Co-Occurring Disorders: Diagnosis – Treatment Guide

Co-Occurring Disorders: Diagnosis – Treatment Guide

Co-occurring disorder indicates a drug or alcohol addict with one or more mental illnesses. Formerly referred to as a dual diagnosis or dual disorder co-occurring disorder means the substance abuser has been found to have a mental illness.

  •  This term designates the condition of having both a psychiatric and substance abuse issue. It was formally called “dual diagnosis”.

Psychiatric Disorders Trigger Substance Abuse

When addicts with schizophrenia or schizophrenia sub-types abuse alcohol and/or drugs. their mental illness tends to be more severe than it would be if they were not addicts. To determine if hallucinations and delusional thinking can be attributed to mental illness, patients entering a rehab center will need to undergo detoxification first before a co-occurring disorder diagnose can be correctly made.

Nearly 20 Millions Americans Suffer From Depression. It Is a serious medical condition. many people are “self-medicating” their depression with drugs and/or alcohol, resulting in a “co-occurring” disorder.

Severe depression, bipolar depression and mania are considered mood disorders. When a mood disorder continues affecting an addict following detoxification, they will likely receive a co-occurring disorder diagnose.

Personality Disorders

Many addicts suffer from one or more personality disorders that make them more likely to adopt drug-seeking behaviors. Personality traits characteristic of personality disorders will severely impair an addict’s ability to maintain employment, engage in healthy relationships, exert proper impulse control and recognize abnormal thinking patterns.

The DSM-IV categorizes personality disorders in clusters. For example, Cluster A includes schizoid and paranoid personalities, Cluster B includes borderline, narcissistic and antisocial personalities and Cluster C includes avoidant, obsessive-compulsive and dependent personalities.

Prevalence of personality disorders among substance abusers is extremely high, so high that the majority of integrated treatments for co-occurring disorders focus on patients with antisocial and borderline personality disorders.

Treating Co-Occurring Disorders

General treatment guidelines for addressing addiction and mental illness involve the following principles and protocols:

  • Developing and utilizing therapeutic alliance to help fully engage patients in treatment
  • Maintaining a perspective that emphasizes recovery and a goal-oriented future
  • Monitoring psychiatric symptoms through empathetic, supportive counseling methods
  • Providing motivational support consist with the patient’s stage in recovery
  • Using cognitive behavioral therapy and relapse prevention techniques
  • Facilitating patient participation in group therapy

Features of the recovery perspective found in integrated treatments for co-occurring disorders include acknowledging the long-term, internal process of recovering from an addiction and understanding how recovery progresses in stages that happen over the patient’s lifetime.

Aftercare Support

Neither addiction nor mental illnesses are “curable”. Instead, integrated aftercare services must be incorporated into a recovering addict’s treatment plan to address emerging physical and mental issues on an ongoing basis. In addition to medical care and psycho-therapeutic counseling, patients may also benefit from holistic therapies involving creative, spiritual and nature-oriented activities.

Also essential to an excellent aftercare support program for addicts with co-occurring disorders are medications for controlling mental illness symptoms that heavily contribute to addictive behaviors. Since many substance abusers with mental illnesses or personality disorders turn to drugs or alcohol as a form of self-medication, case managers need to impart the importance of taking medications as prescribed to their clients in treatment.