
Treating Co-Existing Conditions
In the past, many treatment programs treated only mental illness or substance use disorders. This approach often meant that patients struggled to progress in their recovery, as the condition not being treated would interfere with their ability to manage the condition they were attempting to address. It is now understood that the conditions should be treated together, for optimal recovery.
Because the warning signs for substance use disorders and mental illness often overlap in unexpected ways, diagnosing a person who has co-occurring disorders can be complicated, and it is easy for a clinician to misdiagnose a person or fail to recognize one of their conditions. For this reason, it is important that assessments thoroughly screen for both mental health and substance use disorders and that treatment programs offer services that can meet the needs of people who experience both. This may include:
- Detox: This initial stage, when the drugs are leaving a person’s body and they are likely experiencing withdrawal symptoms, can often be made safer and easier with medical supervision and care.
- Inpatient rehabilitation: This level of treatment is often recommended for people with co-occurring disorders, as it provides them with around-the-clock supervision and support.
- Therapy: Several different therapy options could be helpful, depending on the specific needs of the patient in question. It may also be beneficial for some patients to participate in more than one type of therapy or in group and individual therapy to address their needs from different angles.
- Medication: Medications may help manage both, mental health and addiction, but it is also important that people with dual diagnoses receive treatment from a team that understands their conditions, as there are some medications that could be commonly used for one of their disorders, that are contraindicated for the other. Receiving the wrong medication could make it more difficult for them to recover.
- Supportive housing: Living in a community with other people who are in recovery may help to reinforce the changes a person with co-existing conditions made during their treatment.
- Self-help and support groups: AA, NA, and other recovery groups can provide added support and there are even groups that are specifically for people with dual diagnoses, for example, Double Trouble in Recovery.
At Palms Behavioral Health, our individualized treatment plans are trauma-informed, evidence-based, and developed to address the needs of the whole person, not just one disorder. Our services include inpatient and outpatient treatment, with group and individual therapy, art therapy, occupational therapy, medication management, and more.
