Mick Broylin, not his real name, has been fighting demons for most of his adult life. As a teen growing up in Brooklyn, N.Y., Broylin crafted a very thick façade, hiding behind a skepticism and paranoia that helped pave a path of destruction. His only true friend was a crack pipe.
After playing the game for 20 years, Broylin finally hit a bottom that tore at his soul. He entered a 90-day rehab program where he began putting his life back together. Through counseling, he learned his addiction to crack was only a symptom of a deeper issue.
Broylin was diagnosed with post-traumatic stress disorder from a difficult childhood where he’d watched his mother being physically beaten by his father. His counselor explained that mental disorders often co-exist with substance abuse.
Medically termed co-occurring disorders, what Broylin learned about his addiction is becoming more prevalent.
According to Psychology Today, co-occurring disorders refer to the presence of two or more disorders, such as mental health and substance abuse disorders, at the same time. The term co-occurring replaces dual disorders and dual diagnosis because it is a more accurate description. All three terms, however, are used interchangeably.
Those who suffer with COD often have one or more disorder relating to alcohol or drug abuse and mental disorders. COD occurs when at least one disorder of each type can be established.
COD is especially difficult for sufferers since oftentimes their symptoms can be exacerbated by their other disorders. For instance, anxiety disorders might prompt the sufferer to use more alcohol, which may actually cause even more anxiety.
Moreover, substance use is maladaptive and can lead to addiction. When substance use is combined with a severe mental illness such as depression, schizophrenia or bipolar disorder, more dramatic symptoms are often experienced.
For example, people with COD are at higher risk for relapse of mental health or addiction recovery, hospitalizations, social isolation, homelessness, suicide, violence, sexual and physical victimization, incarceration and so on.
Dr. Troy Pulas, the medical director at WestBridge South Community Services located in Brooksville, said COD is prevalent among his patients. In fact, the foundation of WestBridge is to focus on treating COD to help people in their recovery.
“When we are talking about co-occurring disorders, we are talking about addiction and mental health and any additional medical issues,” Pulas explained. “People who have mental illness often have unrecognized addiction.”
In fact, national studies indicate that co-morbidity rates among COD are high when looked at as a whole.
“But when you look at specific disorders like schizophrenia, the co-morbidity rate jumps as high as 45 to 55 percent. And with bipolar disorder, it can be as high as 65 percent,” Pulas said.
Rates might be higher in certain medical diagnoses because patients are self-medicating to relieve symptoms of the mental disorders, Pulas said. Or, perhaps like with bipolar disorder, the patient may turn to alcohol or drug use to reach a similar euphoric experience they’ve had during their manic state.
Originally from California, Pulas did his residency at Boston University Medical Center in Boston. He moved to Hernando to become part of the new facility, WestBridge South, which officially opened in April 2012.
COD is common, Pulas said. Yet many recovery facilities only focus on one disorder at a time. Oftentimes patients are told to work on their mental issues first before attempting substance abuse recovery or vice versa.
WestBridge has found a better success rate treating both disorders simultaneously. In fact, the WestBridge concept was incepted after its founders, Al and Loralee West, struggled to find effective treatments for their loved one who suffered from COD.
“Like we did, other families struggling to find adequate care often bounce back and forth between drug treatment facilities and psychiatric hospitals. It can be a long and complicated process to find the right help,” they noted on the WestBridge website.
WestBridge has facilities in different areas of the United States, including Boston and New Hampshire. They opened the facility in Brooksville to accommodate people from all over the United States.
Pulas said that many of the clients that receive care from WestBridge are usually introduced to the facility by family members who are searching for solutions.
Many times, the clients seen by WestBridge have failed in other treatment facilities. “People will usually start with residential treatment and then out-patient treatment with psychiatric out-patient therapy,” Pulas said. But sometimes the symptoms get worse.
WestBridge offers all-inclusive treatments, whether out-patient or residential in-patient treatments, that typically extend at least 90 days with regular therapies that gradually transition them into normal life
WestBridge uses evidence-based practices designed for people with COD as well as Alcoholics Anonymous and other community-based mutual help groups.
This includes a multi-disciplinary team, cognitive behavioral therapy and motivational interviewing — comprehensive services offered under the same umbrella: stage-wise intervention, which meets each client at their specific stage change of addiction and mental illness and stage of treatment.
Mick Broylin celebrated six years of sobriety from his crack addiction that almost cost him his life. “It isn’t easy,” Broylin said. “I have to make a concerted effort to stay clean.” He currently attends regular AA meetings and receives outpatient therapy for his PTSD.
For more information about COD or WestBridge Community Services, visit their website at www.westbridge.org. WestBridge South is located at 7300 Grove Road in Brooksville and can be reached at (877) 461-7711.