Treating addiction is complicated: the multiple factors that can lead to addiction, the chronic nature of the disease, and the changes it causes to the brain generally make a multi-faceted treatment approach necessary. When addiction is coupled with other mental illness – a condition referred to as “dual diagnosis” – the combined diseases make treatment even more complicated.
According to the Australian Government site www.mindhealthconnect.org, substance abuse is a major contributing factor to mental health issues.
People who abuse drugs and alcohol are much more likely to develop mental illnesses than those who don’t.
Likewise, having a mental illness can make it more likely that someone will develop a drug addiction. It isn’t always possible to tell whether addiction triggered the mental illness or vice versa, but studies show that 50% of people with severe mental illness struggle with substance abuse – a much higher rate than that of the general community. And compared to the general population, people addicted to drugs are twice as prone to suffering from anxiety and mood disorders.
The Nature of Dual Diagnosis
In discussing how addiction and other mental health issues interact, it’s important to understand that addiction itself is a mental illness. Addiction changes the brain in very fundamental ways. It alters a person’s hierarchy of needs and desires. Essentially, needs and desires become focused on procuring and using the drug. Addiction also results in compulsive behaviour, and a weakened ability to control impulse. Fundamental changes to the brain, compulsive behaviour and an inability to control impulse are also symptoms of other mental illnesses.
Drug use is thought to influence the development of other mental illnesses. For example, cannabis users have an increased experience of psychosis, thought to be related to their use of the drug. Conversely, drugs can help people with mental illness deal with their symptoms or feel better in the short term, and so can lead those with a mental illness into addiction.
Other Risk Factors
A dual diagnosis can also be influenced by:
- Stress and anxiety: both of these contribute to the development of addiction and other mental illnesses.
- Developmental factors: Drug use disorders and other mental illnesses are developmental. If they manifest while the brain is still developing, up to the final teen years, the brain will develop differently and in ways thought to increase the likelihood of both drug use and other mental illness.
- Genetic factors: if others in the family have been addicted or have another mental illness, the patient is more likely to have both.
Diagnosis and Treatment
As drug abuse and other mental disorders are found to co-occur so often, anyone seeking help for either condition should be evaluated for both, and subsequently treated for both if required. Adapting behavioural therapies to the have proven effective. Treatment will be modified to address both conditions. For example, if patients in recovery for alcohol addiction are receiving social education in response to their mental illness, that education will be adjusted to provide support in avoiding alcohol in social situations.
Some medications are suitable for treating both drug abuse and mental illness, and so they are particularly appropriate prescriptions for a patient with a dual diagnosis. When prescribing, it’s important to consider the effect of medication on both the patient’s mental illness and their addiction as well.
What if Someone You Love is Addicted and Has a Mental Illness?
If someone you love has a mental illness and is in recovery from addiction, it’s important to know their recovery may be complicated by the dual diagnosis. It’s also important to ensure the mental illness is treated with the same attention and focus as the addiction because addicts in recovery are much more likely to relapse if their mental illness goes untreated.
How You Can Help Someone with a Dual Diagnosis
If someone you love is unaware of how serious their addiction and mental illness are, an intervention from those they love can help them take the step of seeking help and support. In an intervention for a patient with a dual diagnosis, it’s likely they’ll respond strongly with fear or anger. Arrange for support from a professional to get the best possible outcome, both for the patient and for the family.
Remember – both addiction and other forms of mental illness are treatable. However desperate you are, and whatever has happened in the past, it’s important to show the patient love, compassion and support as they deal with the significant challenges of addiction and other mental illness.