Ontrak Health is a behavioral health engagement program that provides affordable, long-term treatment options for those struggling with mental health issues. In the following article, Ontrak Health discusses co-occuring disorders and their relationship with mental health.

Studies show that individuals with substance use disorders (SUDs) have a higher risk of developing at least one primary condition or chronic disease. The coexistence of a SUD and a mental illness, dubbed ‘co-occurring disorder’, is relatively common in many people undergoing treatment.

Similarly, Ontrak Health reports that people with mental illness are more likely to develop a substance use disorder than those unaffected by mental health concerns. In fact, the SAMHSA survey, 2021 National Survey on Drug Use and Health, showed that roughly 9.2 million American adults have a co-occurring disorder. However, the relationship between mental health and addiction isn’t talked about nearly enough.

The Relationship Between Substance Use Disorder and Other Mental Health Disorders
The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders identifies mental disorders and states that co-occurring conditions can include any combination of at least two SUDs and mental conditions.

Ontrak Health notes that this affects those from all walks of life and of all ages, and that these conditions aren’t defined by any one specific SUD and mental disorder combination. Instead, the most common conditions seen in people with SUD are as follows:

• Attention deficit hyperactivity disorder (ADHD)
• Conduct disorder
• Major depressive disorder
• Post-traumatic stress disorder (PTSD)
• Schizophrenia
• Anxiety and other mood disorders
• Bipolar

On the other hand, Ontrak Health says that patients with mental health disorders often misuse substances like:

• Alcohol
• Tobacco
• Stimulants
• Marijuana
• Opioids
• Prescription drugs
• Hallucinogens

While individuals can have both a mental disorder and a SUD, one didn’t necessarily cause the other. Ontrak Health explains that research suggests three possibilities to explain why mental and substance use disorders coexist:

• Common risk factors — Studies show SUDs and mental disorders run in families, with certain genes making some more vulnerable than others. Environmental factors, like trauma or stress, can create genetic changes handed down through generations, contributing to the development of both disorders.
• Mental disorders can contribute to SUDs — Field scientists found that people with anxiety, PTSD, depression, and other mental disorders may utilize alcohol or drugs as self-medication, leading to SUDs down the road. Additionally, the changes in the brain that occur in people with mental illnesses could enhance the rewarding side effects of substances, increasing the likelihood of continued usage.
• SUDs can trigger mental disorders — Ontrak Health says that substance use can incite brain structure and function changes, making individuals more likely to experience a mental disorder.

Diagnosing Co-Occurring Disorders

Practitioners note that making an accurate diagnosis in the case of two or more simultaneous disorders is challenging — several symptoms are the same for both disorders, increasing the difficulty of pinpointing the actual condition.

Ontrak Health explains that providers should utilize several comprehensive assessment tools to reduce the likelihood of a misdiagnosis. After all, accurate diagnoses are required for effective treatment delivery.

Upon solidifying the diagnosis, practitioners tailor treatment plans to ensure the patient’s specific amalgamation of mental disorders, SUDs, and symptoms are soothed.

Treating Co-Occurring Disorders

No two co-occurring disorders are the same, even when patients are diagnosed with the same combination. Every person reacts to treatment differently, necessitating highly individualized plans for each person.

Ontrak Health reports that when someone has both a SUD and a mental health disorder, well-established practitioners note the efficacy of treating these simultaneously rather than separately. Healthcare providers consider the specific addiction, mental health condition, and the patient’s age before recommending treatment plans.

Typically, clinical professionals provide behavioral therapies in conjunction with medications to handle co-occurring disorders.

Behavioral Therapy

Extensive research has found a few effective behavioral therapies for treating individuals with co-occurring mental and substance use disorders. Such therapeutic techniques for adults include:

• Cognitive behavioral therapy (CBT) — A talk therapy designed to help people learn healthy coping mechanisms by challenging irrational thinking and changing behavior.
• Assertive community treatment (ACT) — A community-based care that focuses on outreach and individualized treatment plans.
• Dialectical behavior therapy (DBT) — Involves concepts of acceptance and mindfulness while teaching skills that help control intense emotions, improve relationships, and reduce self-destructive actions.
• Contingency management (CM) — Encourages healthy behavior by offering rewards or vouchers.
• Therapeutic communities (TC) — A common type of residential treatment helping people develop healthier attitudes and behaviors.

Medication

Ontrak Health explains that alongside therapies, practitioners prescribe various medications to treat the SUD and lessen the symptoms of the coexisting mental disorder. Research indicates a plethora of medications are particularly effective for treating alcohol, nicotine, and opioid addiction.

Conclusion

Co-occurring disorders are not unusual for people in mental health treatment. However, it is important for practitioners to treat these issues simultaneously. While many may suffer under the same conditions, treatment plans should be highly individualized. There is a plethora of medication options and/or behavioral therapies that may help individuals who suffer with these conditions. While the link between substance abuse disorders and mental health issues may be unknown, options are available to those who are experiencing any combination of them.