January 11, 2021 Treatment

Living in Recovery with Co-occurring Disorders

The truth about co-occurring disorders

Addiction and other mental health conditions are not separate issues- they are best treated together. There are common myths about co-occurring disorders, often called a dual diagnosis. We’d like to help dispel common myths today.

First, what are co-occurring disorders?

An individual is considered to have co-occurring disorders if they have had both a substance use disorder and a mental health disorder at some point in their lifetime. The disorders must not merely manifest symptoms from a single illness but rather the presence of two or more independently diagnosable disorders.

Myth #1: Co-Occurring disorders are uncommon.

Nothing could be farther from the truth! It’s rarer these days to have a substance use disorder without a dual mental health condition. Approximately 7.7 million Americans live with a co-occurring disorder. Typically, there are multiple interacting disorders, meaning one or more mental health conditions and a substance use disorder.

Myth #2: It’s impossible to tell which one came first, the mental health problem or the substance use disorder.

This is a complicated one, considering that addiction sometimes has similar signs and symptoms as common mental health disorders.

The reality is that either one can come first, or they can occur concurrently. Somehow, we’ve decided that mental illness that occurs during substance use is not valid, which is false. Despite which came first or second, both disorders should be treated simultaneously.

Undiagnosed or undertreated mental illness often results in self-medication or the use of substances to make emotional pain more tolerable. Drug and alcohol use can mask the symptoms of a mental health condition, making assessment and treatment all the more critical.

The truth is that it is entirely possible to have one, and not the other, and vice versa.

Myth #3: Individuals with co-occurring disorders cannot maintain recovery from addiction.

Addressing mental health and substance use disorders through an integrated approach provides more significant opportunities to succeed in treatment and recovery. An integrated approach means bringing all healthcare components into one place to address the physical, social, mental, emotional, vocational, and spiritual elements of wellness.

Undoubtedly, patients with co-occurring disorders can successfully change unhealthy behaviors and achieve recovery that involves:

  • Abstinence from drugs and alcohol
  • Improved mental, emotional, and physical health
  • Enhanced ability to care for oneself and others
  • A higher degree of independence
  • Enhanced self-worth
  • Employment, safe and sober housing, and fulfilling relationships

Myth #4:  Individuals with co-occurring disorders do not belong in 12-step or mutual aid support groups.

The use of mutual or peer support programs has been the hallmark of addiction treatment and recovery for decades. Those in recovery from co-occurring disorders that attend mutual support groups are no different than those in recovery without a co-occurring disorder. Often, they are afraid of being judged or shamed but can recover nonetheless. People with mental health problems can benefit just as others do from others’ shared experiences and achieve recovery through the mutual support of their peers. In fact, there are groups dedicated to individuals with co-occurring disorders:

  • Double Trouble in Recovery
  • Dual Recovery Anonymous
  • Dual Diagnosis Anonymous
  • Dual Disorders Anonymous

Myth #5: If you take psychiatric medication, you’re not sober.

The reality is that medications may be an essential key to recovery. The risk of not taking medications or stopping them without a doctor’s supervision may be more dangerous to recovery.

The person in recovery can determine with a doctor’s supervision if a potential treatment could lead to relapse on a particular substance. It may not be prudent in recovery to take a medication known to cause dependence. Working with a medical provider or addictionologist trained in addiction medicine may provide added comfort knowing they understand.

Myth #6:  People with co-occurring disorders frequently relapse.

Ensuring proper treatment plans that address mental health and substance use will improve the likelihood that recovery plans will do the same. Meaning, relapse risk can increase for those abstaining from drugs and alcohol that do not address their mental health in recovery plans for the future. For individuals in treatment with a co-occurring diagnosis, special attention must be paid to medication management, physical activity, diet and nutrition, sleep, and support.