The treatment of addiction is complex enough on its own, but unfortunately, many who struggle with drugs and alcohol must contend with the added difficulty of mental illness. When these two concerns combine, physicians refer to it as dual diagnosis: co-occurring mental health issues and substance use disorders. Rates of mental illness are higher within the demographic of drug addicts and alcoholics; similarly, those who have depression, PTSD, or anxiety are more likely to develop a substance use disorder than the general population. Today we’ll discuss treatment options for those who need to recover not only from addiction, but also from mental illness.  

Types of Co-Occurring Mental Illness

Certain categories of mental illnesses are more common in those with a history of substance use. These co-occurring diagnoses are mood disorders, anxiety disorders, and psychotic disorders. Mood Disorders – Characterized by a depressed mood, these disorders are commonly indicated by dulled emotions, slowed movement and thought processes, worsened personal hygiene, disinterest in previously enjoyed activities, weight loss or gain, low self-esteem, and sleep disruption (too much or not enough sleep). Possible mood disorders include:

• Major depression
• Bipolar disorder
• Dysthymia (a low-grade depression over a long period of time)

Anxiety Disorders – These disorders hijack the body’s “fight or flight” response in non-life-threatening situations, resulting in high levels of fear and anxiety in day-to-day life. Racing heartbeat, shortness of breath, feelings of detachment from one’s body, and a gripping sense of terror are common in anxiety disorders, which can include:

• GAD (generalized anxiety disorder)
• PTSD (post-traumatic stress disorder)
• Panic disorder
• Social anxiety
• OCD (obsessive-compulsive disorder)

Psychotic Disorders – Put simply, these disorders indicate a detachment from reality. Hallucinations, paranoia, delusions, mood shifts, depressive or manic symptoms, and issues with attention span may indicate that someone has schizophrenia or schizoaffective disorder.

• Schizophrenia
• Schizoaffective disorder

These issues may manifest in different ways for each person – just as everyone’s recovery is unique, so too is their personal experience of a mental health issue.  

Signs of Co-Occurring Mental Health Disorders

Co-occurring disorders are uniquely challenging to diagnose, because side effects of ongoing substance use may mask serious symptoms of mental illness. Once you or your loved one have begun working towards sobriety, certain signs of the above disorders may emerge. If you suspect that mental illness is at play, don’t hesitate – contact your doctor or treatment provider to begin addressing the problem as soon as possible. Certain patterns emerge among those who need treatment for both addiction and mental illness:

1. Worsening mental health symptoms, even during rehab. Those with mental health disorders may choose to dull their symptoms with drugs and alcohol. Doing this not only fails to treat the disorder itself, but it also robs the person of the ability to create coping mechanisms. It may even interfere with prescribed medications for their diagnosis. When use of these substances is ceased, most neurotypical people begin to feel better over their time in rehab. However, those who require additional mental health care will probably begin to report lower mood, heightened anxiety levels, or reemergence of long-forgotten issues.
2. Substance use problems that seem uniquely treatment-resistant. Those with co-occurring disorders may have attended inpatient or residential treatment multiple times without lasting results. While they have stopped using, they cannot manage the symptoms of their undiagnosed or untreated mental health disorders. This results in a vicious cycle of relapse that can only be stopped through proper clinical intervention.

Fully Integrated Treatment

The path to healing for those with co-occurring disorders is best handled by licensed clinical professionals who have experience with dual diagnosis patients. For lasting results, the mental illness and substance use disorder should be treated simultaneously. These two concerns feed into one another and working on just one will not suddenly cure the other. If the addiction is treated, but not its root cause, it’s possible that sobriety will not stick. On the other hand, treating just the mental illness doesn’t stop dangerous substance use that can catalyze other mental health symptoms. If possible, those seeking freedom from both addiction and mental illness should find a provider that handles the full continuum of care. Services such as housing, case management, family education, and life skills training can be instrumental in getting one’s life back. Makana Path offers intensive addiction treatment options that incorporate all aspects of the individual, including any mental health concerns. Call 1-866-922-0776 today to learn more.