Information About Behavioral Health

Substance abuse often accompanies mental health problems in what is known as a dual diagnosis or co-occurring disorder. Bipolar disorder, depression, anxiety and PTSD are frequently part of these dual disorders. Such mental health issues can lead to drug or alcohol dependence through an attempt to normalize one’s life or solve associated problems through self-medication.

While trying to end a substance abuse problem can seem overwhelming, adding mental health concerns compounds the struggle. However, there are specialized treatments available to help people with a dual diagnosis.

Understanding the Link Between Substance Abuse and Mental Health

For an addict with mental health concerns, both aspects of the dual diagnosis present roadblocks in daily functioning. It becomes increasing difficult to function, navigate the difficulties of life and relate to other people. Even worse, substances being abused affect mental health and exacerbate those problems. In turn, mental health issues often lead individuals to use more of the drug of choice. Left untreated, the mental health concerns will continue to contribute to addiction and vice versa.

What comes first: Substance abuse or the mental health problem?

People with mental disorders frequently enter into addiction. While they are closely linked conditions, and each contributes to the other, neither is a direct cause of the other. In other words, not all addicts develop mental health problems like anxiety and depression, just as not all anxiety and depression patients develop a substance abuse problem.

Self-medication through alcohol and drugs is a common method for depressed individuals or those suffering from anxiety disorders. At the beginning of this substance use, the individual may feel that their depression or anxiety is alleviated through the high or numbing effects produced by the drug. Eventually this euphoric or relaxing effect transitions into exacerbation of their mental health problems.

For individuals with risk factors for mental disorders, using drugs or alcohol can provide a catalyst for the development of such problems or make present issues worse. This danger is true for people with genetic predisposition to mental problems, those with environmental influences toward mental disorders, or people with similar vulnerabilities. Substance abuse can also trigger new symptoms. At the very least, people on medications such as anti-anxiety drugs, antidepressants or mood stabilizers risk serious complications due to an interaction between those and alcohol or drugs.

Recognizing Co-Occurring Disorders or Dual Diagnosis

Denial is one of the biggest factors complicating the diagnosis of co-existing substance abuse and mental health disorders. Individuals often deny they have a drug problem, just as those with a mental health issue deny their struggle. Together, the two problems are often dismissed, or just one will be acknowledged. Fear, shame and even being unaware are common reasons why people cannot readily admit their problems.

For doctors and treatment providers, determining a dual diagnosis is often just as difficult. Depression, anxiety and bipolar disorders can hide behind the substance abuse, just as drug or alcohol use can be hidden beneath more obvious symptoms of mental illness. For an accurate dual-diagnosis, it may take some time to pinpoint professionally which disorders exist and what behaviors are attributable to substance abuse.

Signs and Symptoms of Substance Abuse

There are some common signs that an individual is abusing drugs or alcohol. Those may include:

• Desire to reduce amount of substances consumed
• Struggle to cut back on use
• Lying about frequency or amount of substance use
• Friends and family members exhibit concern regarding the individual’s use of drugs or alcohol
• Shame, guilt or other negative feelings surrounding drinking or use of drugs
• Regret over things said or done when drunk or high
• Blackouts from drug use or drinking
• Relationship problems stemming from drug use or alcohol consumption
• Trouble with work or the law due to drug use or drinking

Signs and Symptoms of Common Co-Occurring Disorders

Commonly co-occurring mental health issues include depression, anxiety and bipolar disorder. Symptoms of these matters may include:

• Helpless or Hopeless feelings
• Lack of interest in daily life
• Loss of appetite or weight fluctuation
• Problems sleeping
• Changes in energy
• Mood changes
• Reckless behaviors and impulsivity
• Unrealistic beliefs
• Excessive worry, edginess
• Frequent headaches, racing heart and edginess

Treatment for Substance Abuse and Mental Health Disorders

The best outcome for people suffering from co-occurring disorders stems from an integrated treatment program including simultaneous care for the addiction and mental health problems.

With a substantial commitment to recovery, individuals with co-occurring disorders can emerge from treatment with a new lease on life, free of addiction. Relapses often occur but are not a sign of defeat. Those can also be overcome with greater strength and continued hope for a collective future.

Group Support for Substance Abuse and Co-Occurring Disorders

Like others going through addiction recovery, people with dual diagnoses benefit from group support. Such groups help participants maintain sobriety, gain interpersonal support and openly discuss problems associated with their diagnosis and recovery.

Twelve-step programs are very popular for those recovering from substance abuse. These offer people with co-occurring disorders necessary tools for overcoming addiction, and they often intrinsically help bring stability and calm to recovery in a manner well-suited for former addicts with mental health disorders. Programs are free and are located in almost every community in the United States.

One obstacle which may need to be overcome as part of 12-step program participation is that of being on prescribed psychiatric medication. As a participant in the group, anyone requiring such medication should not be pressured regarding its use and should instead be made to feel supported.

Self-Help for Substance Abuse and Co-Occurring Disorders

Sobriety is only the first step in recovery for a person with mental health needs. Continued mental health treatment is crucial, as is learning new coping skills and improved decision making.

Other necessary expertise and behaviors a recovering dual-diagnosis addict must attain will include remaining connected with healthy and productive individuals for interpersonal support, better management of stress, improved relaxation through natural means, improved diet and wellness, regular exercise and consistent sleep.

Helping a Loved One with a Substance Abuse and Mental Health Problem

Having a friend or family member with a dual-diagnosis can be difficult. Seeing that loved one undergo typical struggles and setbacks is often emotionally trying.

Keys to enduring the bumpy road toward their ultimate, healthiest recovery include:

• Be encouraging but understand that their sobriety and maintenance of a healthy mental state is entirely on their shoulders, not yours.
• Seek support for your stress and struggles associated with their plight.
• Set solid boundaries to prevent yourself from becoming overwhelmed or having your life disrupted.
• Educate yourself about their condition and how you can be productively supportive.
• Be patient and understanding that he or she is on a long road with potential for relapses along the way.