Co-occurring disorders and how they impact mental health

A co-occurring disorder, also commonly known as a dual diagnosis, is a condition in which a patient is afflicted with two or more disorders at the same time. It’s a term that has become more important as mental health advances and evolves. Alongside behavioral health software and other technological improvements, doctors, psychologists and social workers continue to seek out more precise terminology for patient conditions.

According to Psychology Today, the term “co-occurring disorders” has come to replace “dual disorders” or “dual diagnosis” in psychological parlance in a large part to acknowledge that some patients are diagnosed with three or more disorders, not just two. Often, the disorders a patient deal with are any combination of mental problems and drug abuse. For a diagnosis of co-occurring disorders, it’s important that doctors can independently identify one disorder of various types, ruling out the possibility of a perceived co-occurring disorder actually being a symptom of another condition.

Examples of co-occurring disorders

As noted by Psychology Today, co-occurring disorders tend to manifest in two spectrums: drug abuse and mental health issues. Some common examples included major depression with cocaine addiction, panic disorders with alcohol addiction, and schizophrenia with both alcohol and numerous drug addiction. And, of course, multiple disorders or multiple substance abuses can be observed in one patient.

Not all mental health disorders are easily diagnosable, either. Unlike schizophrenia or depression, a condition such as gambling addiction is more difficult to classify. But a recent study reported on in Psych Central indicated that between 10 and 20 percent of people with substance abuse problems also have gambling problems, indicating the possibility of co-occurring disorders.

The data comes from Flora Matheson, Ph.D., and her colleagues, who conducted a review of existing studies on drug use and problem gambling. The study’s results were published in the journal ISRN Addiction.

Interestingly, Matheson noted that substance abuse and problem gambling may at times substitute for one another, both providing forms of excitement.

“Substitution of one behavior for another has long been identified as a key issue in the field of addiction and perhaps the very notion of substitution could be studied in its own right,” she said. “It could very well be that in some cases the primary addiction is not to any one behavior, but to a process where the object can be and does get replaced and alternated.”

Treatment
Treating co-occurring disorders is extremely complicated, but as DualDiagnosis.org noted, coordinated care models are making it more manageable for patients and their caretakers than separated treatment.

Not long ago, treatment for drugs and alcohol addiction was completely separate from treatment for mental illness. Vastly different approaches were used in entirely different facilities and by teams of doctors with no communication whatsoever, according to the news source. Awareness of co-occurring disorders has helped change that.

DualDiagnosis.org cites the U.S. Department of Health and Human Services estimate that severe psychiatric disorders, such as schizophrenia or bi-polar disorder, impact up to 5 percent of the national population. Combine that with the 7 million Americans who also deal with drug or alcohol addiction and the overlap is considerable.

Today, co-occurring disorder treatment is its own field. And it utilizes a coordinated care platform to keep patients safe, sheltered, properly treated and out of jail.

Integrated care is imperative in co-occurring disorder cases in part because of the complexity and breadth of the problems at hand. Psychiatry and therapy must be represented to regulate medications and help patients better understand their illnesses. Addiction treatment specialists will need to work closely with the psych teams to help patients deal with their alcohol and drug abuse. Often, the justice system may need to be involved, as will social workers. And of course, patients’ families and caretakers also play a significant role.

DualDiagnosis.org offered five simple reasons coordinated care works:

1. The recovery plan is specifically designed by doctors as part of a team to deal with the negative side effects of mental illness, such as social anxiety or low motivation.
2. When pharmacologists and addiction specialists work together, they can craft a medication therapy plan that effectively deals with mental illness and substance abuse.
3. With all grounds covered, from mental health specialists to addiction treatment specialists, doctors don’t need to hesitate about prescribing psychotherapeutic medications.
4. Group therapy offers patients a strong and structured support network for those dealing with both mental illness and addiction. It offers a glimpse into the lives of other people dealing with co-occurring disorders.
5. Patients – and caretakers – will have a much clearer picture of their unique relapse triggers, and the relationship and interplay between their addiction and mental illness.

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