Co-Occurring Disorders

In an attempt to gain a position as a psychologist, I will be discussing schizophrenia and the disorder’s casual factors, associated symptoms, the areas of the brain it affects, and the neural basis of the disorder. I will continue on to discuss appropriate drug therapies. In addition I will also be reviewing two separate case studies, each on a different disorder. I will be examining each problem from the perspective of a bio psychologist. I will define the patient’s diagnosis at length I will relate each case to the nature-nurture theory, and talk about any helpful drug interventions or solutions for each disorder. When talking about drug intervention, it is also important to discuss the positive and

“Hallucinations and voices that caused schizophrenia and other psychotic disorders have been stopped with the use of new medications”. (MHT, 2) “Just as aspirin can reduce a fever without curing the infection that causes it, psychotherapeutic medications act by controlling symptoms,” (MFMI, 4). “Another advantage of these medications is an increased understanding of the causes of mental illness. Scientists investigate the results of the medications, and through these results, they have learned a great deal about the working of the brain system.” (MFMI, 4) The use of new drugs has made it possible for mentally ill persons to live a normal life.

Co-occurring disorders can be difficult to treat due to the complexity of symptoms. Both the mental health and substance abuse disorders have biological, psychological, and social components assessed throughout the treatment process. Co-occurring disorder individuals battle to maintain their sobriety as they need to find services for both mental health and support groups catering to their unique needs.

Practice: This article first identifies the scope of the problem, followed by the effect of dual diagnosis on treatment outcome, followed by how individual PTSD treatments work and how they view substance abuse, followed by addressing the problems with sequential treatment of PTSD/SUD, lastly addressing the integrated treatment approaches. These implications are supported by empirical data collected from various studies.

According to the Substance Abuse and Mental Health Services Administration (2009) the most effective dual diagnosis treatment plans combine mental health and substance abuse programs contain interventions that are customized for the client. While inpatient James will receive an Integrated Dual Diagnosis Treatment (IDDT) plan personalized for him (Boyle & Kroon, 2006). The treatment plan for James must include the problems, symptoms, goals, outcomes, methods and services to be successful (Stevens & Smith, 2013).

Individuals with a mental illness often turn to drugs or alcohol to reduce their symptoms, as opposed to or in addition to seeking treatment for their illness. This problem is much worse than previously imagined, with experts estimating 65 percent of prison inmates suffering from a dual diagnosis. The prevalence in the general population is likely very high also, thus anyone with a mental illness or substance abuse problem may find they need specialized care.

A statistical piece of information that was interesting is that how the number of mental disorders increases as the number of substance abuse disorders increases as well. Services, U.D. (2005) states the likelihood of mental disorders rises alongside with substance abuse dependencies. With the rise of both abuses at the same time, it complicates treatment for the mental disorder patients that have drug use however, multiple drugs is normal for those who are substance abusers (Services, U.D., 2005). The reason this information is found to be interesting is because with the two disorders rising at the same level, it appears that the challenges will be harder and more co-occurring disorder patients are going to need help with their issues. As a counselor, one must be dually competent to treat these clients or have staff available to treat the clients who have co-occurring disorders to ensure an effective outcome.

Strengths and Weaknesses for Integrated Treatment In a perfect world, integrated treatment approaches for all clients is a thorough, thoughtful, and positive approach to the overall recovery of the individual, especially for those with co-occurring disorders. Currently, through my professional work as a drug and alcohol case manager, both site and field-based, I see the strengths as a collaborative and integrated approach to treatment for these individuals, including a variety of programs and professionals, ranging from drug and alcohol treatment providers, mental health counselors, psychiatrists, and certified recovery and peer specialists. Van Wormer and Davis (2018) highlighted the evidence-based Assertive Community Treatment (ACT) approach

