Why Are Co-Occurring Disorders So Common When It Comes to Addiction?

Addiction Recovery Publishing Addiction Recovery August 5, 2023

Why Are Co-Occurring Disorders So Common When It Comes to Addiction?

When it comes to addiction and recovery, we must focus on “first things first.” What this means is that we focus on the issues that require the most immediacy. This may include an intervention, a detoxification process, and a following treatment program. However, once the recovery process begins, it is not uncommon for other issues to rise to the surface. This includes co-occurring disorders. When this happens, it’s critical to get to the underlying core root causes of these disorders because the only way to fully heal at the cellular level is to address and treat all of the issues of both addiction and mental health.

The Prevalence of Co-Occurring Disorders

Many people may be unaware of the current prevalence of addiction and co-occurring disorders. The truth is that they are much more common than most people think. According to the National Institute on Drug Abuse (NIDA), “7.7 million adults have co-occurring mental and substance use disorders. This doesn’t mean that one caused the other and it can be difficult to determine which came first.” Also, “of the 20.3 million adults with substance use disorders, 37.9% also had mental illnesses,” and “Among the 42.1 million adults with mental illness, 18.2% also had substance use disorders.”

It is also important to note that these statistics most likely underestimate the number of people that are struggling with co-occurring disorders. The reason for this is that it is rather common for the symptoms of addiction to overshadow those of an unknown co-occurring disorder. For example, an individual struggling with substance use disorder (SUD) may be unaware that they also struggle with an anxiety disorder because some of the symptoms overlap, such as insomnia, depression, and unprovoked mood swings.

Understanding Co-Occurring Disorders and Addiction

According to the NIDA Common Comorbidities with Substance Use Disorders Research Report, there are “Three main pathways [that] can contribute to the comorbidity between substance use disorders and mental illnesses.” These include “Common risk factors [that] can contribute to both mental illness and substance use and addiction. Mental illness [which] may contribute to substance use and addiction,” and “substance use and addiction [which] can contribute to the development of mental illness.” This is the symbiotic nature of co-occurring disorders.

Co-occurring disorders often contribute to the severity of the symptoms of each other. For example, alcohol use disorder (AUD) will often elevate the symptoms of depression associated with mental illness because alcohol is a depressive substance. It is this interconnectedness of addiction and comorbidities that also often makes it so difficult to initially diagnose.

Why Co-Occurring Disorders Are Often Missed

There are many reasons why addiction and co-occurring disorders may be missed initially. As previously mentioned, the symptoms are often similar. Also, many recovery centers specialized in addiction are not specialized in mental health disorders, thus making it much more likely to miss the latter. The same goes for individuals getting help for a mental health disorder that also do not disclose the full extent of their alcohol or substance use. 

According to NIDA’s Comorbidities Report, “Establishing causality or directionality is difficult for several reasons. For example, behavioral or emotional problems may not be severe enough for a diagnosis (called subclinical symptoms), but subclinical mental health issues may prompt drug use. Also, people’s recollections of when drug use or addiction started may be imperfect, making it difficult to determine whether the substance use or mental health issues came first.” Ultimately, while, yes, it is important to get to the underlying issues of which issues may have caused the other, it is more important that they both be treated as soon as possible and at the same time.

The Importance of Treating Co-Occurring Disorders in Tandem

While it may seem obvious why both addiction and mental health disorders must be treated in tandem, that doesn’t mean that it always happens. This is because it is easy to get tunnel vision and focus solely on the issue that was first discovered. For example, it is easy to think that if addiction is the problem, then addressing it will be the solution. This is not the case with co-occurring disorders.

Co-occurring disorders make it difficult to treat one disorder without being impeded by the other. For example, it is hard to focus on the underlying causes of substance abuse when still distracted by the depression brought about by bipolar II disorder. Also, it is important to keep in mind that, in this example, the issues of bipolar II disorder are most likely intrinsically linked to those other underlying causes, and in some cases, they may be the primary root core cause.

One Disorder Can Trigger the Other

Just as one disorder may bring about the other, and as one disorder may interrupt the treatment of the other, one disorder may “retrigger” the other post-treatment if not addressed properly. This can happen in an emotional, mental, or even physical capacity.

