Understanding mental illness and addiction as dual disorders requires an understanding of both diseases and how the co-disorders affect each other. This kind of co-morbidity is difficult to treat. Both diseases can mask symptoms of the other and or have very similar symptoms. Symptoms of drug abuse, such as extreme anxiety, depression, paranoia, delusions and hallucinations are similar to symptoms of mental illness. These symptoms impact a person's life causing a lack of self-care and a decline in functioning. These can also be symptoms of psychiatric problems. (Cutter, Elam, Jaffe, and Segal, 2008) Due to the similarity of symptoms, diagnosis of addiction in a mental hospital and transversely mental illness in a treatment center can be very difficult to diagnosis. When treating this kind of co-occurring diseases many aspects come into play.
According to the American Psychological Association (2007, December) "New research reveals that this type of dual diagnosis may stem from a common cause: developmental changes in the amygdale, a walnut-shaped part of the brain linked to fear, anxiety and other emotions." Similar results have been found, by research done by other institutions. The Genetic Science Learning Center (GSLC) at the University of Utah stated "Historically speaking, the idea of addiction as a brain disease is a very new one. People once saw addiction as a personality flaw and a sign of weakness. This stigma still persists in society today and is a major challenge for addicts and the people who treat them (2006a)." This concept multiplies when you add mental illness as a second primary disorder.
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In the past both diseases have been treated as bad behavior or as an invalid diagnosis. In an abstract from an article published in The Journal - Addiction Research Foundation; a call to both the mental health field and the drug and alchol field was sent out. The very counselors who were treating these patients needed to become educated in spotting co-occurring disorders. Both fields needed to recognize the other field in order to make sure the patients were receiving proper care. If one or the other disorder was not be treated even the best intetions could harm the sick individual seeking help. (Spotting Dual Disorders, 1993 Feb/March) In the thirteen years since this article was published great strides in the dual diagnosis for addiction and mental illness have ocurred. It does appear that if there is hope for the mentally ill, who are addicted, it is imperative that both diseases are addressed.
New Research shows a 6:1 ratio in persons suffering from the disease of addiction and mental illness, and without mental illness (Genetic Science Learning Center, 2006a). These ratios varied according to which research source they were found. In a separate research study it was found: Fifty-three percent of drug abusers and 37% of alcohol abusers have at least one serious mental illness, Roughly 50% of individuals with severe mental disorders are affected by substance abuse, 29% of all people diagnosed as mentally ill abuse either alcohol or drugs, 16% of jail and prison inmates are estimated to have severe mental and substance abuse disorders. (Cutter, Elam, Jaffe, and Segal, 2008) The one thing all the research sources searched had in common was that the ratio of addiction in the mentally ill was always higher than in the general population. All this information leads to the question, "Which came first the chicken or the egg?" The answer is both.
Here are few examples of how an addict can become mentally ill and how a mentally ill patient can become an addict. This is just a sample of how this occurs. The GSLC reported "that individuals with a particular variant of the COMT (catechol-o-methyltransferase) gene may be more likely to develop schizophrenia if they smoke marijuana regularly. As many as 1 in 4 people may have this variant (2006a)." In this case the drug started the mental illness.
Ritalin is a drug that is good example of how the treatment for one disorder can become the cause of another. In a separate report, also published by GSLC, it explained how the drug Ritalin, used to treat the disorder ADHD (attention deficit hyperactivity disorder), can be a gateway drug to addiction. Although, Ritalin has helped thousand of people to control their symptoms, it is a stimulant very similar to cocaine. Over time in can cause unwanted changes to the brain. Ritalin itself has become an abused substance since it so similar to cocaine. Ritalin and cocaine actually compete for the same binding sites on neurons in the brain. Many children suffering from ADHD are taken off Ritalin when they become adults. Many of these children become addicted to cocaine (2006b). In this case the drug prescribed for the illness causes the addiction
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There is also the reverse example with ADHD when undiagnosed in adults. Adults with ADHD often become addicts because the cocaine helps them feel calm and in control (2006b). In this case, the addict is unknowingly self medicating an undiagnosed disorder. The same can be said for many other types of illegal drugs.
