A significant number of those in the grip of addiction are presenting with, what is termed, co-occurring disorders. The most common additional problem someone with drug or alcohol addiction has is a secondary addiction or compulsive disorder, such as over-eating, gambling, sexual compulsion or co-dependency. In addition, many addicts present with a co-occurring mental disorder, the most common of which are depression, anxiety, or bipolar disorder. Successful treatment is thus necessitated by a thorough understanding of the complexity of addiction, using a model that aims to address the whole picture.
Poor emotional management skills
It is generally acknowledged that the age at which an addiction manifests, marks the cessation of person’s emotional maturity. What drives a substance abuse, at least initially, is a desire to experience feelings that are different from what one is actually feeling. And the inability to sit with difficult feelings is immediately aided through the use of a mood altering substance, whatever the drug of choice. So while poor emotional management skills may pre-date the addiction particularly in early recovery, this difficulty will come to the fore, and likely mimic symptoms of mental health issues. In addition, post acute withdrawal syndrome, a distinct set of symptoms that can last up to 6 months after the cessation of intake of the drug of choice, can resemble or even aggravate already existing mental health symptoms.
What came first, the chicken or the egg?
People suffering with eating disorders often present with obsessive compulsive symptoms (OCD), that are manifested in highly ritualistic eating patterns. Discovering whether the eating disorder is borne out an underlying obsessive compulsive disorder or whether the obsessive compulsive behaviours are merely a symptom of the eating disorder, can be vital in order to get to the route cause and prevent relapse. If the OCD symptoms are in fact an underlying mental disorder, then these symptoms will persist post successful treatment of the eating disorder. This procedure is the same regardless of the drug of choice, and will invariably guide the treatment course.
Is recovery possible where dual diagnosis is concerned?
How then, one might ask, does someone with both problems recovery? The simple answer to this is naturally, to treat both. However, according to Richard Atwater, a clinical professional counsellor with a thorough knowledge on addiction and dual-diagnosis, the reality is not always that simple. For mental health concerns medications and psychotherapy are the treatment of choice. ‘The difficulty is uninformed sufferers may think they can substitute the therapy and meds for recovery, or that now the mental-health concerns are manageable, the substance abuse will disappear and both assumptions are dangerously false’, Atwater warns. Successful treatment is thus contingent on a treatment provider who is equipped to tackle the complexities of both disorders, whilst thoroughly evaluating over time, that what needs to be treated is in fact being treated.