Since time immemorial, comorbidity drug use-related disorders and mental health problems has baffled scientists. This association has always given rise to question: which problem could have possibly come first – the drugs or the mental illness.
This has been quite a challenging mystery to unravel, the reality being, any given mental ailment can significantly increase the chances of drug abuse for immediate or short-term relief, whereas, those who are habituated to prolonged drug use could start manifesting early symptoms of mental health problems.
Although the two are closely linked with each other, one may not directly cause the other. In most of the cases, self-medication with alcohol or drugs to alleviate depression or anxiety may have serious side effects and can heighten the risk for more serious problems, in the form of mental disorders, in the long run. Such a high rate of comorbidity between the two calls for a holistic approach to identify, assess and treat both theorders.
Determining one's vulnerability to co-occurring disorders
Although it is difficult to determine what causes a chronic disability, such as a mental disorder or a substance abuse problem, one can check his or her vulnerability to acquire the co-existing condition by looking at the following factors:
Family history : If someone's parents or grandparents have struggled with a mental disorder, besides drug or alcohol addiction, it is likely that he or she will be at a greater risk of developing these problems.
Sensitivity to alcohol or drugs: If someone is highly sensitive to the effects of alcohol or drugs, or is able to notice a close connection between substance use and his state of mind, it calls for an immediate break on addictive behavior.
Symptoms when sober: If depression or anxiety persists even after one has achieved sobriety, it could be a sign of a mental health problem.
Diagnosis and treatment
Dealing with strong urges for drugs or alcohol has always been a daunting task. Moreover, things can get further complicated if someone is struggling with mental health problems, such as depression, anxiety or bipolar disorder. In other words, battling co-occurring disorders can pose an aggressive challenge to the patient as well as the caregiver.
Dual diagnosis calls for a comprehensive approach to treatment, which can identify and evaluate each disorder concurrently. Thus, it becomes imperative for a patient seeking psychiatric illnesses to get screened for substance use disorders and vice versa. Since an accurate diagnosis is complicated, it may be necessary to observe patients after a period of absence in order to distinguish between withdrawal symptoms and those related to comorbid mental disorders. In a rehab center, a patient is likely to undergo the following four phases of treatment:
Evaluation and assessment: It helps the patient and his family to create a foundation for treatment and to determine appropriate treatment.
Detoxification: It involves safe management of withdrawal from alcohol and drugs.
Rehabilitation: It is the primary phase of treatment which includes assessment and implementation of a personalized treatment plan, such as individual or family therapy.
Continuing care: It offers a continuous, comprehensive support to patients after discharge.
Road to recovery
Regular care from trained doctors and customized therapies may greatly help a comorbid patient to cope with stress. These programs are specifically designed to help patients recover from the dual conditions through integrated interventions. In many instances, healthcare practitioners may stick to only behavioral therapy for patients who are uncomfortable taking medications, given their history of substance abuse.