Those struggling with both substance abuse and mental health issues have what is referred to as a co-occurring disorder, or a dual diagnosis. It can be difficult, however, to recognize which is the primary issue. A mental health diagnosis, such as clinical depression, can certainly exacerbate an individual’s problems with addiction. Similarly, a person experiencing a substance abuse issue may find that their mental health deteriorates as their use escalates. Left untreated, co-occurring disorders can lead to a vicious cycle of repeated drug use and the worsening of mental health symptoms. In order for a patient to overcome addiction, mental health, or a co-occurring disorder, professional care is often necessary at a drug and alcohol treatment facility that is properly equipped to address both issues.
It’s important to understand the relationship between substance abuse and mental health when seeking help for yourself or a loved one. Both addiction and mental health diagnoses are chronic, medical conditions. While they cannot be “cured,” they can be treated and effectively managed with the right tools and approach to treatment.
There are several ways that mental health disorders can affect an individual’s issues with addiction. The first, is that patients often go without the appropriate medication evaluation and management until they are seeking treatment following a crisis. There is a misconception that it is only the patients who have gone without any medication, or who have been noncompliant with their regimens, that are most likely to struggle with the use of drugs or alcohol. While medication noncompliance often plays a large role in the increased use of substances, those who are on medication can battle addiction just the same. As Rob Cole, LMHC, clinical director of mental health services at Banyan Treatment Centers explains, this is because finding the right medication protocol to address a mental health disorder is not a one-size-fits-all solution. Instead, the process of finding the best treatment for each person is like trying to find “the right key to open the lock,” so to speak. Every patient is a unique individual, who will react differently to any given medication. What works for one will not always work for another. It can take time and persistence to find the best fit. This can be tiresome and frustrating for someone struggling with a mental health disorder. They may seek out drugs or alcohol in an attempt to self-medicate, when doctor prescribed medications have “failed.” Substance use often allows patients to feel “better,” “normal,” or “in control.” They may use stimulants to bring themselves “up” and depressants or sedatives to bring themselves “down.” This is an extremely dangerous cycle, and patients are often in need of long-term treatment to break free. Additionally, a patient with a primary mental health diagnosis can worsen their existing symptoms with the use of drugs and alcohol. Substances can decrease the effectiveness of medications that were otherwise beneficial, and induce mood swings in those struggling with a diagnosis such as bipolar disorder.
A co-occurring disorder with substance use as the primary diagnosis is similar to primary mental health diagnoses in many ways. Many individuals who struggle with addiction develop conditions such as depression, anxiety, and mood swings, along with feelings of helplessness and hopelessness. Those struggling with addiction can find themselves unemployed, homeless, and without emotional support from those they were once close with. These circumstances alone would cause a deteriorating state of mental health in an otherwise healthy person. Add drugs and alcohol to the mix and you may observe drastic mood swings, unpredictability, and a person who seems to be out of control. For those suffering from a dual diagnosis with addiction as the primary issue, these symptoms often improve when the substance abuse is addressed.
If a loved one is struggling with addiction or a mental health disorder, encourage them to seek help and set firm boundaries. Don’t enable your loved one by allowing them to neglect themselves. Make it clear that in order for your relationship to continue they must take action to get better. Don’t make excuses for your loved one, justify their behavior, allow them to steal or lie to you, and don’t fund their drinking or drug habit. It’s often difficult to tell the difference between enabling and helping. Enabling is doing something for the person that they could do for themselves, where as helping is giving them assistance with something they are unable to do themselves If you are struggling, the most important thing to do is often the hardest. Ask for help from someone you trust. A parent, a close friend, or a trusted doctor. Even if it is your family doctor, and not a provider who specializes in mental health or addiction treatment, they will be able to refer you to the correct professional. They most likely have a list of treatment providers, rehabilitation programs, and counselors or therapists that they have worked with in the past, and know which ones their patients have had positive experiences with. There are national helplines that you can call, and resources that you can find online. SAMHSA (the Substance Abuse and Mental Health Services Administration) can be a great resource for anyone who is looking for help. The first and most important step is admitting that you have a problem- the second is seeking help.