Which Came First: An Overview of Co-Occurring Disorders
Co-occurring disorders, often referred to as part of a dual diagnosis, the presence of an additional psychological diagnosis in addition to addiction. For example, anxiety and addiction can be co-occurring disorders. Anxiety may be replaced with depression, schizophrenia, or a number of other mental disorders.
It is quite common for addicts to have a co-occurring disorder. The Journal of Child and Adolescent Substance Abuse published research that revealed the following percentages of people had a co-occurring disorder in addition to a marijuana addiction:
- 28.8% were diagnosed with anxiety disorders
- 37.7% were diagnosed with depression
- 74% were diagnosed with conduct disorder
- 77% were diagnosed with ADHD
According to the Substance Abuse and Mental Health Services Administration, in 2014, roughly 7.9 million adults in America had co-occurring disorders.
Many people wonder whether an addiction triggers a psychological condition or whether the condition triggers the addiction. The answer? It depends. The human brain and psyche are complex and an adjustment in the functioning of one part can lead to an adjustment in another part and that extends from addiction to condition and from condition to addiction.
In all honestly, the reason that mental disorders and addiction have such an overlap isn’t completely understood, but four common models were developed to explain the relationship between substance use disorders and co-occurring ones. The following discussion will explore the relationships between both disorders and examine those that are the result of addiction and those that are the reverse.
If you have co-occurring conditions and you feel nervous about the impact that could have on your drug and alcohol treatment, don’t worry. Call Disorders.org and speak to a knowledgeable representative that can answer all of your questions and direct you to appropriate treatment.
Bidirectional Model
Social isolation and poverty are environmental factors that lead to co-occurring disorders.
Proponents of this model highlight interpersonal and socioenvironmental factors, including:
- Drug availability
- Social isolation
- Lack of culpability by adult caregivers
- Poverty
They believe these factors contribute to both co-occurring and substance use disorders via a complicated interaction between genetic susceptibility and environment. The model states the existence of either substance use or co-occurring disorder increases vulnerability for acquiring the other.
This model has never been evaluated systematically.
Common Pathway Model
This model highlights shared genetic or environmental factors, which are believed to cause both disorders.
According to the National Institute on Drug Abuse, children and adolescents with conduct disorders and other psychiatric conditions face a higher rate of addiction than other young people. In this instance the model would contend that both disorders shared roots.
Other sources discovered relatives of patients with an opiate addiction had higher rates of alcoholism, substance use disorders, and major depression. In this instance, the model indicates genetic factors increased the individual’s susceptibility to both disorders.
Primary Co-Occurring Disorder and Secondary Substance Use Disorder Model
This is known as the self-medication model. It argues preexisting psychological disorders are a major cause of substance use ones because drug addicts have begun using to decrease the painful feelings that result from their mental disorders.
An opiate addict may be using to reduce anxiety. A cocaine addict may be using the stimulant to self-medicate depression.
If nicotine is viewed as a drug (and it is certainly addictive) then this model is born out among smoking schizophrenics, of whom 75 to 95 percent are smokers. The smoking certainly didn’t cause the schizophrenia, but the high rates of smokers among the group point to cigarettes serving as some sort of succor to these individuals.
If this model is followed, treating the mental illness resolves the addiction.
Should Comorbid Disorders Be Treated Together?
Someone with any type of addiction is very likely to have a mental health disorder such as anxiety or depression.
Primary Substance Use Disorder and Secondary Co-Occurring Disorder Model
This model is the reverse of the previous one. It is known as the disease model. It argues substance use disorders actually are the cause of most co-occurring disorders in addicts.
In some cases, this can be substantiated. For example, stimulant users are prey to something known as stimulant psychosis, a condition that mirrors the symptoms acute schizophrenia spectrum psychosis. So similar are the two, it has been argued that amphetamine-induced psychosis could be used as a model for primary psychotic disorders. I this instance, the mental disorder is certainly the result of the drug use.
If this model is followed, treating the addiction resolves the mental illness.
It is tricky to determine which came first, but that doesn’t matter once you are grappling with the pair of them in day to day life. You just know that you need help. We can give you the support and treatment you deserve. Call 888-647-0051 (Who Answers?) and get started today.
