Co-Occurring Disorders and Drug Use

By Jill Gonzalez

Researchers have confirmed that nearly 50 percent of adults who have a substance abuse disorder also have a co-occurring mental illness. A serious mental illness is present at least 20 percent of the time, but unfortunately, these co-occurring conditions are not always easy to diagnose.

People who have substance abuse issues and a mental illness have much more difficulty coping with their problems and finding help because the presence of multiple disorders makes it difficult for many professionals to properly diagnose. The most common mental health disorders that appear in people who are abusing drugs are anxiety, depression and bipolar disorder.

Understanding Dual Diagnosis

Mental illnesses and drug abuse can have similar symptoms, but the reality is that they are very different issues that must be dealt with individually. You cannot simply treat a person for drug abuse and ignore their mental illness. Both problems must be treated as separate health issues in order for patients to achieve a complete recovery.

Drug addiction is common in people who have some type of mental illness, but a direct cause-and-effect relationship does not exist. In other words, it would be unrealistic to try to blame one condition on the other.

To better understand the relationship between drug use and mental illness, there are a few important points to consider:

  • Drugs are frequently used by people who suffer from depression or anxiety in an attempt to mask the symptoms of those mental illnesses.
  • Drug use can make the symptoms of mental illness worse, and drugs can interact with prescription medications that a person may be given for their mental health condition.
  • Drug use can make the symptoms of mental illness more pronounced in a person who is at risk for developing a mental illness, but doesn’t actually have one yet.

Diagnosing Co-Occurring Disorders

Even professionals who are experienced in treating substance abuse sometimes have difficulty diagnosing mental illness. Often, the primary culprit is denial. Patients do not want to admit, even to themselves, that they might have a mental illness, or they might not want to admit to having a drug problem. Either way, very few patients want to think about the possibility of having both.

The first step to recovery is admitting that you have a problem. Drug abuse and mental illness are both conditions that cannot be dealt with unless people are willing to admit that they have a problem.

Symptoms of Drug Abuse

There are signs that you may have a problem with drug use. If you have experienced one or more of the following symptoms, you may have a drug problem.

  • Lying to others about how often you use drugs or about your drug use in general
  • Trying unsuccessfully to cut back on your drug use
  • Blacking out from drug use
  • Experiencing problems in your relationships because of your drug use
  • Feelings of guilt or shame because of your drug use
  • Getting into trouble at work or with the law due to drug use

In addition to being aware of these signs of drug abuse, you should also be aware of the most common signs that a co-occurring disorder might exist.

The following symptoms are indicative of bipolar disorder:

  • Hyperactivity
  • Feelings of extreme anger or rage
  • Feelings of euphoria or irritation
  • Increase in energy levels
  • Decreased need for sleep
  • Racing or jumbled thoughts or speech patterns

These are the most common symptoms of anxiety disorder:

  • Difficulty concentrating
  • Restlessness
  • Nausea, dizziness or unexplained trembling
  • Rapid heartbeat and shortness of breath
  • Extreme worry or tension
  • These are the most common symptoms of depression:
  • Lack of energy
  • Changes in sleep patterns
  • Extreme feelings of guilt or worthlessness
  • Changes in appetite or weight
  • Loss of joy
  • Feeling helpless or hopeless

Treating Co-Occurring Disorders

To properly treat a dual diagnosis of drug abuse and mental illness, you need to find a program that specializes in treating both of your conditions. Keep in mind that there are some programs that are specifically designed to treat drug abuse and certain mental illnesses.

You should also choose a program that offers comprehensive treatment, including aftercare to help prevent a relapse and counseling services that will help you work through your problems and re-adjust to your life once your dual diagnosis treatment program is complete.

You might also consider incorporating group therapy into your treatment program, as this can be an excellent way for you to gain a new perspective on your situation. Group therapy allows you to hear other people’s stories and realize that you are not alone. Sometimes it helps to see that there are other people going through the same type of experience, and it also allows you to make connections to others during a time when you probably feel isolated from everyone else in your life.