If an individual is being treated for a mental health disorder but also has addiction struggles that aren’t being addressed, the physical components of drinking or using can knock them off of their recovery plan. Or, if they are attempting to recover on their own, symptoms of withdrawal and craving can bring back disordered behaviors that can act as coping mechanisms. 

Also, if an individual is being treated solely for addiction, but other co-occurring mental health issues are not addressed, the potential for relapse is significantly increased. It is not uncommon to attempt to treat symptoms of mental illness by self-medicating with substances. Ultimately, untreated co-occurring disorders represent a vicious cycle. That is why comprehensive addiction and mental health care is key. All issues must be treated to ensure a healthy long-term recovery.

The Importance of Comprehensive Addiction and Mental Health Care

As previously mentioned, there are many recovery centers that focus solely on addiction and others that primarily deal with mental illness. Here at Exclusive Hawaii Rehab, we are licensed and certified to treat both. In fact, we have a specific focus on treating those with dual diagnosis.

We focus on treating addiction and co-occurring disorders via individualized multi-tiered recovery plans. These plans generally fall under our “non-12-Step approach,” which includes “traditional” therapies, experiential therapies, and other holistic treatment options. However, we would like to note that many of our clients find it extremely helpful for their long-term journey to connect to 12-Step, Dahrma, or SMART recovery once they get home after their stay.

“Traditional” Therapies for Addressing the Core Root Causes of Co-Occurring Disorders

The key to healing at the cellular level is healing all aspects of the mind and body. Traditional mental health therapies and psychotherapies generally focus on the issues of the mind. More specifically, therapies like cognitive-behavioral therapy (CBT), dialectical behavior therapy (DBT), psychodynamic therapy, interpersonal therapy, and humanistic therapy focus on one’s disordered cognitions (thoughts) and phycology (emotions) so they can then begin to moderate and mitigate the negative behaviors associated with them.

These evidence-based therapies can help get to the underlying core root causes of both addiction and mental illness, which is a key component of healing and growing. However, it is also important to grow on a physically and biologically healthy level.

Nutrition Therapy and Co-Occurring Disorders

Many individuals that are struggling with addiction are also struggling with a lack of nutrients necessary to function at full capacity. That is why connecting with licensed nutritionists and licensed dieticians is crucial. They can help redirect how an individual takes care of their physical self, and taking care of the physical self is critical to all other aspects of cognitive and emotional recovery.

“Food Is Medicine”

Here at Exclusive Hawaii Rehab, we believe that “food is medicine,” and thus, the right medicine is critical for recovery. According to the peer-reviewed article New Approaches to Nutritional Therapy, “In order for foods to be therapeutically beneficial, the appropriate micro- and macronutrients must be delivered in a nutritionally dense format without contaminants. While plants are the main source of micronutrients, nutrient content can be altered with improper handling. Fruits and vegetables picked before their peak ripeness contain fewer phytochemicals.” That is also why we utilize horticulture therapy at our 30-acre luxury facility.

The Benefits of Horticulture Therapy

Here at Exclusive Hawaii Rehab, our clients grow on many levels, and they also literally grow the fruits and vegetables that help sustain their new healthy lifestyle. Onsite there are now lime, orange, tangerine, and longan fruit trees that help our nutritionists and naturopathic doctor to educate our clients on what healthy phytochemicals can be found in natural foods to combat the mineral deficiencies that many of us in recovery face. Food truly is medicine, and our clients learn that firsthand by literally getting their hands in the dirt and helping it to grow. However, horticulture therapy is not the only way that we utilize nutrients to help our dual-diagnosed clients heal.

The Benefits of Infusion Therapy for Recovery on the Cellular Level

Here at Exclusive Hawaii Rehab, we are uniquely qualified on the Big Island to offer Concierge IV infusion therapy. These nutrient, antioxidant, vitamin, and mineral-rich infusions help our clients recover on the cellular level. 

We offer such infusions as nicotinamide adenine dinucleotide (NAD) infusions which can help with exhaustion, stress levels, mental focus, enhanced mood, and physical wellness. Also, we offer glutathione infusions, which can reduce oxidative stress, decrease inflammation, and help the body to effectively eliminate toxins. These infusions work particularly well for those clients that are looking to recover from addiction. 

As with traditional mental health, and nutrition therapies, infusion therapies are almost always more effective when utilized alongside other treatment modalities. These modalities include those within the experiential realm.

