There is a strong link between mental illness and substance abuse. Quite often, an underlying mental health condition can lead people to self-medicate with drugs or alcohol to relieve their symptoms. These substances can cause serious mental health conditions with long-term use.
Because of this connection, it's not uncommon to struggle with a mental illness and substance use disorder at the same time. There are three terms often used to describe this occurrence: comorbidity, dual diagnosis and co-occurring disorders.
These terms are often used interchangeably when referring to someone who has both an addiction to drugs or alcohol and other mental health conditions. However, there are slight differences between comorbidity, co-occurring disorders and dual diagnosis. It's important to know how they vary, especially if you are seeking treatment for addiction and mental illness.
First, it's vital to recognize that drug addiction is a mental illness. Drug and alcohol use disorders can change your brain's structure and function. Changes occur to some of the same areas of the brain impacted by other mental disorders like anxiety, depression and even schizophrenia.
The disease of addiction has numerous characteristics, such as compulsive and often uncontrollable cravings. Despite the devastating consequences of abusing drugs or alcohol, an addicted individual may continue to seek out these substances unless they receive professional treatment.
Comorbidity is one of the terms that describes someone who has both a mental illness and addiction. The term comorbidity also has a broader meaning. It can describe any circumstance where two disorders or diseases occur in the same person, such as alcoholism and depression comorbidity. While this term can apply to drug addiction and mental illness, it could also describe someone who has Parkinson's disease and anxiety disorder, for example.
Someone with comorbidity doesn't have to have both disorders at the same time. Sometimes, one illness will begin when the other seems to end. Comorbidity implies that there is some kind of connection between the two disorders, affecting both how they progress and their treatment.
Dual diagnosis is a more general term for two or more conditions that occur in the same person at the same time, whether physical or mental. The presence of heart disease and diabetes could be a dual diagnosis. Today, dual diagnosis treatment is the term most often used to describe treatment for those with a mental illness and an addiction.
Co-occurring disorders describe a variety of diseases that commonly occur along with drug abuse or alcohol addiction. This term almost exclusively refers to someone who has a mental illness that contributes to or comes as a result of an addiction. However, an addicted individual's co-occurring disorder could also be HIV, cancer, hepatitis C or another disease.
A comorbid diagnosis refers to any chronic condition, such as depression, that is present at the time of addiction. Some conditions have common underlying factors that result in a comorbid diagnosis, while others directly result from other conditions and lead to comorbidity.
Every case of dual diagnosis is unique, and while anyone can receive a dual diagnosis, it is most common in individuals experiencing substance abuse. Some common symptoms of dual diagnosis include:
The most common mental health conditions that coincide with substance use disorders are anxiety disorder, bipolar disorder, post-traumatic stress disorder and other behavioral disorders. There isn't a limit to the combinations of mental illnesses and substance use disorders that can contribute to a dual diagnosis. Some prevalent examples include:
A dual diagnosis can also affect how you receive treatment. Trying to stop excessive drug or alcohol use alone, can be extremely risky and it is best to detox under medical supervision from a treatment team to ensure a safe withdrawal. Since every dual diagnosis is different, it's best to take an individualized approach to treatment. Doing so helps the individual receive treatment for substance abuse and any underlying issues that may contribute to their substance dependency.
After receiving a diagnosis for co-occurring disorders, many individuals wish to know which disorder they developed first. For example, if someone has a drug use disorder and a mental health problem like depression, they often want to know which condition contributed to the other. However, discovering which one occurred first is not always possible.
While co-occurring disorders are specific to the individual, certain combinations are more common than others, such as:
Since co-occurring disorders interact, experiencing difficulty with one — like alcohol abuse — can cause both to worsen. Abusing drugs and alcohol can also worsen symptoms of depression, anxiety or psychosis. Additionally, it is common for individuals with mood disorders or other mental health issues to use alcohol or drugs to self-medicate.
The best treatment option is an integrated approach that involves treating substance abuse and mental health together instead of separately. Integrated treatment can involve behavioral therapy and medication to help an individual understand how their disorders interact and the best way to manage them.
Whether you call it comorbidity, dual diagnosis or co-occurring disorder, correct diagnosis and treatment are essential to give you the greatest chance of recovery. It can be difficult to untangle many of the overlapping symptoms of drug or alcohol abuse and certain mental health disorders to ensure appropriate care. That's why you need addiction treatment specialists who understand the nuances of a dual diagnosis.
At Diamond House Detox, we specialize in evidence-based dual diagnosis treatment programs to ensure you get the highest quality of care. If you believe that your mental health condition has contributed to a substance abuse disorder or vice versa, we're here to help. Call (800) 205-6107 or complete our online inquiry form to find out more about treatment for dual diagnosis.
Content medically reviewed by Vicky Magobet, PMHNP-BC, on April 24, 2023