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DUAL DIAGNOSIS

The terms dual diagnosis disorder, co-occurring disorder, and coexisting disorder all refer to the same thing. Individuals with dual diagnosis disorders have a substance abuse or addiction disorder combined with another mental health disorder. These disorders have been traditionally treated as separate and distinct illnesses, oftentimes with treatment provided by differently specialized professionals with little integration of treatment. It is now known that these disorders should ideally be treated simultaneously using a multidisciplinary team approach with frequent communication between the addiction and mental health professionals.

The Prevalence of Dual Diagnosis Disorders

Multiple national studies have shown that about half of those who experience a mental illness during their lives will also experience a substance use disorder and vice versa. And, for many, these dual diagnoses are inextricably linked. Even when only “Serious Mental Illness” data (a more restrictive definition that only records mental disorders with significant impact on everyday life) is used, the link between mental illness and substance abuse is clear and convincing.

illustrated line chart showing the amount with dual diagnosis disorders

The Phenomenon of “Self-Medication”

Recent research has shown that certain specific mental disorders are proven risk factors for developing a substance use disorder. For many of these individuals, they may be engaging in a regimen of “self-medication” to provide some relief for otherwise untreated mental illness. Some of this drug use may even temporarily reduce some of the symptoms of their mental illness in the short run, providing “evidence” to the dual diagnosed individual of their efficacy. However, this limited relief is far outweighed by the long-term negative impact of drug abuse “self-medication.” And, in some cases, certain specific drugs can have an extremely negative interaction with some co-occurring mental disorders, even after only a single use. For example, evidence suggests that periods of cocaine use may worsen the symptoms of bipolar disorder and contribute to progression of this illness. [2]

Beginning Dual Diagnosis Treatment

When beginning dual diagnosis treatment, it is important to get a good history from the patient, the family, and previous care providers to determine the exact nature and the onset of the mental health and substance abuse disorders. Each type of disorder can sometimes display similar symptoms and are often inextricably linked, causing one disorder to fuel the other’s development. Because of the often linked nature of dual diagnosis disorders, treatment for both disorders should be initiated at the same time in a coordinated manner. Substance abuse can worsen a mental health disorder and a mental health disorder can lead to continued substance use in an attempt to treat its symptoms. Because of these complexities, it is critical that a dual diagnosed patient receive treatment in a drug and alcohol rehab that provides coordinated treatment for dual diagnosis disorders.

Common Mental Health Disorders that Co-Occur with Addiction

There are a number of mental health disorders that can co-occur with addiction, marking the individual with a dual diagnosis. All of them make treatment much more difficult unless the dual diagnosis patient has the care of a team of professionals with expertise in both addiction and mental health treatment. The most common mental health disorders involved in dual diagnosis cases are: depression, anxiety, bipolar disorder, and PTSD. Each of these has been the subject of recent research that has helped professionals further understand the connection between these specific mental illnesses and addiction.

infographic about depression showing young man holding their head in their hands
Depression & Addiction
Oftentimes, the word “depressed”, or “depression”, is used interchangeably with the word “sad”. However, clinically speaking, these two terms are very distinct. Sad is an emotion that can be easily changed and is typically related to a specific event or circumstance; whereas, depression is a clinical diagnosis. Depression includes feelings of sadness, low self-esteem, helplessness, hopelessness, and worthlessness.

These symptoms are present daily for a period of at least two weeks. Additionally, the symptoms generally result in an impairment of overall functioning of the individual who is suffering from depression. Addiction can worsen depression, and depression can worsen addiction. For those suffering from a depression-related dual diagnosis disorder, this can lead them to feel like they have fallen into a hopeless trap of despair and powerlessness.

infographic about anxiety showing man holding his head in his hands
Anxiety & Addiction
A clinical anxiety disorder is distinct from the nervousness or anxiousness that individuals experience from time-to-time, such as before taking a test or making a life-changing decision. Although the severity and symptoms of anxiety disorders may fluctuate with life circumstances, a clinical anxiety disorder is typically not associated with any particular trigger. Anxiety disorders lead to a baseline dysfunction in one’s life. An anxiety disorder can lead to substance abuse and vice versa.

Those addicted to drugs and alcohol may seek substances to relieve anxiety. On the other hand, anxiety can be produced by substance use and its related consequences, as well as during drug and alcohol withdrawal. For those with a dual diagnosis of anxiety and addiction, even simple everyday tasks can seem daunting or impossible to achieve, greatly reducing one’s quality of life and ability to function productively.

infographic about bipolar disorder showing two of the same woman holding her head
Bipolar Disorder & Addiction
There are several different types of clinically diagnosed bipolar disorder. The diagnosis is based on the symptoms that present over a period of time. Sometimes called manic depression, bipolar disorder is characterized by significant, regular mood changes. These mood swings cause a change in thinking, emotions, energy level, and the related behaviors.

Sometimes the depression is so severe that suicide seems like the only option. Other times, the mania will progress to hallucinations and delusions. Mania and depression can also exist at the same time in the same individual. It is critical that an addicted person who also has bipolar disorder be treated in a dual diagnosis drug and alcohol treatment center, as this combination can often prove to be fatal – from suicide while in a depressive episode or through risky behaviors when on a manic high.

infographic about PTSD showing soldier holding his head in his hands
Post-Traumatic Stress Disorder & Addiction
There are several different types of clinically diagnosed bipolar disorder. The diagnosis is based on the symptoms that present over a period of time. Sometimes called manic depression, bipolar disorder is characterized by significant, regular mood changes. These mood swings cause a change in thinking, emotions, energy level, and the related behaviors.

Sometimes the depression is so severe that suicide seems like the only option. Other times, the mania will progress to hallucinations and delusions. Mania and depression can also exist at the same time in the same individual. It is critical that an addicted person who also has bipolar disorder be treated in a dual diagnosis drug and alcohol treatment center, as this combination can often prove to be fatal – from suicide while in a depressive episode or through risky behaviors when on a manic high.

Military Veterans and Dual Diagnosis

The link between substance use disorder and PTSD is of particular concern for service members returning from tours of duty in Iraq and Afghanistan. Between 2004 and 2010, approximately 16 percent of veterans had an untreated substance use disorder, and 8 percent needed treatment for serious psychological distress. Data from a survey that used a contemporary, national sample of veterans estimated that the rate of lifetime PTSD was 8 percent, while approximately 5 percent reported current PTSD. In addition, approximately 1 in 5 veterans with PTSD also has a co-occurring substance use disorder.

Get Help For Your Dual Diagnosis Disorders Now

Many people struggling with addiction confront serious mental health issues as well. If you think that you or a loved one may have a dual diagnosis of mental illness and addiction, BWR can help you untangle the strands of these self-reinforcing conditions. Just call us 24/7 at 800-683-4457 to get connected with the experienced mental health and addiction professionals on our team who can help you “reboot” your life on more positive and fulfilling path.

 

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Behavioral Wellness & Recovery is a Joint Commission accredited program. The Joint Commission recognizes excellence in health care organizations and programs.

"THE GOLD STANDARD IN CARE"

Behavioral Wellness & Recovery is a Joint Commission accredited program. The Joint Commission recognizes excellence in health care organizations and programs.

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