Certain screening tools are highly underutilized by providers everywhere. “Despite the high prevalence of mental health and substance use problems, too many Americans go without treatment – in part because their disorders go undiagnosed” (SAMHSA-HRSA, n.d.). Perhaps part of the problems is that providers may not have enough time with the patient to discuss current medical problems as well as screen appropriately for an underlying mental illness. “Diagnosis and treatment of alcohol-related problems are time-intensive procedures that often are difficult to implement in busy clinical settings” (SAMHSA-HRSA, n.d., para. 13). This time constraint may make providers more apt to shy away from figuring out a patient’s underlying mental illness. Currently,

Many individuals suffer on a daily basis with one mental disorder let alone multiple. Few have the resources needed to cope and can turn to other methods of improvement without thinking about the potential outcomes of addictions and worsen their condition. Mental disorders are often than not linked to substance abuse because of the stigma placed over humanity. Society places such a constricting grasp on what is considered normal that people are hiding their symptoms and attempting to mask them to get by; only causing chaos to their lives. It is easier to try an attempt to mask symptoms with alcohol and other narcotics. I chose to focus on Borderline Personality Disorder (BPD) mixed with Substance Abuse for the focus of this piece. All of this can be alleviated by erasing the stigma we 've placed and given these people the many methods of help they seek. One of the first things to think about is the comorbidity between abuse disorders and other mental disorders from an epidemiological standpoint. What is comorbidity exactly? The term was introduced to “refer to any distinct additional clinical entity that has existed or that may occur during the clinical course of a patient who has the index disease under study.” Which basically means when two or more medical conditions ensue simultaneously or consecutively in the same individual they are commonly said to be comorbid. 1

Substance abuse in people with co-occurring severe psychiatric disorders and substance abuse disorder contributes to worse prognosis. As well as more relapses and rehospitalizations, housing instability, impaired social functioning, homelessness. This includes legal problems as well. The advancement of combined treatment models that target both disorders at the same time by the same clinicians are ideal. Individuals with co-occurring mental illness, especially schizophrenia, and substance abuse problems are often non-compliant with treatment. They also have difficulty engaging in outpatient care. (K.T. Mueser 2013). In this paper, I will address co-occurring illness such as schizophrenia and substance abuse. Then, convey a suggested plan

Substance abuse complicates almost every aspect of care for the person with a mental disorder. When drugs enter the brain, they can interrupt the work and actually change how the brain performs its jobs; these changes are what lead to compulsive drug use. Drug abuse plays a major role when concerning mental health. It is very difficult for these individuals to engage in treatment. Diagnosis for a treatment is difficult because it takes time to disengage the interacting effects of substance abuse and the mental illness. It may also be difficult for substance abusers to be accommodated at home and it may not be tolerated in the community of residents of rehabilitation programs. The author states, that they end up losing their support systems

Clearly, this is a very serious disorder, which is often utterly incapacitating. Therefore, individuals urgently require efficacious treatment, both for survival and for quality of life, and many different kinds of treatment and therapy are used. This paper will examine the use of two of these, cognitive behavioral therapy and drug therapy, and evaluate which one is better. It will take the position that drug therapy is a more effective therapy for treating schizophrenia than is cognitive behavioral therapy.

Post-Traumatic stress disorder (PTSD) affects many different people in different ways. Along with post-traumatic stress disorder often comes a co-morbid aspect that patients see as coping mechanisms for the post-traumatic stress disorder that they know little about. Post-traumatic stress and alcohol/substance abuse addiction often find themselves closely related due to the vast amount of individuals who use alcohol or other substances to treat the symptoms of PTSD. When a patient takes on substance abuse, they no longer have one disorder to deal with, they have two. Patients and counselors

Unfortunately with over a third of patients diagnosed with schizophrenia non adherent to their prescribed medication (Haddad, Brain & Scott, 2014) the development of medication compliance can be a vital intervention for patients in the acute environment. In the case of Bruce repeated reinforcement of tasks, ongoing behavioural interventions involving de-escalation techniques and establishment of a routine to improve his level of functioning will also be key nursing interventions to assist in the improvement of Bruce’s current mental and physical