Dual Diagnosis and Co-Occurring Disorders: Say What?
You have probably heard the terms “dual diagnosis” and “co-occurring” disorders being discussed more frequently as addiction treatment professionals continue to learn about the connection between mental illness and substance abuse.
But what do these terms mean?
Dual diagnosis, also known as co-occurring disorder, refers to someone who has been diagnosed with both a mental illness and a drug or alcohol problem. The symptoms of one disorder tend to worsen the symptoms of the other. What does this tug-of-war look like? How does one problem complicate the other?
More here about the connection between addiction and mental health conditions. Then, we invite your questions and feedback at the end. In fact, we have a comments section at the end for your questions…and we try to respond to real-life questions personally.
Which comes first: A mental health problem or addiction?
The answer is that it’s different for each person. A mental health disorder can be considered a risk factor for drug use, which may lead to addiction. In other cases, drug use can trigger the development of a mental health disorder. But what’s clear is this:
Once both issues are co-occurring, they are likely to perpetuate one another.
Difficulty in Identifying the Root Problem
Mental illness can be difficult to diagnose among those struggling with a drug or alcohol addiction because psychiatric symptoms are sometimes misattributed to the person’s drug use. Likewise, the display of withdrawal symptoms or a person’s altered state under the influence of a given substance is occasionally misinterpreted as mental illness.
Problems with substance abuse can cover up a person’s mental illness, making underlying issues difficult to diagnose and properly treat. For example, long-term abuse of alcohol can lead to Wernicke-Korsakoff syndrome, a serious brain disorder with symptoms that include:
To better understand the interplay between addiction and mental health issues, we need to examine how addiction hijacks a person’s brain.
How Addiction Hijacks the Brain
Drugs and alcohol cause an unnatural surge in the neurotransmitter dopamine, which produces a feeling of euphoria. Another neurotransmitter called glutamate is also released. Glutamate is responsible for memory functions, making it more likely that you will remember your experience with whatever substance that has just been introduced to your system.
Increased levels of dopamine and glutamate end up causing drugs or alcohol to become a higher priority in the brain’s functioning.
Given the body’s reaction, harmful substances become rewarding and associated with pleasure in the memory. Addiction is playing out a chemical process. But why can’t we simply stop using drugs once our brains start shifting focus from other important needs to the need for drugs or alcohol?
Unfortunately, it’s not that simple.
Addiction alters the structure of the brain. As neurotransmitter levels change, the brain’s pleasure center is impacted, affecting the way a person learns and makes decisions. Furthermore, chronic substance abuse can lead to the brain adapting to our habits. Rather than making complex decisions and thinking through problems rationally, our brains shift activity away from the prefrontal cortex—which controls emotions and decisions—and place it towards the dorsal striatum—which is where we form habits.
At this point in the addiction cycle, a person’s brain has been conditioned to seek out his or her substance of choice to maintain balance in response to various triggers. Combining this state of addiction with a mental health disorder creates a situation fraught with physical, mental, and emotional dangers.
Mental Illness Can Perpetuate Addiction
Though substance use often exacerbates the symptoms of mental health disorders, many people suffering from social anxiety, PTSD, bipolar disorder, and other conditions are prone to addiction because of a hope that their symptoms will be alleviated by drugs and/or alcohol. According to the Anxiety and Depression Association of America, those with anxiety disorders “are two to three times more likely to have an alcohol or other substance abuse disorder at some point in their lives than the general population.”
People living with depression and other mental disorders are experiencing feelings of:
In search of an escape from these feelings, many individuals dealing with a mental illness turn to substance use. The substance use, in turn, worsens their mental illness symptoms and the cycle of addiction is perpetuated.
Substance Abuse Affects Mental Illness
As mentioned above, substance use disorders and mental health disorders often have a reciprocal relationship with each other. For example, it is common for those living with anxiety or mood disorders to use alcohol or drugs as a means of alleviating their symptoms. But mood-altering substances (especially alcohol) can only reduce symptoms of social anxiety temporarily. In fact, using alcohol to alleviate anxiety can often result in increased levels of anxiety, irritability, or depression a few hours after consumption.
Additionally, those suffering from low self-esteem may turn to drugs or alcohol as a means of boosting their mood through the brain’s release of dopamine. However, “self-medicating” in this way ultimately has the opposite effect as the feelings of euphoria wear off, and the individuals are left to restart addiction’s vicious cycle once again.
Dual Diagnosis Questions
If you or a loved one are caught between a mental health disorder and addiction…don’t despair! There are effective therapy methods that can help you manage both conditions successfully. You can learn more about what you can expect from dual diagnosis treatment and suffer no more.
If you have any questions that we didn’t address in this article, please post them in the comments section below. We welcome your feedback and try to respond to all legitimate inquiries in a personal and prompt manner.
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New legislation will reduce the penalties for low-level marijuana offenses.
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Growing cocaine elsewhere can be a challenge, but it is possible. Also, cocaine needs a high level of industrialization to be produced. It has been estimated that around 297g of dry coca leaf can yield a gram of cocaine, which explains why its cost is more expensive than most other illicit drugs. By comparison, 297g of dried marijuana can yield the same amount of smokeable marijuana. As such, small-time barons opt to grow pot instead.
Sigmund Freud was known to encourage the use of cocaine in 1884 as a therapeutic tonic.
Freud argued in his paper Uber Coca that cocaine has the ability to cure sexual impotence as well as depression. Due to its growing recognition from well-known individuals, the cocaine industry was formed and colonial powers began to scout for regions where they can farm coca.
The plants, then, were brought over to Europe, Australia, India, and the rest of Southeast Asia. By 1920, the previously Dutch colony of Jana became the leading manufacturer of coca worldwide, exporting tons of coca leaves to companies in Netherlands. In the year 1925, this ended with the Geneva Convention that banned cocaine use for its addictive nature. However, as the people already knew that coca can grow outside of South America, they later reverted to Australia.
An Asst. Professor at the Texas Tech University in the Dept. of Chemistry and Biochemistry, Dr. John C. D’Auria conducted several studies on these plants and later revealed the intricacy of its cultivation.
While other illicit plants like marijuana can grow anywhere, coca is not as easy to grow. Dr. D’Auria revealed that the woody plant Erythroxylum coca is unlike the Cannabis sativa that is herbaceous. This difference is due to how they are cultivated. Coca has the capacity to grow 1,650-4,950 ft. in the humid Amazon forest giving its unusual proclivity for low atmospheric pressure and high moisture available in only a number of places outside of Andes.
Dr. D’Auria pointed out that growing tens of coca plants can be enough for occasional chewing or for making tea but may not be enough to get the purified form of cocaine from the coca leaves expecting high-yield from illicit sales.
He further exclaimed the difficulty of extracting a useful amount of the substance from the leaf of coca revealing that the process takes chemistry knowledge on top of skill. Because of this, Australian drug barons opted to import coke rather than to manufacture it themselves. However, there’s another way that has been overlooked.
The Australian cocaine shrub Erythroxylum australe native to the North Territory of Queensland and in the Northern New South Wales, contains 0.8 percent of medetomidine, the alkaloid comparable to cocaine although it is illegal to grow the plant in New South Wales.
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How Much Is A Gram Of Cocaine? is courtesy of Detox of South Florida’s Blog
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