Addiction and Mental Health Conditions: Does It Matter Which Came First?

Millions of people deal with addiction and mental health conditions each year. SAMHSA’s National Survey on Drug Use and Health (NSDUH) found that in 2012, about 22.2 million Americans ages 12 and over had struggled with some type of substance dependence or abuse. This survey also found that approximately 43.7 million Americans ages 18 and over had at least one mental health condition in 2012. What many people may not realize, though, is that many people struggle with not one, but both of these conditions. Specifically, the NSDUH reported that 8.4 million adults met the criteria for having a substance use disorder alongside another mental health condition. While millions of people struggle with both conditions, not many people understand how they relate to each other. It’s therefore helpful to know the ways that substance use disorders and mental health conditions develop and interact with each other.

What are Co-Occurring Disorders?

When a person has both a substance use disorder and another mental health condition, she is diagnosed with what is called co-occurring disorders. As Psychology Today explains, a person has co-occurring disorders if she has one or more disorders related to the abuse of alcohol or other drugs along with one or more mental health disorders. These disorders can appear in any combination, and can vary individually in their severity.

How Do Co-Occurring Disorders Relate to Each Other?

The National Alliance on Mental Illness lists the following ways that co-occurring disorders can affect each other:

• Substances can be used as a type of self-medication: The person’s mental health condition may be untreated or under-treated, and she may begin using drugs as a way to make the condition’s symptoms temporarily go away or feel less intense. In the long run, however, substance abuse tends to worsen mental health conditions.
• Substances can intensify mental health conditions: Whether the person is currently intoxicated or is going through withdrawal, substance abuse can intensify the symptoms of mental health conditions.
• Substance use can lead to the onset of a mental health condition: All drugs affect the way the brain functions, but some can create severe neurological changes that can either lead to the development of a mental health disorder, or can cause a latent condition to become active.

Keys to Effective Treatment for Co-Occurring Disorders

While substance abuse can sometimes lead to mental health conditions, it’s rarely clear which condition developed first. Instead, these conditions relate to each other in complex ways. Fortunately, however, it’s normally not necessary for a healthcare professional to know which condition occurred first. Instead, as SAMHSA’s Treatment Improvement Protocol (TIP) 42 explains, healthcare professionals try to assess whether the conditions are more or less severe. Additionally, this TIP gives six guiding principles for healthcare professionals to use when treating a person with co-occurring disorders:

• Focus on recovery: Rehabilitation is short-term; both the patient and her healthcare professionals should work towards achieving long-term recovery.
• Take a multi-problem approach: Since co-occurring disorders are multi-faceted, addressing each aspect of them is crucial to effective treatment.
• Create several phases of treatment: Treatment should involve various stages that meet the person’s individual recovery goals.
• Identify and address specific problems early on: Since every person is different, treatment should assess and help deal with any unique problems that the person may have, or situations that may develop during recovery.
• Prepare to adjust according to any possible cognitive or functional impairments: Co-occurring disorders can damage a person’s body in multiple ways, and effective treatment must adapt to accommodate these impairments.
• Use support systems to increase the treatment’s effectiveness: Social and professional support are key to successful recovery because of the intensity of the recovery process.

Get More Information about Co-Occurring Disorders

Co-occurring disorders are complex, and they can be difficult to manage alone. Some people may worry that in order to receive quality treatment, they will need to know which condition developed first, or whether one condition influences the other one in specific ways. The reality, though, is that treatment for co-occurring disorders can be effective as long as the person works together with the rehabilitation center’s staff to identify and manage all disorders she is struggling with. If you are seeking treatment for co-occurring disorders, call us at now 615-490-9376. Our admissions coordinators are available 24 hours a day to answer your questions about these conditions and get you the help you deserve.