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What is a Dual Diagnosis?
When a person is diagnosed with a SUD and a mental health disorder at the same time, it is considered a dual diagnosis. The interaction between the two disorders makes treatment more complex. This can result in a higher risk of unfavorable health effects. A relatively state-of-the-art addiction recovery center can treat both substance use and mental health issues at once.
Previously, the belief was that simultaneous mental health problems and substance abuse could be treated separately. This was common until the 1990s. As a result, substance abuse and mental health treatment were considered separate.
When these two problems are combined, people frequently couldn’t qualify for mental health treatment until they had achieved sobriety. Because of the lack of sufficient treatment at that time though, many people were forced into programs that didn’t seem to address either illness. It is now known that individuals who have a dual diagnosis, struggle more with obtaining care since they often experience depression and anxiety along with other mental health issues.
What Should Be Included in Dual Diagnosis Care?
For the best chance of a full recovery, dual diagnosis treatment should include:
- Specialists in substance abuse and mental health treatment that work as a team to make sure the needs of both conditions are met.
- Psychotherapy, which has a key role in treating co-occurring disorders. Prescription medication may also be necessary.
- Therapy that allows the individual to make his or her own choices is the most reliable and commonly used approach.
- The involvement of spouses, partners, children, and any other family members whether they get treatment individually or participate in family meetings.
Warning Signs of a Dual Diagnosis
An evaluation by a psychiatrist or an addiction specialist is necessary to officially diagnose someone with a dual diagnosis. However, no matter what your line of work is, you can detect signs of something wrong in yourself or someone else.
Symptoms of SUD
- Has difficulty maintaining good grades or good performance at work or school
- Taking part in behaviors that are harmful to themselves or others
- Solving problems by stealing or lying
- Staying up late at night and sleeping during the daytime
- Quitting the use of alcohol, drugs, or gambling but frequently relapsing
- Speaking openly about regretting a habit
- Seeking a higher high through larger doses of drugs, more and stronger drinks, or more extreme practices
Symptoms of a Psychological Disturbance
– Isolation from others. Deliberately turning away from offers of support and friendship.
– Believing in things that aren’t true. Experiencing sensory events that others aren’t (hallucinations).
– Feeling hopelessness, despair, or worthlessness for several consecutive weeks.
– Following complex rituals to relieve anxiety and maintain high standards of order while doing hard mental and physical activities.
– Struggling to maintain a job, a home, or friendships because of mood swings or behavioral issues.
– Moods and energy levels change drastically.
– Using alcohol, drugs, and compulsive activities to manage mood or stress.
These signs add up to co-occurring disorders. Addiction treatment specialists with backgrounds in psychology are the best people to consult with for such a diagnosis. In a rehab center that has an integrated dual diagnosis program, intake counselors and specialists will evaluate a patient’s mental health and SUD history before designing a treatment plan.
Why Do Substance Use and Mental Health Disorders Occur Together?
Even though substance use and mental health disorders often occur together, it doesn’t mean that one caused the other. The truth is, it can be difficult to figure out which disorder came first. According to researchers, there are three possibilities for why substance use and mental health disorders co-occur together:
- There are common risk factors that may contribute to the development of both substance use and mental disorders. These risk factors include:
genetics
stress
trauma - Mental disorders can be partly responsible for drug use and SUDs. An example would be mental disorders changing the brain and making it more likely for a person to develop a substance use disorder. A person with a mental disorder that may start abusing drugs or alcohol in an attempt to feel better is another example of this.
- Substance abuse can contribute to the development of a mental health disorder. SUD alters the brain and may change it in ways that make a person more likely to develop a mental disorder.
What are Common Co-Occurring Disorders?
A large nationally representative sample revealed that people with mental, personality, and substance use disorders were at an increased risk of using prescription opioids for nonmedical use. Further research showed that 43% of people in SUD treatment for misuse of prescription painkillers also have a diagnosis or symptoms of mental health disorders such as depression or anxiety. Individuals with schizophrenia have higher rates of alcohol, tobacco, and other forms of drug abuse than the general population.
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Adolescents and Co-Occurring Disorders
It’s true that having a mental disorder in childhood or adolescence can increase the risk of drug use later on in life and cause someone to develop a substance use disorder. Some researchers have even discovered that mental illness may foreshadow a SUD. This suggests that the diagnosis of mental illness in youth can be what people need to receive treatment that will reduce the development of dual diagnoses.
One study found that adolescent-onset bipolar disorder provides a higher risk of subsequent substance abuse compared to adult-onset bipolar disorder. Other research also suggests that adolescents often develop internalizing disorders such as depression and anxiety while developing SUDs.
Can a SUD Cause Symptoms of Mental Disorders?
A person with a substance use disorder can struggle with some of the same symptoms as those suffering from natural psychiatric disorders. All of the consequences of a SUD with mental illness result directly from the dual diagnosis. Examples of this include the use of methamphetamine that has been linked with psychiatric disorders such as psychosis, mania, and Parkinson’s disease.