In an article publish in Science Daily; Dr. Potvin came to many of the same conclusions. His research showed that up to 50 percent of mentally ill patients also suffer from drug addiction. He did a study on how drug addiction affected the brain and found that in many of the dual diagnosed patients there was a deterioration of the cerebral structures. Most of his research included patients who were schizophrenic. Patients with this disorder seemed to be more sensitive to drugs and to the effects of drugs. Dr. Potvin's study showed a clear correlation between drug addiction and the worsening of mental illness symptoms â€¦Dr Potvin stated, "The odds that a mental disorder manifest in an individual can increase if he or she consumes drugs." (University of Montreal, 2009 February) Scholars in the mental health field and the addiction field have argued if one caused the other or not. In some cases the answer is yes, in others no. However, the very definition of dual diagnosis indicates that both diseases exist independent of each other. Both diseases must be addressed simultaneously for the patient to get better. The fact that a mental health patient will use alcohol or illegal drugs to self medicate means the patient can not be treated for just addiction. If the mental health issues are not simultaneously addressed the patient is doomed to continue in his/her addictive behavior. Like wise the addict who becomes mentally ill because of the drug or alcohol abuse will not be able to sustain the reprieve from the mental illness if the addiction is not addressed.
How dual diagnosed patients are treated has changed over the years. The preferred way to treat co-morbidity is in treatment centers dedicated to treating only dual diagnosed patients. (Cutter, Elam, Jaffe, and Segal, 2008) However, many of the top Drug and Alcohol centers in the country are beginning to address co-occurring disorders. Fortunately, some centers have taken a proactive approach to dual diagnosis of mental illness and addiction. Caron Treatment Center in Wernersville, PA employs a licensed psychologist on every unit to make or eliminated any potential undiagnosed mental illness. Some of the psychiatric hospitals will send a patient to rehab after getting their mental illness under control. Unfortunately, not every drug and alcohol treatment center address mental illness and not every psychiatric hospital will address addiction. Hopefully, the upward trend to treat both disorders simultaneously will continue.
In the article, Spotting Dual Disorders is Key, it states that, "In the US, Alcoholics Anonymous (AA) is actually at the forefront of heeding the prevalence of mental disorders among alcoholics, says Dr Goodwin, who refers to it as a "rapprochement" between the AA movement and the psychiatric community." (1993,Â February). The recovery community AA has embraced all people who how suffer fromaddiction even if they have a second mental illness diagnosis In the basic text of Alcoholics Anonymous (self titled) it says: "There are those to who suffer from grave emotional and mental disorders, many of them do recover if they capasity to be honest.(2001,p. 58)" This text was first publish back in 1939. The early members of this organization recognized long before the medical profession that not only did the mental illness need to be addressed but, if the man was to have full remission he needed to address his problems with alcohol.
In an interview with an unidentified member of AA, the person explained "If someone is suffering from the disease of alcholism and a mental illness, the member is encouraged to seek outside help. The member is also encouraged to follow the advice of the expert in that field. AA can help someone with the disease of alcoholism, but when it comes to the mentally ill, most do not recover unless they also address their mental disorder." (2009, September 15th) AA also holds twelve step meetings that are considered dual diagnosed meetings. These meetings allow the member to speak about their struggles with their mental illness and alcholism. They are encouraged to follow their doctor's advice on how to treat the mental illness and to follow AA's advice on how to recover from alcoholism (Spotting Dual Disorders, Feb/Mar 1993). It does appear the recovery community of AA and the psycriatic community is coming closer together.
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In conclusion, the research shows this is not a new problem. Both addiction and mental illness are diseases of the brain and should be treated simutaniously. With the new breakthroughs in the medical field there is more hope now than ever before- that people suffering with both diorders will be properly diagnosed. When a patient with dual diagnosis of addiction and mental illness is given the proper treatment for both disorders recovery can truly happen.
A new hope is on the horizon.