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MENTAL HEALTH MATTERS: Co-morbid: It's not forever

Herald Democrat - 6/12/2020

This column strives to make mental health topics easily accessible and understandable for everyone in our community. When we read about mental health, just like any health condition, there can be confusing terms. It's helpful to unpack these terms and explain how they are used.

The term 'Co-morbid disorders' are sometimes referred to as 'co-occurring' disorders. They are mental health issues that severely interfere with the quality of a person's life and they occur simultaneously with an equally damaging condition. In these cases, it's sometimes difficult to tell which came first; the chicken or the egg. Perhaps one problem led to the other or vice versa.

Co-morbidity usually starts with some kind of trauma, or some kind of genetic predisposal. For example, a child may have been subjected to repeated child abuse or a youngster may have been diagnosed with ADHD, a condition that entails uncontrolled hyperactivity. An adult may be facing financial difficulty or have experienced the death of a spouse of other family member. In order to cope with these life altering situations, people develop ways to cover the pain. A mental health disorder can occur when those ways of coping begin to cause major problems in a person's life. That abused child may grow into a rebellious and angry young person, using anger and criminal behavior to cover the pain of abusive memories. That adult dealing with the grief of loss may have begun drinking heavily to dull the pain of broken heartedness. These additional conditions that develop are considered to be 'co-morbid' conditions.

Clinicians working with substance use disorders rarely encounter a person who is struggling with addiction that has not been using the drugs to avoid overwhelming feelings of grief, anxiety, depression, incompetence, physical conditions. The list could go on. However, as the title indicates – it doesn't have to be forever. There used to be a division among mental health clinicians regarding treatment. Some thought that if a person was diagnosed with a mental disorder and at the same time was addicted to a drug, the mental disorder got pushed aside until the drug addiction was "cured." Today, however, many addiction professionals are more than competent to spot problems, make assessments, and treat mental health conditions while also treating addictive behaviors. There has been a major shift in treatment plans that incorporate treating mental health and substance use disorders. This is called an integrated approach and provides faster and more reliable results.

Community Health Centers like Texoma Community Center provide the ideal structure for finding an integrated approach for co-morbid conditions. There has been an amazing transformation from the old MHMR days to centers that can treat the whole person. While 'co-morbid' used to be a term that sounded very bad, today clients do not have to live with one condition or the other forever, they can receive amplified recovery as treatment is coordinated for both. That's not bad – that's very, very good.

Betty Towler is a Licensed Master Social Worker and Licensed Chemical Dependency Counselor at Texoma Community Center in Sherman, Texas. The views and opinions expressed here are the author's own and do not necessarily reflect those of the Herald Democrat.

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