The stoppage of benzodiazepines may result in extremely severe anxiety. Suddenly stopping the use of stimulants may cause depression. Also, chronic alcoholism leads to adverse effects on cognition and memory (Korsakoff’s syndrome).
Diagnosis and Treatment Options for Dual Diagnosis
Diagnosis
How much care you need when suffering from a substance use disorder depends on how severely you are suffering from substance abuse. Therefore, people looking for help with SUDs and mental disorders need to be evaluated by health care professionals for each disorder.
Because it can be demanding to make an accurate dual diagnosis due to overlapping symptoms, the physician should use extensive evaluation tools to provide targeted treatment and reduce the chance of a missed diagnosis.
Treatment Options for Dual Diagnosis
Co-occurring disorders treatment will not be effective until it addresses both disorders. It is vital that treatment, which may include behavioral therapies and medications, be created to address the individual’s specific combination of disorders and symptoms. Such treatment should also consider the patient’s age, whether or not he or she has misused substances, and any mental disorders that the patient is suffering from.
Treatment for SUDs
Treatment for substance abuse might include:
Detoxification
Detox is the process of allowing toxic substances to clear from the body by stopping use.
Withdrawal Management
Substance withdrawal can be very uncomfortable and may even be life-threatening, depending on the substance and severity of the addiction. A supervised withdrawal period can make the difference between success and failure to detox.
Behavioral Therapy
Several behavioral therapies have been found to have promise for treating people with co-occurring disorders. Treatment specialists frequently recommend behavioral therapies alone or in combination with medications. Some of the effective behavioral therapies for adults with SUDS and co-occurring disorders include:
Cognitive Behavioral Therapy (CBT)
CBT is a type of talk therapy that teaches people to cope with difficult situations by showing them how to confront irrational thoughts and behaviors and then change them.
Dialectical Behavior Therapy (DBT)
This type of therapy uses concepts of mindfulness and acceptance, as people are aware of and tuned in to their current situations and emotions. It teaches people to control intense emotions, reduce self-destructive behaviors (drug use, suicidal thoughts, and attempts; self-harm), and improve relationships.
Contingency Management (CM)
The principles of CM encourage healthy behaviors by offering rewards or vouchers for healthy behaviors like meeting attendance, clean drug screens, etc.
Medications
Effective medications exist for treating opioid, alcohol, and nicotine addiction. They also exist for lessening the symptoms of many mental disorders. Some medications may be useful in treating multiple disorders.
Treatment for Mental Health Problems
Therapy
Individual Therapy
During individual therapy, the patient and therapist work one-on-one to build a trusting relationship and explore underlying causes that deal with mental health issues.
Group Therapy
In group therapy, several patients work with two or more therapists to discuss their common problems and methods of dealing with their addictions and mental issues. Group therapy participants learn new perspectives and receive support from other group members.
Medications
Many medications are available to treat mental disorders. But it’s important to get and stay sober during your mental health treatment. If a medication is prescribed for your mental health problem, mixing it with drugs or alcohol can have serious and dangerous effects. In addition, talk therapy is much less effective if you’re being influenced by alcohol or drugs.
Denial and Dual Diagnosis
Denial is common in both substance abuse and mental health issues. It can be difficult to admit how dependent you are on alcohol or drugs or how much they affect your life. Many people even tend to ignore their substance use disorder treatment and even disregard medical advice because mental disorders may affect their perspective and perceptions. Furthermore, a person’s mental condition can cause such extreme symptoms that only alcohol or other drugs can ease. Thus, people continue to suffer from substance use and mental health issues.
The symptoms of conditions such as depression, anxiety, bipolar disorder, or PTSD can be frightening. So individuals may try to ignore their mental illnesses and just hope they go away.
Sometimes, people are ashamed or afraid of being viewed as weak by admitting that they have a problem with substance use and/or mental illness. However, mental health problems and substance abuse can happen to anyone. Admitting that you have a problem and that you need help is the first step towards recovery.
Dual Diagnosis Treatment in New Hampshire
Around-the-clock intensive, residential, or inpatient treatment programs may benefit patients who suffer from dual diagnosis disorders. Such programs are available in New Hampshire at Live Free Recovery Services.
Here at Live Free Recovery Services, we are also able to provide outpatient rehabilitation programs. Thus, our patients with mental and substance impairments can continue working, attending school, and caring for family members while receiving treatment and therapy for their substance use and mental health issues.
From medically supervised detox to sober living, Live Free Recovery will help you achieve recovery. Don’t wait. There really is an answer to your substance use and mental health problems. Contact us today.
References:
www.medlineplus.gov/dualdiagnosis.html
www.nimh.nih.gov/health/topics/substance-use-and-mental-health
www.helpguide.org/articles/addictions/substance-abuse