Integrated Treatment for Co-Occurring Disorders

Mom Hugging Child and separating the Addict and my child

Contributed by Kim Dennis, MD, CEDS – CEO/Medical Director Emeritus, Timberline Knolls.

For countless individuals who may be struggling with addiction, another serious mental health issue may compound their existing symptoms.

Co-occurring disorders, also known as dual diagnosis, are the existence of both a mental health and simultaneous substance use disorders. Research has identified an undeniable connection between substance use disorders and mental health disorders, with as many as six out of ten individuals who struggle with addiction also having at least one other mental health disorder [1].

Examples of co-occurring disorders include a person who is both an alcoholic and dealing with depression, or an individual who is addicted to illicit drugs and also struggles with post-traumatic stress disorder.

Dealing with addiction in itself can be overwhelming, and the complexities of a mental health disorder add to the challenges experienced by those with co-occurring disorders.

Thankfully, there are many resources and evidenced-based treatments that can help support a person seeking recovery and wishing to overcome the challenges they may be facing.

Understanding the Link Between Substance Use Disorders and Mental Health Disorders

While it is not fully understood why mental health disorders and addiction commonly coincide, there are many overlapping factors that can help shed light on this issue.

Tramadol being poured out of the bottle - Co-occurringGiven the complexity of co-occurring disorders, the resulting factors that may contribute to the progression of these issues are multifaceted.

Some of the linking factors that may contribute to the development of co-occurring disorders include biological influences, such as genetics, family history, and a person’s neurobiology.

Psychological experiences, such as the experience of trauma and/or abuse, and environmental factors, such as early exposure to drugs, and media/cultural influences may also contribute to the development of addictions and mental health disorders.

Many individuals who develop co-occurring disorders have certain behavioral and/or personality traits that increase susceptibility to riskier behaviors associated with addiction, such as compulsivity and extreme/rigid forms of thinking.

For example, a person with a mood or personality disorder who tends to act impulsively may be more likely to misuse substances, including drugs and/or alcohol.

Additionally, a person with an untreated mental health disorder may develop maladaptive coping mechanisms in attempt to manage the symptoms of their underlying disease. This is often observed with individuals who struggle with major depression or an anxiety disorder.

If unable to effectively cope with the symptoms experienced with these mental health issues, a person may be more likely to use substances as a form of self-medication. Another important aspect to consider is the impact of drugs or alcohol on the body, brain and mental health.

A person who is misusing a substance, such as illicit drugs, may exacerbate the symptoms of a preexisting mental health condition.

The Importance of Integrated and Comprehensive Treatment

Because there are many potential interconnected factors between substance addiction and mental health disorders, seeking out integrated and comprehensive treatment that addresses both conditions is necessary for recovery.

In many situations, a person may seek out treatment for either an addiction or a mental health disorder, whichever may present more severely at the time, and leave the other issue on the back burner.

This is referred to as serial treatment (one after the other) and typically leads to a poorer prognosis for recovery and healing. Because mental health and substance use disorders share similar underlying causes, treatment that can effectively address these concerns will help a person heal holistically. Integrated treatment of both disorders leads to the best long term outcomes.

Treatment for co-occurring disorders that is provided through a specialized treatment center can help address mental and substance use disorders simultaneously.

Friends discussing alphaprodine abuse.An effective comprehensive treatment approach involves collaboration across disciplines, including care for improving psychiatric symptoms, safely withdrawing from substance use, learning how to recover from addiction, addressing medical and behavioral concerns, and working to improve overall quality of life.

Often this includes working with a specialized treatment team that involves a primary care physician, psychiatrist, therapist, addiction counselor, registered dietitian, social worker, and more.

Seeking Out Appropriate Help and Care for Co-Occurring Disorders

If you or a loved one is struggling with both a mental health and substance use disorder, it is important to know that there is hope for recovery and healing.

Be sure to reach out to a specialized professional to discuss your concerns and receive an assessment to determine an appropriate approach for treatment.

Seeking out integrative and comprehensive care for co-occurring disorders is an evidenced-based approach towards long-term recovery.

Community Discussion – Share Your Thoughts Here!

If you are in recovery from co-occurring disorders, what forms of treatment or resources were helpful to you?

[1]: National Institute on Drug Abuse, “Addiction and Co-Occurring Mental Disorders”, 28 April 2016

About the Author:

Dr. Kim DennisDrKim Dennis is a board-certified psychiatrist who specializes in eating disorder treatment, addiction recovery, trauma / PTSD and co-occurring disorders. As CEO/Medical Director Emeritus, she provides consultation to the clinical director and participates in the Timberline Knolls Clinical Development Institute and other outreach initiatives. Dr. Dennis maintains a holistic perspective in the practice of psychiatry.  She incorporates biological, psycho-social and spiritual approaches into individually-tailored treatment plans. Dr. Dennis is published in the areas of gender differences in the development of psychopathology, co-occurring eating disorders and self-injury, and the use of medication with family-based therapy for adolescents with anorexia nervosa. Dr. Dennis received her undergraduate degree from the University of Chicago. She obtained her medical degree from the University Of Chicago Pritzker School of Medicine and completed her psychiatry residency training at the University Of Chicago Hospitals, where she served as chief resident. During her training, she was part of the multi-disciplinary eating disorders team specializing in treating adolescents with anorexia and bulimia and their families. She is a member of the American Medical Association, Academy for Eating Disorders, the American Academy of Addiction Psychiatry and the American Society for Addiction Medicine.  She is on the medical advisory board for the National Association of Anorexia Nervosa and Associated Disorders.

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