Utilizing Experiential Therapies for Co-Occurring Disorders

Experiential therapies can often be overlooked because they technically don’t qualify as “evidence-based.” However, that does not mean that there have not been many studies conducted that show experiential therapies to be highly effective; it simply means that certain agencies (such as the Food and Drug Administration) have not officially signed off on them. 

This designation may be a good reason to incorporate experiential therapies into a foundational, evidence-based plan rather than rely solely on them. However, this designation should not be a deterrent to them altogether, especially when experiential therapies such as nature immersion therapy have been shown to be effective in aiding a positive recovery path.

The Benefits of Nature Immersion Therapy

According to the International Journal of Environmental Research and Public Health, “Besides physical health improvements, nature exposure can bring about positive influence upon psychological constructs such as boredom, friendliness, wellbeing, and liveliness.” Also, “Besides improvements to physical and psychological well-being, exposure to natural environments has been shown to bring about positive impacts on cognitive functioning.” Just as nutrition therapy heals us from the inside out, reconnecting with nature can quite literally heal us from the outside in. Also, there is no better place to acquire the healing benefits of nature than at Exclusive Hawaii Rehab on the Big Island of Hawaii.

The Healing Powers of the Ocean

Oceanscapes are sometimes overlooked when it comes to nature immersion therapy. This is a mistake. The Pacific Ocean, just steps from our recovery center, offers our clients to experience the therapeutic benefits of swimming with tropical fish and green sea turtles. There is also an opportunity to feed and swim with the majestic manta ray, which many clients have referred to as offering them a spiritual experience.

Also, the ocean does not merely offer immersion therapy. It also offers other mind-body recovery options, such as surf therapy. Exclusive Hawaii Rehab is located a mere 15 minutes away from a local break called Honoli’i that offers some world-class surfing and boogie boarding. Both the physical accomplishment of catching a wave and the meditative component of being one with the ocean can have lasting effects that carry long into our recovery lives. However, recovery in Hawaii doesn’t have to take place in the water; it can also happen on the beach, looking out over the horizon line.

A Holistic Approach to Recovery

Just as traditional, nutritional, and experiential therapies work well together, so do holistic means of treatment. The idea of holism is to utilize the interconnectedness of the mind-body. By taking a whole mind-body approach, one can feel the effects of physical and mental well-being simultaneously. This can happen via meditation, breathwork, massage, reiki, and yoga. All of these can take place on the white sands of the Big Island, looking out over the beautiful blue Pacific Ocean.

The Benefits of Yoga for Whole Mind-Body Recovery

Yoga has been shown to have positive emotional, mental, and physical effects for over 3,000 years. Yet, many people minimize it as solely a recreational activity. This is a fallacy.

According to the peer-reviewed International Journal of Yoga, “Yoga encourages one to relax, slow the breath and focus on the present, shifting the balance from the sympathetic nervous system and the flight-or-fight response to the parasympathetic system and the relaxation response. The latter is calming and restorative; it lowers breathing and heart rate, decreases blood pressure, lowers cortisol levels, and increases blood flow to the intestines and vital organs.” Yoga can help us grow and effectively round out an exceptionally comprehensive recovery plan. 

The Importance of Long-Term Recovery for Co-Occurring Disorders at Exclusive Hawaii Rehab

Here at Exclusive Hawaii Rehab, we don’t believe in one-note recovery. This is also why we have been so effective in treating co-occurring disorders. We don’t just focus on a diagnosis; we zoom out and focus on the whole self.

Recovery is not just about where we are at the moment. Recovery is about where we’ve been and, more importantly, where we’re going. At Exclusive Hawaii Rehab, we help clients heal at the cellular level so they not only get to where they want to be in recovery but are also who they want to be when they get there.

The idea that an addiction or mental health disorder is black and white is the first mistake one can make when searching for appropriate care. The truth is, more often, one can perpetuate the other. Learning about both one’s mental health and substance use can educate them about their triggers and how and why they respond to certain situations the way they do. Here at Exclusive Hawaii Rehab, we offer comprehensive recovery plans for treating co-occurring disorders. If you feel like you or a loved one may be struggling with addiction, mental illness, or both, you are not alone. We can help. For more information on comorbidities and how they can be treated, contact Exclusive Hawaii Rehab at (808) 775-0200.