Co-Occurring Disorders
A person who has alcohol or drug problems and emotional/psychiatric problems is said to have co-occurring disorders. To recover fully, the person needs treatment for both problems. Co-occurring disorders are more common than you might think. According to a report published by the Journal of the American Medical Association:
- Thirty-seven percent of alcohol abusers and 53 percent of drug abusers also have at least one serious mental illness.
- Of all people diagnosed as mentally ill, 29 percent currently abuse either alcohol or drugs and 60 percent will abuse either alcohol or other drugs some time during their lifetime.
What Kind of Mental or Emotional Problems are Seen in People with Co-occurring Disorders?
The following psychiatric problems are commonly found in persons with co-occurring disorders:
- Mood disorders , such as depression and bipolar disorder.
- Anxiety disorders , including generalized anxiety disorder, panic disorder, obsessive-compulsive disorder, and phobias.
- Other psychiatric disorders , such as schizophrenia and personality disorders
How Can a Physician Tell Whether the Person's Primary Problem is Substance Abuse or an Emotional Disorder?
At the initial examination, it may be difficult to tell. Since many symptoms of substance abuse mimic or mask other psychiatric conditions, the person must go through withdrawal from alcohol and/or other drugs before the physician can accurately assess whether there is a psychiatric problem also.
If a Person Does Have Both an Alcohol/Drug Problem and an Emotional Problem, Which Should Be Treated First?
Both problems should be treated simultaneously. For any substance abuser, however, the first step in treatment must be detoxification -- a period of time during which the body is allowed to cleanse itself of alcohol or drugs. Some persons with co-existing psychiatric problems will need mental health evaluation and treatment to get through detoxification.
What Does Treatment Involve?
Treatment for a psychiatric problem depends upon the diagnosis. For most disorders, individual and group therapy as well as medications are recommended. Expressive therapies and education about the particular psychiatric condition are often useful adjuncts. A support group of other people who are recovering from the same condition may also prove highly beneficial.
What is the Role of the Patient's Family in Treatment?
Whether treatments for substance abuse or a psychiatric problem, education, counseling sessions, and support groups for the patient's family are important components of overall care. The greater the family's understanding of the problems, the greater the chances for lasting recovery.
As a relative or friend, you play an important role in encouraging a person to seek professional diagnosis and treatment -- and to stay in treatment. By learning about co-occurring disorders, you can help this person find and stick with an effective recovery program.
How Can Family and Friends Help with Recovery from the Substance Abuse?
They need to learn to stop enabling. Enabling is acting in ways that essentially help or encourage the person to maintain their destructive bahavior pattern. For instance, a woman whose husband routinely drinks too much, might call in sick for him when he is too drunk to go to work. That's enabling. When family and friends participate in the recovery program, they learn how to stop enabling. If they act on what they've learned, the recovering substance abuser is less likely to relapse to drinking or taking drugs.
How Can Family and Friends Help with Recovery from a Psychiatric Condition?
They should be calm and understanding, rather than frightened or critical. They should be warm and open, rather than cool or cautious. Although it is fine to ask the person matter-of-factly about psychiatric treatment, that shouldn't be the only focus of conversation.
There Is Hope
The more you know about co-occurring disorders, the more you will see how substance abuse can go hand-in-hand with another psychiatric condition. As with any illness, a person with co-occurring disorders can improve once proper care is given. By seeking out information, you can learn to recognize the signs and symptoms of co-occurring disorders - and help someone live a healthier, or more fulfilling life.
For more information,contact the
Missouri Department of Mental Health, Division of Alcohol and Drug Abuse
P.O. Box 687, 1706 East Elm
Jefferson City, MO 65102
573-751-4942
1-800-364-9687
