In order to provide effective treatment to patients, doctors must first properly diagnose the disorders they are treating properly. Often times, patients have two or more conditions rather than just one. In fact, approximately 80 percent of Medicare spending goes to treat patients with four or more chronic conditions (“Defining Comorbidity: Implications for Understanding Health and Health Services”). When patients have a substance abuse problem and a mental illness, a number of factors can complicate the correct diagnosis of each disorder. Due to the frequency of comorbid conditions, doctors are searching for new ways to better identify these related conditions.
Complications in diagnosis
When comorbid conditions are present in an individual, the symptoms for each condition tend to mingle with each other. This can create challenges for proper diagnoses in several ways. First, the symptoms of one disorder can “hide” the symptoms of another disorder. For example, the symptoms of alcoholism are very similar to those of depression (Columbia University, “Assessing comorbid mental and substance-use disorders: A guide for clinical practice”). When doctors diagnose alcoholics, the symptoms of depression might get misattributed to the condition of alcoholism. Without receiving a diagnosis for all of their problems, comorbid patients will have a much more difficult recovery process.
Secondly, the symptoms of one disorder often mimic the symptoms of another disorder. For example, alcoholics both in the midst of intoxication and suffering withdrawal show symptoms similar to that of a depressive. When a doctor examines alcoholics without realizing that they have a substance abuse disorder, they might misdiagnose the patients as depressives. The problem could also be reversed, where depressives might be misdiagnosed as alcoholics even if their drinking is not abusive. Without the proper diagnosis, patients will receive treatment for the wrong condition.
Untangling the disorders
The challenges presented by comorbid conditions require doctors to remain more vigilant during the diagnosis process. In the past, mental health and substance abuse were regarded as unrelated conditions and treated by completely separate institutions. That has changed in recent years as research has revealed how interrelated the two types of conditions truly are. Doctors must analyze each patient closely to identify when mental illness and substance abuse intertwine. Doctors can do this by taking careful study of each symptom to ensure that conditions are not hiding or masquerading as comorbid conditions.
One useful clue lies in the way comorbid conditions tend to amplify each other (National Institute on Drug Abuse). For example, when patients display unusually amplified symptoms of alcoholism, this might be a clue that the very similar symptoms of depression are a contributing factor and also require treatment. Only by correctly diagnosing both disorders can patients receive the treatment they need to make a complete recovery.
If you or someone you know might be suffering from a substance abuse disorder, it might be intensified by comorbid mental illness. Call the Arizona Drug Addiction Helpline to get information and advice on how to seek proper diagnosis and treatment.