Many members of my support group, myself included, have both a mood disorder and substance abuse problems, past or present.  Is this really that common?

Substance abuse is a problem for many of those suffering from a psychiatric disorder.   A person who has both a mental illness and a substance abuse problem is referred to as dually diagnosed.  In a recent survey of its members by the National Alliance for the Mentally Ill, eighteen percent of those who responded indicated that substance use occurred in their household.  Of these families, sixty two percent indicated it was a serious problem.  The results of this study are conservative compared to other research.   Many studies have shown that those with a major depressive disorder also are more likely to use substances.  Moreover, adults with major depression are more likely to be substance dependant than their non-depressed counterparts.  Those with antisocial personality disorder, schizophrenia, and manic depression are particularly susceptible.  Untreated substance abuse problems in dually diagnosed patients can lead to difficulties with compliance, decline in overall health and added stress for day-to-day management.

How is it treated?  Does the treatment work?

Dual diagnosis can be effectively treated.  Both the substance abuse problems and the psychiatric condition must be specifically addressed.  Dually diagnosed patients do best in specialized treatment programs.  The effects of each condition may exacerbate or cause other symptoms and neglect of any illness may result in relapse.  For example, an individual who is treated for alcohol abuse may not respond well if the symptoms of the underlying depressive disorder remain pervasive.  Specific treatments vary depending on the concomitant illnesses.  Alcohol abuse can respond well to traditional treatments such as abstinence coupled with support group attendance.  Other types of substance dependance may require more aggressive procedures. It is important to establish realistic goals, educate the sufferer and his or her family, focus on rebuilding or building a stable environment and discuss relapse prevention strategies. Treatment of psychiatric illnesses should be undertaken by psychiatrist. A careful history and observation will help identify psychiatric disorders, if they exist undiagnosed in those suffering from substance abuse problems.  Psychiatric medications such as antidepressants have been shown to be safe even in individuals with coexisting drug and alcohol problems.  Most psychiatric medications, with the exception of benzodiazepines such as Valium and stimulants such as Ritalin, are not abused by patients with substance abuse problems.