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The National Institute on Drug Abuse (NIDA) describes “comorbidity” as a condition that occurs when two or more disorders or illnesses exist at the same time. In addiction treatment centers, this condition is also called dual diagnosis. Male and female drug addicts are twice as likely as the general population to experience incidence of comorbidity.
Many persons who become addicts consciously or unconsciously suffered from a mental disorder prior to addiction. And, many persons who did not suffer a mental disorder prior to addiction developed a coinciding mental disorder during addiction.
Interestingly, male and female addicts are likely to experience different mental disorders. Men who suffer drug addiction are more likely to suffer comorbidity than are female addicts. Males with comorbidity are more likely to suffer anti-social personality disorders. Females suffering drug addiction are more likely to have high rates of mood and anxiety disorders.
The Three Most Common Dual Diagnosis Disorders
The three most common incidents of comorbidity occur when the addict suffers from extreme depression, anxiety or bipolar disorder. Persons who suffered these conditions are prone to abuse the prescription medications that ease the symptoms. This can lead to addiction.
Signs and Symptoms of Depression
- The patient experiences feelings of helplessness and hopelessness.
- The patient loses interest in daily activities.
- The patient cannot experience pleasure.
- The patient’s appetite changes.
- The patient undergoes dramatic weight change.
- The patient is restless and suffers irregular sleep patterns.
- The patient resists exerting himself or herself.
- Patient has low self-esteem.
- Patient experiences frequent guilt.
- The patient lacks focus.
- Males are more prone than females to feelings of anger, physical pain, and reckless behavior.
Common Signs and Symptoms of Anxiety
- Patient experiences overweight tension and worry.
- Patient is restless or nervous.
- Patient feels they are “on edge.”
- Rapid heartbeat and shortness of breath are common symptoms.
- The patent experiences nausea, trembling, or dizziness.
- The patient suffers headaches.
- The patent complains of muscle pain.
- The patent has difficulty concentrating on tasks at hand.
- The patient has sleep difficulties including insomnia.
Common signs and symptoms of Mania in Bipolar Disorder
- The patient experiences either euphoria or extreme irritability.
- The patient has unrealistic beliefs.
- The patient requires less sleep than is healthy.
- The patient has elevated energy levels.
- Rapid speech and racing thoughts are common to bipolar patients.
- The patient is extremely impulsive.
- The patient is hyperactive.
- Patients experience rage and/or anger.
Causes of Comorbidity
Drug addiction treatment centers try to ascertain which disorder came first. The drug addiction of the concurrent mental disorder is important to structure the most effective rehabilitation protocol.
After careful review of the patient’s physical and psychological evaluation and the patient’s medical history, the treatment center will determine which disorder initiated comorbidity.
Addiction and mental disorders share many of the same symptoms and are the result of shared risk factors. It is important that the dual diagnosis patient be treated for both disorders at the same time.
Shared Risk Factors
- Genetic disposition and other genetic factors can increase the risk of mental disorders and a second disorder occurring at the same time.
- Environmental triggers like physical or sexual abuse, stress or trauma can cause early drug abuse and addiction and are often accompanied by a secondary disorder.
- Interference with regions of the brain can pave the way for a mental disorder. Drugs affect the brain’s perception of risk and reward.
- Drug and mental disorders are described as developmental disorders, meaning that they start in formative teen years and intensify over time. Teens who are exposed to drugs run a high risk of other mental disorders and addiction that worsen s they mature.
Treatment for Comorbidity or Dual Diagnosis
There is strong emphasis on behavioral therapy when treating comorbid disorders. Therapies can be influenced by a number of factors including:
- Patient’s age
- Type of drug used
- Length of addiction
- Length of mental disorder
Treatment centers and psychotherapists agree that the only effective treatment for dual diagnosis is an integrated protocol that treats the mental and addiction disorder concurrently. If the two or more disorders are not treated simultaneously, the probability of relapse is high.
Treatment centers have a consistent theme for comorbid disorders. That message is “hope.” No matter how the patient has suffered, there is always hope and rehabilitation is the means to a hopeful solution. Even if the addict relapses, it is not the end of the journey.
It can take years to develop the skills to manage the addiction, but there is life after treatment.
Treatment centers understand that relapse is part of the recovery process. It is not how or how often the patient falls that matters but rather that the patient picks himself/herself up. However, the patient stands a much better chance of preventing relapse by attending aftercare programs.
Peer support groups are a source of great comfort and validation for the recovering addict. Groups like Narcotic Anonymous teach patients that it is acceptable to lean on another recovering addict. In cases of dual diagnosis, the patient may need continued counseling after discharge from the treatment center.
In comorbid cases, the patient should verify that the center is licensed and accredited but also that the center is experienced with the specific mental disorder. Not all centers are qualified to treat depression, bipolar or anxiety disorders. If the patient is diagnosed with a comorbid condition, he or she should only enroll in a treatment center qualified to manage both disorders.
