Being diagnosed with a Substance Use Disorder (SUD) can be difficult enough to recognize and seek treatment for. We struggle enough to manage our lives and find treatment for the use of drugs and/or alcohol. Our substance use has impacted us significantly at work, school, and/or home and led us to seek help and make wholesale changes in our lives. Now we also hear the term “co-occurring disorders.” What exactly are co-occurring disorders?
Co-occurring disorders are when there is a diagnosable SUD and the co-existence of a mental health diagnosis. Common mental health diagnoses that co-exist with SUDs include, but are not limited to depression, anxiety, bipolar disorder, and other mood or anxiety disorders. These mental health diagnoses could be conditions that existed before substance use, particularly because many people self-medicate for mental health conditions with substances. Or, the mental health condition could occur after substance use, or even as a result of our substance use. Formerly known as dual diagnosis, co-occurring disorders can sound like double the trouble. However, to have both diagnoses made while we are seeking treatment for substance use can be very helpful in our recovery success.
There is a stigma surrounding depression that those diagnosed with depression are merely sad or cry a lot. This is not helpful, because not everyone is sad or even cries when depressed. Actually, the symptoms of depression include a sense of hopelessness, apathy, a lack of interest in activities, irritability, inability to concentrate, isolation, insomnia, excessive sleepiness or other sleep disturbances, excess eating or a loss of interest in food. The most dangerous symptom of depression, of course is suicidal ideation or suicide. The risk of depression-related death makes this diagnosis very important to both acknowledge and treat.
The trouble with depression as a co-occurring disorder with substance use is that the symptoms of depression can be masked by substance use or mistaken for symptoms of substance use alone. Depression is the most common reason that people attempt suicide, and substance use is the second most common reason. So if we are diagnosed with both disorders simultaneously, our risk of suicide could be even higher. Even if we are only diagnosed and treated for one disorder and not the other, we are still at high risk for suicide. We can also risk relapse of symptoms of either disorder if we only treat the one.
As with depression, anxiety and anxiety disorders also come with stigmas. People think that we simply worry too much or are too nervous about certain situations. However, anxiety is a potentially crippling disorder that prevents us from being able to function normally. Anxiety is characterized by feelings of restlessness or agitation, irritability, difficulties with sleep, fatigue, lack of concentration, muscle tension, nausea, and excessive and uncontrollable fears or worries. There are more specific types of anxiety, such as social anxiety, phobias, or panic disorders. Panic attacks are the primary symptom of a panic disorder, and can render us completely unable to function, often with little to no warning. All of these symptoms are real, physiological symptoms of a medical diagnosis, not just something made up or in our heads.
As with other co-occurring disorders, substance use complicates anxiety disorders, in that symptoms can be more extreme and more frequent while using substances. Anxiety is also commonly a side effect of extensive substance use. Whether anxiety existed prior to our substance use or the SUD developed because of the anxiety isn’t as important as getting treatment for both disorders simultaneously.
Bipolar Disorder Plus
Formerly known as manic depression, bipolar disorder is characterized by the same symptoms as depression, but also with periods of manic symptoms. Symptoms of mania include excessive amounts of energy, little or even no sleep, racing thoughts, pressured speech, irritability, quick and often explosive anger or rage, engaging in risky behaviors, and an inflated sense of self. For many people, they enjoy mania, or even hypomania, where the symptoms are less extreme. However, there is always the crash, resulting in a period of depression which inevitably follows the mania. Bipolar disorder carries a double threat of death, as someone who is depressed is at high risk for suicide, but someone with true manic symptoms may hallucinate or experience god-like delusions which could also lead to a fatality.
Bipolar disorder is the disorder that has the highest rate of co-occurring substance abuse, with up to 46 percent of bipolar patients having an SUD during their lifetime. Because substance use worsens the symptoms of bipolar disorder, the importance of diagnosing and concurrently treating both disorders cannot be emphasized enough. When either bipolar disorder or substance use can seriously harm our livelihood or relationships, and with the threat of losing our lives so much higher with both co-occurring disorders, we cannot afford to prolong our treatment even one more day.
Co-occurring disorders are when our substance use is complicated by a co-existing mental health disorder. While this can feel doubly overwhelming, the best news is that by being diagnosed and treated simultaneously, we give ourselves the gift of recovery from both disorders. Both mental health diagnoses and substance use are very treatable, especially when both are known. By seeking treatment simultaneously, you are doubling your chances for success in recovery.
Find the answers for both substance use and any co-occurring disorders at AToN Center. Call (888) 535-1516 now. The phone call you make today could save your life.