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Surabhi Verma

Understanding the Complex Interplay Between Mental Health and Addiction in Dual Disorders

Audience: High School Students


Over the course of six years, the number of programs that offered treatment for Dual Diagnosis increased by four percent. Photo generated by Chat GPT-4.


In 2010, American singer and songwriter Demi Lovato checked into rehab for her cocaine addiction. This ongoing affliction caused her to resort to manipulation and lies in an attempt to cover up the severity of her addiction. She would secretly take cocaine on planes and sneak drinks of vodka from Sprite bottles. Thirty minutes was the most she could stand before needing more cocaine. Lovato was only 19, realizing that her last bit of her teenage years, which should have been fun and rebellious, were instead overtaken by this addiction. Only after she checked into rehab did she realize that she had both addiction and bipolar disorder – a dual disorder. 


A dual disorder, a type of co-occurring disorder, is a term to describe a person who has both a mental health disorder and a substance use disorder simultaneously. Examples are alcoholism and depression, prescription drug addiction and anxiety, and marijuana addiction and schizophrenia. On average, over four million people in the United States live with a dual disorder, with more than 50% of them not receiving treatment for either disorder. Regardless of which comes first, the development of one disorder does not necessarily increase the risk of a second (meaning that just because a person has one disorder, does not mean the second disorder will always develop). However, the co-occurence of both generally results in the symptoms of one disorder worsening that of the other. 


If a mental health disorder occurs first, the lack of treatment for the symptoms may cause some people to cope using alcohol or illegal drugs. If drug abuse comes first, its long term addiction can cause mental and emotional struggles. Common risk factors like genetics and environmental factors are thought to play a role in the development of either disorder. Symptoms of a substance use disorder include withdrawal from one’s family and friends, sudden behavioral changes, engaging in risk activities, a high tolerance for the substance, and the need of the substance in order to function. Symptoms of a mental health disorder include extreme mood changes, confusion, avoidance of social activities, and suicidal thoughts. 


Treatment for both disorders happens at the same time. This can include medication, behavioral therapy, support groups, and in-patient care. Some medication could be provided for one or both disorders that help reduce the symptoms of both conditions in a dual disorder. For example, bupropion has been approved by the FDA for treating depression and nicotine dependence. Behavioral therapy includes cognitive behavioral therapy and dialectical behavioral therapy. Cognitive behavioral therapy teaches how to cope with and change ineffective patterns of thinking. Dialectical behavioral therapy aims to reduce self-harm behaviors, such as drug use, cutting, and suicidal thoughts and actions. Support groups are extremely helpful in giving the emotional and social support necessary for maintaining sobriety (the state of being sober). Group members share their experience, answer each others’ questions, and provide tips on how to overcome daily challenges. Sometimes in-patient care from a dual diagnosis treatment center is the most beneficial. There, medical attention and mental health care is provided, including therapy, support, and medication.


Being the support to someone who has a dual disorder can be challenging. They may deny the presence of their disorders entirely and therefore are not willing to receive treatment. On top of this, the journey of recovery after treatment begins can be a lengthy one. It is important to be encouraging and supportive of the person on every part of the road, accepting them even in their mistakes or potential relapses. Dual disorders can affect anyone, from celebrities and influencers to everyday people like you and me. Just because the disorder can’t be “seen,” does not mean it does not exist. People may relapse, as did Lovato after being six years sober. However, it is crucial to remember that full recovery is possible and liberating. If you are struggling, ask for help. People are always here for you. 


Call 988 for the Suicide & Crisis Lifeline.



Bibliography:

Bupropion - StatPearls. (n.d.). NCBI. Retrieved September 3, 2024, from https://www.ncbi.nlm.nih.gov/books/NBK470212/


Demi Lovato and Sobriety. (2024, January 23). I Am Sober. Retrieved September 3, 2024, from https://iamsober.com/en/blog/demi-lovato-sobriety


Demi Lovato's Addiction and Bipolar Disorder: a Dual Diagnosis in Rehab. (2016, June 14). The Cabin Chiang Mai. Retrieved September 3, 2024, from https://www.thecabinchiangmai.com/blog/demi-lovatos-addiction-and-bipolar-disorder-a-dual-diagnosis-in-rehab/


Dual Diagnosis: Definition & Treatment. (n.d.). Cleveland Clinic. Retrieved September 3, 2024, from https://my.clevelandclinic.org/health/diseases/24426-dual-diagnosis


Facts and Statistics About Dual Diagnosis. (n.d.). Michael's House. Retrieved September 3, 2024, from https://michaelshouse.com/dual-diagnosis/facts-statistics/


What is Dual Diagnosis? A Review of Examples and Treatment Options. (2022, January 17). Teensavers. Retrieved September 3, 2024, from https://www.teensavers.com/post/what-is-dual-diagnosis-a-review-of-examples-and-treatment-options

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