The most common co-occurring disorders
People who have a combination of a substance use disorder and a mental health disorder are diagnosed with co-occurring disorders, also called dual disorders or dual diagnosis.
Substance use disorder
A substance use disorder is
Alcohol or drug abuse is diagnosed when substance use persistently interferes with functioning at work, at school, and in social relationships. It is also diagnosed when substance use creates or worsens a medical condition, or when substance use occurs in dangerous situations.
Alcohol or drug dependence is a more severe condition than alcohol or drug abuse. In addition to facing more negative consequences, people with dependence have also failed to abstain from or control their use of substances. In some cases, physiological dependence may also exist, which is indicated by tolerance (needing more of a substance to get the same effect) and withdrawal (experiencing symptoms such as tremors or nausea when substance use has stopped).
Mental health disorders
People are diagnosed with a mental health disorder when they have problems with feelings, thinking, functioning, or relationships that are not due to drug or alcohol use, and are not the result of a medical illness.
Some of the most common mental health disorders found in chemically dependent people are:
The primary symptoms of co-occurring disorders vary somewhat based upon the specific substance use and mental health disorder.
Some typical symptoms of co-occurring disorders do exist, however:
-
Using drugs or alcohol to reduce the difficulty or pain associated with the psychiatric problem, and finding out that even if substances worked at first or in the short term, they have not been the solution for the psychiatric problem.
-
The psychiatric problem has generally got worse because of drugs and alcohol.
-
The addiction to alcohol or drugs has generally got worse because of the psychiatric problem.
-
It seems harder to get treatment for both, or harder to benefit from treatment because of having both disorders.
-
It seems harder to talk about with others, or harder to find others who share the same common problem, co-occurring disorders, than if I just had one disorder.
Using alcohol and other drugs makes co-occurring mental health disorders worse
People with mental health disorders often use substances to feel better. People who are anxious may want something to make them feel calm; people who are depressed may want something to make them feel more animated; people who are fearful of others may want something to make them feel more relaxed and less inhibited; and people who are in psychological pain may want something to make them feel numb.
Using alcohol or other drugs often develop into a substance use disorder. It not only fails to repair the mental health disorder but also prevents a person from developing effective coping skills, having satisfying relationships, and feeling comfortable with themselves.
In short, drug and alcohol use makes mental health disorders worse.
Mental health disorders make substance use disorders worse
Having a mental health disorder can make people more sensitive to the effects of substance use, and the consequences from excessive episodes of use or chronic long-term use can happen more rapidly. With the best of intentions, people with a mental health disorder may try to stop using substances. However, sometimes when the substance use stops, the symptoms of the mental health disorder return or worsen.
These people may wonder why they should bother trying to get clean and sober. If they manage to get into treatment, they might find that they are judged and even criticized for their psychiatric symptoms. A few treatment professionals may even hint that if only patients were more honest and tried hard, their psychiatric symptoms would disappear with good recovery work.
In short, mental health problems make substance use disorders worse.
