Addiction and Mental Health: Do You Have a Dual Diagnosis?

Addiction vs. Substance Use Disorder

Substance abuse has emerged as a serious health concern in the United States. According to SAMHSA’s 2015 Behavioral Health Barometer, among the entire United States population that’s aged 12 or older, there were 6.4% of people dependent upon or abusing alcohol, and 2.7% of people dependent upon or abusing illicit drugs. That’s an estimated 17.0 million people who abused alcohol, and 7.1 million people who abused illicit drugs in 2014.

The American Society of Addiction Medicine defines addiction as “a primary, chronic disease of brain reward, motivation, memory and related circuitry,” that is “characterized by inability to consistently abstain, impairment in behavioral control, craving, diminished recognition of significant problems with one’s behaviors and interpersonal relationships, and a dysfunctional emotional response.” This definition is commonly accepted within the field of addiction treatment, and is the basis for self-help groups like Alcoholics Anonymous.

There is much debate about the definitions and perspectives on substance abuse. However, each definition gives us different insight into the condition, which causes unspeakable pain for so many people and their families.

In the mental health field, Substance Use Disorder (SUD) is the term used to describe illicit drug or alcohol dependence and abuse. SUD is classified as a mental disorder in the Diagnostic and Statistical Manual of Mental Disorders—Fourth Edition, also known as the DSM-IV. Some people are hesitant to use the label “mental disorder” because of existing stigmas about mental illness, but we need to work to eliminate these stigmas in order to provide the best care. Approaching substance abuse from a mental health perspective can be an enormous help to a large chunk of our population that is suffering.

Substance Abuse and Mental Health

There are significant links between substance abuse and mental illness. According to the National Alliance on Mental illness,

“a mental illness is a condition that affects a person’s thinking, feeling or mood. Such conditions may affect someone’s ability to relate to others and function each day. Each person will have different experiences, even people with the same diagnosis.”

It is undeniable that these distortions in thoughts and feelings, along with the inability to function daily, are also characteristics of substance abuse and addiction.

In 2014, there were 43.5 million adults aged 18 or older with a mental illness, and 18.2% of them also suffer from a Substance Use Disorder. In the entire adult population of the United States, 3.3% of people had a co-occurring Substance Use Disorder and a mental illness. That’s almost 8 million people.

In the substance abuse community, about a third of all alcohol abusers and more than half of all drug abusers report experiencing a mental illness. This is called a dual-diagnosis—when someone experiences a mental illness and a substance abuse problem simultaneously:

“It can range from someone developing mild depression because of binge drinking, to someone’s symptoms of bipolar disorder becoming more severe when that person abuses drugs during periods of mania.

Either substance abuse or mental illness can develop first. A person experiencing a mental health condition may turn to drugs and alcohol as a form of self-medication to improve the troubling mental health symptoms they experience. Research shows though that drugs and alcohol only make the symptoms of mental health conditions worse.

Abusing substances can also lead to mental health problems because of the effects drugs have on a person’s moods, thoughts, brain chemistry and behavior.”

Approaching substance abuse as a mental health issue can broaden our understanding of the condition, and lead to more comprehensive care.

The Importance of Screening for Mental Health Conditions

In many substance abusers, there are underlying thoughts and motivations for addictive behaviors. For myself, low self-esteem, poor coping skills, and high anxiety contributed significantly to by substance abuse. Because mental health problems and substance abuse are so interwoven, it is important for people who identify as addicts or alcoholics to get checked for depression, anxiety, and other mental illnesses.

Not all of us think about our mental health enough, but we can start to seek information now. It may be an important step in maintaining our recovery. Mental health conditions are real, extremely common, and, most importantly, they are treatable. Recovery from mental illness is also possible.

Mental Health America is a non-profit organization dedicated to addressing the needs of those living with mental illness and promoting the overall mental health of Americans. They are a fantastic resource for information, and also provide an amazing set of screening tools, which can help you determine if you are experiencing the symptoms of a mental health condition:

http://www.mentalhealthamerica.net/mental-health-screening-tools

These screens are only for the purpose of gaining information that can be used in pursuing treatment. These are not diagnostic tools. There are a number of screens available:

• Depression Screen—for individuals feeling overwhelming sadness

• Anxiety Screen—if you feel that worry and fear affect your day-to-day life

• Bipolar Screen—for individuals who have mood swings, or unusual and extreme shifts in mood and energy

• PTSD (Post-Traumatic Stress Disorder) Screen—for those who are bothered by a traumatic life event

• Alcohol or Substance Use Screen—help determine if your use of alcohol or drugs is an area to address

• Youth Screen—for young people (age 11-17) who are concerned that their emotions, attention, or behaviors might be signs of a problem

• Parent Screen—for parents of young people to determine if their child’s emotions, attention, or behaviors might be signs of a problem.

• Psychosis Screen—for young people (age 12-35) who feel like their brain is playing tricks on them (seeing, hearing, or believing things that don’t seem real or quite right).

• Work Health Survey—explore how healthy or unhealthy your work environment is

After a screening, you will be provided with information and resources, which can help you discuss the results with a mental health professional. As stated earlier, these screening tools will not provide you with a diagnosis for a mental health condition – only a psychiatrist, psychologist, or other mental health professional are qualified to make a diagnosis. The results of a screening will simply give you useful information so you are better prepared to go into a counseling session, and possibly help you and your counselor reach a diagnosis faster.

A mental health diagnosis isn’t terminal, and it is by no means an indication that something is “wrong” with a person. Like with any other illness, a mental health diagnosis puts an individual into a category based on his or her symptoms. A diagnosis brings that individual closer to finding the appropriate treatment.

If you aren’t ready to seek professional guidance, there are many more resources available where you can find information on your own about different conditions and their possible treatments:

• National Alliance on Mental Illness
  • https://www.nami.org/Learn-More/Mental-Health-Conditions/Related-Conditions/Dual-Diagnosis

• Substance Abuse and Mental Health Services Administration
  • http://www.samhsa.gov/disorders

• National Institute on Drug Abuse (NIDA)
  • http://www.drugabuse.gov/

• National Institute on Alcohol Abuse and Alcoholism (NIAAA)
  • www.niaaa.nih.gov

• Healthy Place
  • http://www.healthyplace.com/addictions/

Support groups can help build a support network for recovery from both addiction and mental illness. There are many groups online, as well as classes or groups that you can find in your area for support with a condition. Therapists and counselors are also an important element for many people in addiction recovery to achieve holistic mental wellness.

As survivors of addiction and substance abuse, we know what it means to feel hopeless and lost when looking for help. We don’t need to feel this way about our mental health either, because help is available if we want it. For me, understanding my mental illness has helped me to seek more personalized help and maintain my recovery. I am not ashamed—I am proud to know more about myself, and to better understand the mechanisms of my mind. All of this empowers me, and keeps me further away from relapse.