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Dual Diagnosis: Illness of the Mind or Disease of the Brain?

This year, within the U.S., about one out of five adults will come up against mental illness. Of the 20 million adults who have faced substance use disorder, more than half also experienced a co-occurring mental illness. According to the Substance Abuse and Mental Health Administration, around 56% of men and women with dual diagnosis leave either one or both conditions untreated. Establishing whether mental illness led to substance abuse or vice versa is difficult with these behavioral health disorders, since the relationship of comorbidity is high.

What Is Comorbidity?

When two illnesses or disorders have either a sequential or simultaneous presence within an individual, experts say the patient’s condition is comorbid. The interactions between the two conditions have a direct effect on how each of the illnesses manifests within a person’s life. Comorbidity could imply that one disease caused the other, but this is not a correct prognosis all the time-even if symptoms of one illness appeared before the onset of the other one.

Is Addiction a Mental Illness or a Brain Disease?

The field of psychiatry has turned from the term “disease” when testing and attempting to determine the many unknown causes of psychological conditions. However, the use of “disorder” seems in-line with the nature of addiction-as the behavior that individuals carryout with a substance use disorder is often dysfunctional, driven by incessant syndromic cravings, and marked with continual excessive use of illicit drugs.

What might be more challenging to conclude is whether addiction is a “brain” disorder or disease. The compulsive behavior of those who develop a dependency-despite any current or foreseeable adverse consequences-shows a signature characteristic that exists in many mental illnesses. However, if you compare substance use disorders, as neural phenomena, to other chronic brain diseases, such as dementia, a subtle distinction is clear between the diseased.

People with dementia lack control because of changes in the brain. Whereas, a person with addiction may also lack control from changes altering the brain to use substances, but the individual makes deliberate choices with his “mind” to engage in behaviors with the aim of self-medicating or seeking reward and incentive for those choices. Some argue under the disease fallacy of addiction, changes that occur in the brain misconstrue the person’s normal hierarchy of needs to desire new priorities-which are to buy illicit substances and consume them.

Theories on Dual Disorders of Addiction and Mental Illness

Researchers continue to conduct studies to gain more insight and a better understanding of the dual diagnosis. Below summarizes what they conclude about the comorbidity of unhealthy substance use disorders and psychiatric disorders combined as a mental health issue:

  • Psychiatric disorders can cause sufferers to self-medicate, which could lead to substance use disorder with their continual efforts to treat medical symptoms using illegal drugs-for example, many patients who have schizophrenia smoke cigarettes to improve their cognition.
  • Certain narcotics and medications that users may misuse can bring about one or more symptoms consistent with other mental illnesses-sometimes following a significant number of years misusing. An example of this would be the elevated risks of psychosis when smoking marijuana.
  • Psychiatric illnesses and addiction are both disorders brought about by factors which overlap, such as exposure to early trauma or stress, underlying brain or cognitive deficits, or genetic dispositions and vulnerabilities.

Causation of this complex is difficult to determine with comorbidity being oh-so prevalent within a person having a dual diagnosis. Depending on whom within the health industry you speak to, with the brain disease fallacy of addiction being a withstanding, widespread assertion of its nature, provocation to challenge its validity may never fully gain momentum. Substance use disorder may or may not be a brain disease. However, as far as addiction being a psychiatric disorder, more ongoing research should continue to reveal with less ambiguity the reciprocated influence and indistinct connection of substance use disorders and co-occurring mental health issues experienced by a person.

Ramon Antonio Matta is the founder of Content Done Write, LLC. We offer premium on-demand online writing services for many content needs, including original articles, like this one, across multiple niches, white papers, promotional copy, creative fiction and nonfiction, academic papers and more, customized to your order specifications, style or brand’s voice.


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