Introduction
Over the years, research has been intensified on the issue of co-occurring disorders. The increased prevalence of these conditions has caused this to define and understand them and integrate a proper treatment. Moreover, distinguishing between these co-occurrences, comorbidity, and dual diagnosis has also accelerated the process to ensure no confusion arises across the three. Therefore, in understanding these illnesses, it is essential first to describe them in-depth and identify examples to assess and relate the issues that arise in treatment.
Description
Co-occurring disorders can be described both based on the dictionary definition of its conjoined words and clinically. The first definition has it that the condition arises when two or more things simultaneously disturb something’s order (Manukonda, 2018). This definition provides a superficially meaning and often leads to confusion between the term and comorbidity. However, clinically, individuals with the condition are deemed to have one or more illnesses related to drug and substance abuse and one or more mental health issue (Manukonda, 2018). A diagnosis of this is made when at least one disorder from each type is established to exist independent of another.
Nonetheless, care is taken to ensure that such a conclusion is not made based on the clustering of symptoms emanating from a single disorder as it amounts to a misdiagnosis. Therefore, doctors engaged in their identification must ensure that they are accurate and convinced that the symptoms possessed by a given patient link to both a substance abuse issue and mental health condition.
Examples of Disorders and Substances Abused
Major Depression
Major depression entails a persistent feeling of lack of interest, sadness, and a sense of despair that may be assumed to be irritability. However, it is essential to differentiate it from regular mood fluctuations, which are common life experiences. According to the World Health Organization, over 264 million individuals live with the condition, with women being the most affected (Martínez-Vispo et al., 2018).
It affects people of all ages and is considered a leading disability cause as well as a significant overall global disease burden contributor. Moreover, it affects schools, families, and workplaces functionality, leading to strained relationships and depreciated performance. At its worst, it leads to suicide which alone contributes to 800,000 deaths annually (Martínez-Vispo et al., 2018). Therefore, its co-occurrence with an addictive or substance-related disorder makes it lethal.
In most cases, individuals with depression drift to cocaine use and addiction. The drug is preferred because it gives the affected an intense energy burst and fills the brain’s pleasure centers leading to a europhic feeling. Its users are thus able to overshadow the depressive disorder symptoms at least temporarily (Martínez-Vispo et al., 2018). With continued use, the body develops tolerance forcing the individuals to use more and more for effectiveness as they try to enhance their moods. To some, this is a way of self-medicating which only worsens their condition. In the long-run, they suffer from both cocaine addiction and major depression, making it even more challenging to get proper treatment.
Schizophrenia
This other disorder is linked to a variety of issues related to behavior, thinking, and emotions. In most instances, it is associated with hallucinations, delusions, disorganized speech, and the reflection of an impaired functionality ability (Khokhar et al., 2018). Moreover, it affects occupational and educational performance leading to discrimination, stigma, and even human rights violation. Though there is no certainty about its cause, it affects over 20 million worldwide, with such individuals likely to die earlier than the general population (Khokhar et al., 2018). However, it is rare in individuals older than 45years and also uncommon in children. It is prevalent when an individual gets to his/her twenties as the symptoms become more distinct. Early diagnosis is thus vital and a key element in effective treatment.
More than not, the disorder co-occurs with poly-drug addiction and alcoholism. About 50% of people with schizophrenia exhibit illicit drug dependence and alcoholism, with over 70% heavily dependent on nicotine (Khokhar et al., 2018). These individuals also portray heavy cannabis abuse, which elicits relapse as it acts as a stressor. Apart from these, some are also dependent on cocaine, ecstasy, opium, or even methamphetamine. This prevalence of heavy dependence on a range of substances and alcohol by these patients is linked to their neurobiological aspects, medication side effects, psychosocial factors, and genetic vulnerability. It is therefore essential to connect these relationships to advance the requisite treatment to patients with this condition.
Panic Disorder
This disorder arises when an individual experiences unexpected and repeated panic attacks. It refers to the condition that arises from rampant intense fear surges and peak discomforts with such individuals always in fear. In most cases, it leads to specific physical symptoms such as sweating, increased heart rate, and breathing difficulties (Cowley, 2016). In the U.S., the prevalence rate is deemed to be between 2% and 6%, with about 50% of these cases considered severe (Cowley, 2016). Additionally, it coexists with other mood disorders, and it often makes the individuals feel that they are experiencing a heart attack or even dying. The condition is linked to stress, genetics, brain functioning changes, and sensitive temperament (Cowley, 2016). However, it is essential to distinguish regular panic attacks from those that arise from this condition.
In a bid to suppress the disorder’s symptoms, individuals are likely to drift to alcohol addiction. This is because its consumption leads to slowed reflexes and the patients feel relieved. Therefore, they tend to develop a cycle of repeated use whenever panics set in. A study shows that most patients think that alcohol solves their attacks almost immediately, and the continued use is based on self-medication (Cowley, 2016). Therefore, it is highly likely that panic disorder patients develop an addiction in their lives.
Assessment and Treatment Issues
Due to their prevalence, assessment and treatment of co-occurring disorders is a growing issue in the medical field. However, this has been inhibited by a range of factors emanating from the nature of co-occurrence (Manukonda, 2018). The primary issue is the failure to examine either one of these conditions comprehensively. This often arises due to the symptoms of one overshadowing the other. Moreover, most medical personally lack the knowledge and skill to assess and identify these conditions. Their training is often based on either mental disorders identification or substance abuse conditions but not both (Priester et al., 2016). Additionally, healthcare systems lack a single assessment and treatment procedure for such co-occurring conditions. This leads to billing and diagnostic restrictions that delay final healthcare delivery (Priester et al., 2016). It is essential to identify such instances and come up with proper mitigative measures.
Conclusion
Co-occurring disorders continue to endanger the lives of several individuals. It is growingly essential to establish proper measures to ensure that mental conditions do not overlap with alcohol and substance abuse and vice versa. If such a balance cannot be struck, it will be essential to develop therapeutic measures to assess and treat the conditions simultaneously. Therefore, healthcare departments must prioritize co-occurring disorders diagnosis whenever they have patients exhibiting such symptoms. They should also take reasonable care to avoid misdiagnosis.
References
Cowley, D. (2016). Alcohol abuse, substance abuse, and panic disorder. The American Journal of Medicine, 92(1), 41-48. Web.
Khokhar, J., Dwiel, L., Henricks, A., Doucette, W., & Green, A. (2018). The link between schizophrenia and substance use disorder: A unifying hypothesis. Schizophrenia Research, 194, 78-85. Web.
Manukonda, V. (2018). Co-occurring disorders and treatment. Journal of Addiction Research & Therapy, 09(06). Web.
Martínez-Vispo, C., Martínez, Ú., López-Durán, A., Fernández del Río, E., & Becoña, E. (2018). Effects of behavioral activation on substance use and depression: A systematic review. Substance Abuse Treatment, Prevention, and Policy, 13(1). Web.
Priester, M., Browne, T., Iachini, A., Clone, S., DeHart, D., & Seay, K. (2016). Treatment access barriers and disparities among individuals with co-occurring mental health and substance use disorders: An integrative literature review. Journal of Substance Abuse Treatment, 61, 47-59. Web.