What’s The Difference Between Comorbidity and Dual Diagnosis?
There is a strong link between substance abuse and mental health disorders. More than half of those diagnosed with a substance use disorder are also diagnosed with a mental health illness. The terms dual diagnosis, co-occurring disorder, and comorbidity are often used interchangeably to describe a person who is diagnosed with both a mental health disorder and substance use disorder. While dual diagnosis and co-occurring disorders are synonymous, comorbidity is slightly different.
Understanding Comorbidity: Definition and Examples
Comorbidity is a diagnosis describing two or more co-occurring illnesses. With substance abuse, it involves drug or alcohol dependency and health complications connected to substance use. Two separate conditions must be present and the interaction between the two worsens one another. These conditions can occur simultaneously or one after another.
It is common for a person with drug or alcohol addiction to later develop another mental health disorder or vice versa. While the term comorbidity can apply to drug addiction and mental illness, it can also describe someone who has heart disease and high blood pressure. These conditions can cause one another, worsen the other, and complicate treatment. The term would not apply to two distinct diagnoses that are not connected. For example, if someone with a substance use disorder has a sprained ankle.
Comorbidities concerning substance use disorders are often thought of as mental health issues, but they can also include physical conditions. Some common comorbidities in addiction include:
- Depression
- Anxiety
- Bipolar disorder
- Liver/kidney disease
- Diabetes
- Chronic pain
- Certain cancers
- Anorexia/bulimia
- Nicotine addiction
What is Dual Diagnosis? A Detailed Explanation
Dual diagnosis describes an individual with a substance use disorder and specifically a mental health disorder at the same time. Common mental health disorders include depression, anxiety, PTSD, and bipolar disorder. Research has found that more than 50% of people with drug and/or alcohol addiction also struggle with a mental health condition. These conditions can be interconnected and exacerbate each other, creating a cycle that can be difficult to break without professional help.
Individuals with mental health disorders may use or abuse substances in an attempt to self-medicate their symptoms. However, drugs and alcohol have a profound effect on brain chemistry which can worsen mental health symptoms after its initial effects have worn off. The person may then use it again or at higher doses to address worsening mental health symptoms. With frequent substance abuse, the person can develop dependence and eventually addiction.
Drug and alcohol abuse can also trigger a pre-existing mental health illness. Substance abuse can alter brain structure and chemistry in a person with a family history of mental illness or genetic factors, triggering those genes to express themselves. Research has also shown that common risk factors, such as environment and genes, can contribute to both mental health disorders and substance use disorders.
Key Differences Between Comorbidity and Dual Diagnosis
The main difference between comorbidity and dual diagnosis is that dual diagnosis deals with the combination of substance abuse and mental health issues, such as anxiety and depression. For example, dual diagnosis would be drug addiction and Post Traumatic Stress Disorder (PTSD). Comorbidity can include these types of diagnosis but also physical conditions, such as liver disease brought on by chronic alcohol abuse. Comorbid conditions can also refer to disorders outside of substance use disorders, such as a person who has diabetes and high blood pressure.
Another difference is that in dual diagnosis the two conditions happen simultaneously. These disorders can cause one another and worsen the other as well. In comorbidity, medical conditions can happen simultaneously or one after another. For example, a person may have a heart condition and later develop high blood pressure as a result. In comorbidity, these conditions may or may not interact with one another. In both dual diagnosis and comorbidity, the diagnoses are associated with worse health outcomes and more complex clinical management. Essentially, all dual diagnoses are a type of comorbidity but not all comorbid cases are a dual diagnosis.
Common Conditions Associated with Comorbidity
Comorbidities are coexisting health conditions that can be mental, physical, or both. They can be related to one another or occur independently. While some conditions may cause one another, in comorbidity they can also simply be coincidental. Comorbid disease can complicate disease management and lengthen treatment. Some common conditions associated with comorbidity include:
- Anxiety and depression.
- High blood pressure and heart disease.
- Obesity and many conditions such as type 2 diabetes, stroke, sleep apnea, and cardiovascular disease.
- Alcohol use disorder and liver disease.
- Anorexia and anemia.
- Cancer and depression.
Mental Health Disorders Often Seen in Dual Diagnosis
About half of people who struggle with a substance use disorder, also have a mental health disorder. Either one can cause the other and make the disorder worse. Dual diagnosis can include a combination of two or more substance use disorders (SUDs) and mental health disorders. Some of the most common mental health disorders seen in dual diagnosis as it relates to drug and alcohol addiction include:
- Major depressive disorder
- Generalized anxiety disorder (GAD)
- Post-traumatic stress disorder (PTSD)
- Schizophrenia
- Bipolar disorder
- Attention deficit hyperactivity disorder (ADHD)
- Obsessive-compulsive disorder (OCD)
- Panic disorder
- Antisocial personality disorder
The Importance of Accurate Diagnosis in Treatment
When it comes to comorbidity and dual diagnosis, often co-occurring disorders may have similar symptoms. There are no standardized diagnostic criteria for dual diagnosis and often psychiatric disorders and addiction may overlap, making it difficult to accurately diagnose. An inexperienced clinician may miss a dual diagnosis and only the substance use disorder.
Treating both disorders simultaneously is critical for successful recovery. If a person is using drugs or alcohol in an attempt to mask their mental health symptoms, they are likely to relapse if their mental health issues continue. It can be difficult to find mental health services that offer both substance abuse and psychiatric services as many programs focus on one disorder rather than both. Integrated treatment approaches are needed to help patients stop substance abuse while also addressing mental health issues which may be the root cause of their addiction.
Treatment Approaches for Comorbidity vs. Dual Diagnosis
Treatment approaches for comorbidity and dual diagnosis are somewhat similar. They both aim to address all conditions simultaneously and treatment takes into account co-occurring disorders. For example, someone with a comorbidity of pain and alcohol use disorder may not be given any type of addictive painkiller, such as opioids, by their clinician because of their SUD diagnosis. Other types of treatment approaches besides medication in dual diagnosis and comorbidity can include diet and exercise, behavioral therapy, psychotherapy, support groups, and long-term residential treatment.
How WhiteSands Treatment Addresses Both Comorbidity and Dual Diagnosis
WhiteSands Treatment offers mental health treatment for patients presenting with a primary diagnosis of addiction or substance use disorder. Programs for dual diagnosis are available in both inpatient and outpatient settings. Our clinicians are trained to recognize and treat co-occurring disorders commonly associated with substance abuse including anxiety disorders, depression, bipolar disorder, and PTSD.
Mental health and substance use disorder treatment at WhiteSands consists of medication management, cognitive behavioral therapy (CBT), dialectical behavior therapy (DBT), eye movement desensitization and reprocessing (EMDR), and group therapy. Programs are personalized for each patient and focus on the root causes of addiction while providing the right tools and aftercare support for long-term recovery.
If you or a loved one are struggling with substance dependence and a mental health disorder, it is crucial to receive treatment from a dual diagnosis program for successful recovery. Please give us a call today at (877)855-3470 to speak to one of our addiction specialists who can guide you on the next steps to take.
If you or a loved one needs help with abuse and/or treatment, please call the WhiteSands Treatment at (877) 855-3470. Our addiction specialists can assess your recovery needs and help you get the addiction treatment that provides the best chance for your long-term recovery.