Co-occurring disordersWhen a person enrolls in a treatment program for addiction, the counselors and therapists that make up the treatment team might spend a significant amount of time administering tests that measure memory skills, reaction times, stress responses and impulse control.

For people enrolled in care, this assessment process can seem tedious, and they may wonder what in the world they’re expected to prove with each answer they provide. After all, they may feel as though targeting the addiction is the primary goal, while talking about brain health seems somehow unimportant. In reality, this assessment is a vital part of the care an addiction treatment program can provide, as each little test measures a person’s mental health.

Deficiencies found here could impact the care a person receives, and ultimately dictate how easily the person might overcome a substance abuse problem.

Common Causes

A person with a substance abuse issue might easily qualify for a diagnosis of mental illness. People who use and abuse addictive substances tweak chemical levels inside the brain on a regular basis, and their moods might be erratic and changeable as a result. People like this might also have little control over their emotions, unless they have access to the substances they’re addicted to. It’s reasonable to suggest that these sorts of problems are similar to those experienced by people who have another type of mental illness. But when discussing the intersection of mental health and addiction, experts are typically discussing people who qualify for two diagnoses at the same time.

It’s hard to make generalizations about this type of problem, as there are far too many variables involved. The drugs people take, their family history of mental illness, their physical health and more all might play a role in the development of this kind of issue. The path that people might take to a Dual Diagnosis issue can be similarly variable. Sometimes, a mental health concern sparks so much pain and misery that a person is drawn to drugs in order to drown out the distress. In other cases, the addiction causes a little knot of damage that encourages a mental illness to form.
In general, however, it’s safe to say that people who have two conditions have a more complicated road ahead, should they attempt to get well. Often, they have severe issues when they even consider getting help. In a study in The British Journal of Psychiatry, for example, researchers found that people with a Dual Diagnosis issue often had “complex care needs” that involved suicidal behavior, self-harm or a previous failed attempt at sobriety. They needed help, but their needs were really intense.

Education can be a powerful ally, as people who understand the two conditions they have will be in a better position to fight back. Much of that education takes place in a treatment program, but these are the broad strokes concerning some of the most common conditions that tend to form in combination with substance abuse.


The Link to Depression

A Dual Diagnosis problem can spring to life in response to almost any mental illness, but it’s especially common for addictions and depression to coexist. The chemical changes drugs of abuse can bring about are often responsible for this connection, as these substances tend to hijack the systems the brain uses when communicating pleasure. In time, the brain will only access this system when drugs are present, and even then, the signals might be muted and diminished. As the addiction progresses, the person becomes chemically unable to feel pleasure, even when something wonderful is taking place.

Specific drugs can do yet more damage, making depression even more likely. For example, in a study published in the journal Neuron, researchers found that cocaine damages specific trace chemicals inside the brain of drug-exposed mice, making them more susceptible to both stress and depression. When these mice were placed in situations that put pressure on their emotional control, the craving for drugs was severe, and the overwhelming sensation the mice demonstrated was depression. While human beings have brain cells that are quite advanced when compared to the cells mice carry about in their skulls, studies like this do seem to suggest that chemical damage caused by drugs can lead to unusual emotional responses, with depression playing a major role.

Personality Disorder Concerns

Living with depression or anxiety can be difficult, but some people with personality disorders move between emotional extremes on a regular basis, without having much control over the shifts they face. Other personality disorders impact the way the person interacts with the outside world, increasing feelings of both isolation and superiority. These are very complicated disorders, and they are sometimes hard to treat, as people who have these concerns often mistrust those who are trying to help. They may act out in therapy sessions, or simply refuse to go at all.
Not surprisingly, drugs can make these conditions much worse. Drugs can become a tool people like this use in order to keep others at a distance, even as the substances force them to experience even more shifts in mood and changes in behavior. The substances can also cause yet more damage to the portions of the brain that are already impaired when this mental illness is in play. Even if people do choose to participate in therapy, they might find that the treatments just don’t help, unless they get sober first.

Triggering Schizophrenia

Some drugs of abuse have even more complicated relationships with mental illness. Hallucinogenic drugs like marijuana, for example, have been linked with latent schizophrenia. Researchers aren’t really sure of what happens inside the brain, but it seems that drugs like this work a little like gasoline on a flame, allowing a latent problem to grow into an uncontrollable issue. The progression isn’t reversible, either, and the damage can be severe. In a study in the journal Schizophrenia Research, for example, experts found that having schizophrenia in addition to substance use can lead to:

  • Increased episodes of psychosis
  • Violence
  • Homelessness
  • Medical concerns

People like this also tend to be less compliant with the treatment programs their mental health teams put together. They might not take their medications properly, for example, or they might not attend all of their therapy sessions. As a result, they might not get better with time, since they’re not really addressing the issue in a comprehensive manner.

Finding a Solution

Counseling sessionThere’s no question that having a mental illness in addition to an addiction is serious. Without help, people like this may find it hard to recover at all, as they just have too much to understand and too much to control. It can seem overwhelming, and handling one issue at a time doesn’t seem to help.

Real recovery comes about when people choose to enroll in comprehensive programs that address both problems at the same time. In a Dual Diagnosis program, therapists integrate issues that pertain to both conditions in each therapy they provide. People who have anxiety, for example, might learn how their feelings of fear and tension work as a trigger for drug use, and they might learn how to handle those feelings without leaning on drugs. Those who have depression, on the other hand, might learn more about how drugs trap them in a low mood, and they might find that the grey clouds begin to part with each day they don’t use drugs. The therapies are tailored, but they’re also comprehensive, dealing with both the addiction and the mental illness at the same time. Standard addiction programs might focus exclusively on relapse prevention and impulse control, but these programs do much more. This kind of tailored care is the best way to deal with addiction recovery complicated by mental illness.

If you or someone you love needs help like this, please contact us at Black Bear Lodge. We specialize in providing care for people with Dual Diagnosis issues, and all of our programs begin with intense testing and personalized planning. We can help you develop an in-depth understanding of your addiction, and we can help you build up the vital skills you’ll need in order to stay well in the future.