Dr. Kasey Dean is a psychiatric-mental health nurse practitioner and dual-diagnosis specialist at Las Vegas Recovery Center.
Below he shares his thoughts on the relationship between mental illnesses and substance use disorders.
For many people with a substance use disorder, their problems didn’t just start with their first drink or drug—they began months and even years beforehand. Maybe they struggled with social anxiety disorder as a child or experienced periods of chronic depression as a young adult. Whatever the issue, it is common for those with substance addiction to also experience other “co-occurring” mental illnesses, also known as “dual diagnosis”.
50% of those diagnosed with mental illness also have a substance use disorder.
Only 7.4% of the reported 8.9 million diagnosed with dual diagnosis receive treatment for both disorders.
This is an issue that Dr. Kasey Dean, an integrated treatment specialist, hopes to change in his new role as Nurse Practitioner at Las Vegas Recovery Center. “This is a complex problem affecting our country. A contributing factor affecting many Americans is a lack of access to comprehensive treatment,” explains Dr. Dean, Psychiatric-Mental Health Nurse Practitioner (PMHNP). “Unfortunately, most of the country is treated for addiction and mental illness by the legal and jail system. These institutions’ main objectives are not directed at providing comprehensive patient care. For example, while incarcerated, an individual may experience detoxification while his underlying chronic pain or mental illness may go untreated. Consequentially, the individual does not have the resources or tools necessary to ‘deal’ with such problems and maintain sobriety.” Although Las Vegas Recovery Center has programs in place to treat co-occurring mental illness, the center hopes to improve and grow these services with the addition of Dr. Dean. The following is a look at the definition and possible causes of dual diagnosis and the importance of integrated treatment.
Why do mental illness and addiction so often occur together?
Mental illness is defined as the inability to control behaviors, thoughts, or moods. Someone who struggles to control feelings of intense anxiety or depression, for example, will frequently turn to a substance for help. This is called “self medicating” and is an issue many Americans experience, whether they have been diagnosed with a mental illness or not. As a culture, it has become socially acceptable to medicate away the pain; reaching for a beer to ease the anxiety of walking into a party full of strangers, for example, or a smoking a Friday cigarette in celebration of the end of a stressful work week. Instead of sitting with the discomfort or addressing the pain with healthier coping techniques, we try to deny its existence or erase it entirely. And for a percentage of the general population, what may have started off as a well-intentioned method of dealing with life’s little—and big—hardships, will eventually become a destructive dependency. As strange as it may seem to those unfamiliar with mental illness, many with a dual diagnosis do not view their substance abuse as a negative. Oftentimes, addiction—even with all of its inherent problems—is preferred over what is seen as the only alternative– living a life dictated by uncontrollable thoughts or emotions. Compared to mental illness, which can cause drastic and daily mood swings, alcoholism or drug addiction is frequently seen as predictable. It’s a painful constant perhaps, but a constant nonetheless. Many with a mental illness find this comfortable familiarity to be a relief from the struggles of their day-to-day existence.
What are the causes of dual diagnosis?
According to the National Institute on Drug Abuse, it can be difficult to ascertain which issues come first: mental illness or addiction. Dr. Dean agrees, saying: “The relationship between substance use and mental health is dynamic. It’s a two-way street.” Some studies have suggested, as previously mentioned, that individuals with mental health disorders, such as schizophrenia, may turn to alcohol or drugs as means of lessening symptoms.
88 percent of people with schizophrenia smoke cigarettes, with many reporting that nicotine helps decrease feelings of paranoia and anxiety.
Some studies, however, have shown that substance abuse may cause mental health issues to develop, particularly in underdeveloped brains of teenagers “Spice is an example of this,” commented Dr. Dean. “Spice is one name for synthetic marijuana. It’s been known to cause psychosis in people, including audio and visual hallucinations and paranoia, for instance. The damage can be permanent.” Alcohol is another example Dr. Dean cited, saying: “Alcohol use can precede or exacerbate depression symptoms. Since alcohol is a central nervous system depressant, it slows the brain’s normal activities. In addition, alcohol misuse may negatively affect an individual’s health, relationships, professional, and legal circumstances. These lifestyle factors, affected by an individual’s alcohol use, have a great impact on a person’s mental health and overall wellness.”
What can friends and family members do?
Loved ones can learn to understand and identify the signs and symptoms.
Why integrated treatment is important
When an individual with a substance use disorder seeks help, their addiction or alcoholism has often played such a prominent and destructive role in their lives that it can be difficult for friends, family members, and even health care professionals to be able to see other issues. Undiagnosed or untreated mental illnesses can lead to relapse, however, which is why it’s important mental illness is identified and addressed as part of a treatment plan known as “integrated treatment”.
How Las Vegas Recovery Center can help
Las Vegas Recovery Center looks at each patient as a whole person to identify and treat all ailments—physical, mental, and emotional. As Dr. Dean explains, “I view substance disorders under the umbrella of mental illness. There’s no separation. For addiction treatment to be effective, we must treat patients holistically, and that means treating their medical problems, their physical pain, and their emotional pain.” One of the greatest challenges for those with a dual diagnosis is learning new, healthier methods to cope with life stressors; methods that do not involve substance use. Dr. Dean recommends a combination of activities that emphasize self-care. “Developing a strong support of sober friends, exercising and proper nutrition helps. Practice self-care—medicate, do yoga, get a massage and ‘work your program’,” he advises. “You must be vigilant about your recovery—‘vigilant’ is the word I like to use a lot—because if you aren’t…if you don’t make your recovery program a priority, substance use can creep back in.” For more information on Las Vegas Recovery Center, a chronic pain and addiction rehab in Las Vegas, or to speak to an Admissions Counselor, please call the 24-hour admissions line at (888) 219-1158.