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Addiction and Mental Health Disorders

Addiction and Mental Health Disorders: Which Comes First?

It’s very common for mental health disorders and addiction to occur together. This is called having a “dual disorder.” Historically, experts in the field of addiction believed that alcohol dependence and substance abuse dependence were secondary conditions that resulted from untreated mental health disorders such as depression, PTSD and bi-polar disorder. Mental health disorders and addiction are both chronic diseases of the brain and most people who develop them are usually genetically predisposed. Today, studies have shown that it is unclear which condition precedes the other. Extensive research on the subject was done using data collected from The Collaborative Study on the Genetics of Alcoholism (COGA), The Study of Addiction, Genetics, and Environment (SAGE), The Yale-Penn genetic study of substance dependence, and The National Health and Resilience in Veterans Study (NHRVS). Findings showed that substance abuse disorders can cause depression and that depression increases the risk for substance abuse disorders.

So which came first, the chicken or the egg?

When it comes to treating dual disorders, it doesn’t really matter which came first. In order for treatment to be effective, specialists must adequately address both disorders. For years, doctors assumed that mental health disorders were at the root of the problem. Standard treatment focused solely on treating the depression, with the hopes that the alcohol abuse associated with it would eventually stop. But as addiction treatment began to evolve in the late 60s, many enlightened medical professionals started to see the success their patients were having in 12-step recovery programs. Their patients were getting better. The idea that addiction could be the primary disorder was a departure from mainstream thinking. And why is this important? Because up until now, many clinicians have been trained to treat either the substance abuse or the mental health disorder, but seldom both. In many of these cases, the chance of relapse was very high.

Treating a dual disorder requires specialized knowledge from clinicians who understand the complexities of addiction and mental health disorders. It’s imperative that addiction treatment centers are equipped to treat dual disorders, with a fully integrated program that handles all of a patient’s needs. With this level of specialized care, individuals suffering from dual disorders can live happy, healthy and productive lives.

Read more about Positive Sobriety Institute’s Dual Disorders treatment program.

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Positive Sobriety: The Book
Daniel H. Angres, MD

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