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Diagnosing a Co-Morbidity

Figuring out where the line is drawn for a dual diagnosis can be difficult. There are many different factors to consider when diagnosing a comorbidity, such as the severity of each disorder, when either started, preexisting medical conditions, and more. It’s not easy to truly diagnose a comorbidity. Many may feel that they’re experiencing a dual diagnosis, when in reality their mental illness was preexisting or is actually just a group of symptoms that appear to be a mental illness. Actually diagnosing a comorbidity can be difficult, but with the right knowledge and mindset going in, it can be easier to both understand and be more aware of comorbidities.

Many doctors and psychologists have hesitations about diagnosing a comorbidity too quickly. One reason for this is the prevalence of symptomatology. Simply put, symptomatology is the display of symptoms that resemble a disorder but aren’t actually said disorder. For example, if someone experiencing benzodiazepine withdrawal may feel as though they’re experiencing a panic disorder, when in reality it’s likely to be a panic attack that will subside after the user ceases abusing drugs. Many other disorders like depression, psychosis, and anxiety that occur because of a substance abuse issue often disappear after long periods of abstinence as well. However, what happens when a substance use disorder causes or increases the severity of a mental disorder, or a mental disorder leads to drug abuse?

It’s not uncommon for a drug to tap in to a latent mental disorder. While the causes of mental disorders are as varied as they are mysterious, we do know that genetic predispositions play a role in the likelihood of someone developing a mental illness. When combined with environmental factors like stress or trauma, a mental disorder can be only one small push away from coming into existence. Sometimes, this push can come in the form of drug use. Some studies have shown that substance abuse can increase one’s vulnerability to a mental disorder, meaning that drug use can push someone who is close to a mental disorder over the edge. While some links have been found between substances and psychosis, other studies are trying to determine whether depression and anxiety work the same way.

While substance abuse can lead to disorders, it’s also common for mental illnesses to lead to substance abuse, whether intentionally or otherwise. Those who struggle with depression may use alcohol or other substances to combat depression, which due to the chemical interactions that take place during intoxication, will only worsen after the substances have worn off. It can also begin innocently, as those with anxiety may be prescribed a benzodiazepine that can be highly addictive. The drug then creates a dependence, and anxiety and a substance abuse disorder begin to coexist.

This isn’t limited to alcohol or anti-anxiety prescription pills. Anyone with any mental disorder, whether it be insomnia or depression, is vulnerable to a comorbid disorder if they abuse substances. Mental illnesses are a daily struggle, and substance abuse is a constant battle. When combined to form a dual diagnosis, they can be more dangerous together than they ever were individually.