Co-occurring disorders (COD) are those that include both an addiction and a mental illness. For instance, you might suffer from depression as well as an alcohol addiction. Or you might have been diagnosed with Generalized Anxiety Disorder (GAD) and have developed an addiction to benzodiazepine tranquilizers, which are commonly prescribed for anxiety.
Co-occurring disorders are very common. You can imagine that an individual experiencing symptoms of depression or anxiety or the mood swings of Bipolar Disorder might want to quell those uncomfortable feelings with drugs or alcohol. This is one common reason that causes an individual to have a co-occurring disorder, also known as having a dual diagnosis.
If you experience a mental illness in addition to having an addiction, there are some important questions you might want to ask your psychiatrist. The following are a list of those questions. They are meant to help you find a doctor that is supportive and looking out for your best interest.
Is it difficult to get an appointment with you?
If you are experiencing acute symptoms of depression, anxiety, or mania, you’ll want to have your doctor available. He or she can adjust medication, admit you to a hospital, if needed, or have a therapeutic session. However, the availability of that doctor is crucial especially during times of crisis.
Can I contact you during a crisis?
Mental health professionals, like doctors, typically have a method for handling crises when their patients are in need – especially when a crisis happens during holidays, evenings, or weekends. Some therapists will have an after-hours answering service or they will provide you with the number of a clinic to go to during emergencies or they might provide a recorded message with instructions on what to do during a crisis.
What is my diagnosis and how did you obtain it?
Some psychiatrists might prescribe medication, especially during a crisis, even without having a diagnosis. They do this in order to stabilize your mood while they rule out diagnostic possibilities. They might have a working diagnosis, for example. However, asking about a diagnosis is the right of every patient along with knowing the possible diagnoses he or she is considering.
What is the treatment plan?
It is typical for the treatment of most psychiatric illnesses to include both medication and psychotherapy – a dual diagnosis. Often, there will be a psychiatrist to manage medication and a therapist who will facilitate therapy. Both of medication and therapy have been proven to be an effective form of treatment. However, a treatment plan might also include psycho-education, family therapy, support groups, lifestyle changes, and/or instructions on what to do when symptoms become acute.
When can I expect to feel better?
Different medications will take various lengths of time to feel their effects. It could take two weeks, one month, or longer. This is a good question to ask of a psychiatrist or whoever is managing the medication regime.
How will I know that I am getting better?
Having a co-occurring disorder is tricky because feeling better might mean slipping into a period of depression or intense anxiety while you are withdrawing from alcohol or drugs, or if you are waiting for your medication to kick in. However, when depression begins to lift, you might also be able to experience other symptoms such as better sleep, more energy, more socialization, crying less, and fewer thoughts of suicide. A mental health professional will also be able to answer this in more detail.
What if I begin to feel worse?
Some medications will have effects that just aren’t working, particularly if a combination of drugs are being used. The best course of action is to communicate all the side effects and symptoms you are experiencing to your doctor. Some medications may not work at all and instead have an adverse effect.
What side effects should I expect?
This is an important question to ask before you begin to take any medication. Most psychiatrists will be aware of any serious side effects of medication before making a prescription. You should ask questions about side effects, effectiveness, risks, and options before deciding on a medication treatment.
Will you work with my other providers?
A psychiatrist will often coordinate treatment with your therapist, drug counselor, addiction treatment team, and anyone else supporting your health. Doing so can facilitate the effectiveness of a treatment plan as well as provide significant support.
In addition to these questions, it’s important to communicate the severity of your addiction and how your addiction might affect your ability to follow your treatment plan. Although these questions are optional, they can empower you and facilitate having a close connection to your doctor. In this way, you can voice your opinion, make adjustments, and ensure that you are receiving the best care possible.
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