Mental health disorders related to alcohol and drug abuse are often seen as social problems instead of a public health issue.
Martha Kane, clinical director at the Centre for Addiction Medicine in Massachusetts, US says that dual diagnosis is one of the most complex and difficult situations in the mental health/ substance use world.
The interaction between mental health disorders and substance disorders is extremely concerning in the sense that the symptoms of the two illnesses negatively combine to make things more difficult. Consequently, a person may turn to substance abuse to control their disorder, and inadvertently worsen their condition.
Dual-diagnosis: Although addiction is a brain disease, it frequently coexists with other mental illnesses such as major depression, ADHD, and bipolar mood disorder. Dual diagnosis refers to this occurrence.
Due to the danger of dual diagnosis, substance use disorders increase the risk of mood disorders, while mood disorders increase the risk of substance use disorders.
An estimated 20% of all people diagnosed with a mental illness also suffer from substance abuse problems.
Psychologist Kate Saxton, practice manager at Changes Addiction Rehab in Northcliff, Johannesburg said: "Dual diagnosis refers to the formal diagnosis of simultaneous mental health and substance use disorders.
“Either illness can develop first, but drug and alcohol use can exacerbate symptoms of mental health issues. Treating both disorders is crucial for lasting recovery.”
Diagnosis and treatment for co-occurrence or dual diagnosis can be complicated because it is difficult to assess the overlapping symptoms of addiction and mental illness.
Dual-diagnosis treatment centres give their patients a much better chance of long-term recovery or sobriety, but many of these facilities are not equipped to handle dual-diagnosis cases.
Untreated dual-diagnosis can leave a person vulnerable to other serious consequences, including:
• Aggression
• Increase risky sexual activity
• Low quality of self-care
• Physical health problems
• Suicide
In many instances, people resort to alcohol and/or drug use and abuse to cope with symptoms of mental illness.
For instance, someone struggling with depression turns to illicit drug use to suppress their emotional turmoil. Another person with anxiety may try an opiate as a sedative, and they may quickly develop a dependence on the drug, explained Saxton.
"Drug and alcohol abuse may also trigger an underlying mental health issue,” she said.
Dual-diagnosed individuals are impacted differently and, as a result, have various demands. What works in practice for one individual might not work in practice for another. Therefore, understanding the challenges that come with a dual diagnosis is essential to treatment and recovery.
1. Addiction and ADHD: What’s the link?
Up to 50% of people with ADHD also have a substance abuse problem. ADHD is the most common psychiatric disorder among children, and symptoms persist into adulthood in 30 - 80% of cases. ADHD is characterised by inattention, hyperactivity, and impulsive behaviour.
Those with ADHD are more likely to start abusing substances at a young age compared to addicts and alcoholics without ADHD.
2. Addiction and bipolar mood disorder:
According to studies, people with bipolar disorder are also three times more likely to abuse alcohol or be dependent on drugs than the general population.
Bipolar is a mood disorder characterised by manic and depressive episodes that significantly impact a person’s ability to function in a healthy way.
Substance abuse can exacerbate bipolar symptoms as well as trigger the onset of dormant bipolar.
3. Addiction and anxiety:
There is no doubt that everyone experiences anxiety to some degree, but if your symptoms are extreme and interfere with your everyday life, then you might be diagnosed with anxiety disorder. About 20% of people with an anxiety disorder have experienced a substance abuse problem in their lifetime.
4. Addiction and PTSD:
Trauma and addiction have a strong link. According to research conducted on adolescents in the US, up to 70% have a history of trauma.
A 2010 study found that over 60% of young people with PTSD go on to experience substance abuse issues.
While a nationally representative survey notes that 75% of South Africans had gone through a traumatic event, and almost half of them had gone through multiple traumas. South Africa has relatively high rates of trauma and PTSD, which contributes significantly to the country's addiction epidemic.
Saxton indicates that people turn to substances as a self-medicating mechanism. As a result, these people may need to use more and more of the substance to get temporary relief: This cycle frequently results in the development of an addiction.
Since mental health and substance abuse services and training typically don't cross, experts in one sector aren't always familiar with the problems in the other. Finding experts who are proficient in treating both substance abuse and mental illness can be challenging, Saxton explained. Both need to be treated simultaneously for the best chance at recovery.
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