Dual Diagnosis

What is Dual Diagnosis?

Dual diagnosis is also commonly known as co-occurring disorders. It means that a person has both a mental health disorder and a substance use disorder (SUD) simultaneously. These conditions often exacerbate each other, creating a cycle where untreated mental health issues can worsen substance use and vice versa.

Studies have shown that about 50% of those with a substance use disorder will have a mental health disorder as well. Dual diagnosis is thus very common and yet complex to treat. 

In 2020, the number of adults estimated to have dual diagnosis in the U.S. was 17 million. Nuview specializes in dual diagnosis treatment by providing integrated care that will work to address both issues simultaneously for better recovery success.

Common Mental Health Disorders in Dual Diagnosis

Anxiety Disorders

Anxiety disorders include conditions like generalized anxiety disorder that affect a fairly large percentage of the population. Many people with anxiety use alcohol or drugs to try to manage their anxiety and then end up developing addictions. Substances people use to self-medicate for anxiety, such as benzodiazepines, are addictive, contributing to substance use disorders.

Depression

Depression and substance abuse are often closely interrelated, with both being used as self-medication against each other. This may worsen the symptoms of depression and lead to a vicious circle, which further complicates treatment.

Bipolar Disorder

It is estimated that 50% of the people experiencing bipolar disorder presently have issues with addiction. Bipolar disorder, which is characterized by wildly fluctuating moods, can often lead to substance use as a coping mechanism that complicates the course of treatment.

Schizophrenia

Schizophrenia is a disease characterized by hallucinations and delusions that quite often run comorbidly with addiction. Dual diagnosis of schizophrenia can be challenging as the symptoms run together, but integrated care is very important for recovery.

PTSD (Post-Traumatic Stress Disorder

Individuals can use substances to cope with their symptoms or turn to them after the development of PTSD. Research indicates that as many as 50% of individuals comorbidly diagnosed with PTSD and alcohol use disorder have other diagnoses, too, thereby making comprehensive dual-diagnosis treatment crucial.

Common Substance Use Disorders in Dual Diagnosis

Alcohol Use Disorder

Alcohol use disorder is one of the most common substance-related problems in dual diagnosis. Alcohol may aggravate symptoms of mental health disorders, and that aggravation results in increased drinking and worsening mental health conditions.

Opioid Use Disorder

Opioid use disorder is particularly dangerous in the dual diagnosis cases. Many individuals with mental health conditions turn to opioids for relief, but the addictive nature of these drugs can quickly lead to dependency and substance use. 

Cocaine Use Disorder

Cocaine is usually used in association with other mental disorders, such as anxiety and depression. Although the symptoms might disappear for a while because of the stimulating effects of cocaine use, the subsequent crash is capable of severely impacting mental well-being.

Cannabis Use Disorder

Though considered by many as a soft drug, cannabis use disorder is very destructive, especially to people with underlying mental conditions. It heightens anxiety or depression and, in extreme cases, may even lead to psychotic episodes.

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What are the Symptoms of Dual Diagnosis?

With dual diagnosis, symptoms diagnosis vary depending on the combination of mental health and substance use disorders. The individual presents symptoms from both conditions; these usually overlap, which further complicates their diagnosis.

Common Behavioral Symptoms:

• Frequent absences from work or school
• Significant drop in performance
• Mood swings, irritability, or angry outbursts
• Personality changes or lack of motivation
• Engaging in much riskier or secretive behavior

Common Physical Symptoms:

• Red eyes
• Slurred speech
• Impaired coordination
• Changes in pupil size
• Weight fluctuations
• Tremors
• Poor physical hygiene

Social Symptoms:

• Loss of interest in hobbies
• Change in social circles
• Financial difficulties or unexplained need for money
• Ongoing substance use despite relationship problems

Symptoms of dual diagnosis can vary quite depending on the mental health condition and the substance use involved. Nuview Treatment Center treats dual diagnosis by concurrently addressing both sides of the issue for more complete recovery.

What are the Causes of Dual Diagnosis?

There is no single cause of dual diagnosis, but more risk factors, which research suggests, contribute to the comorbidity or co-occurrence of mental health disorders with substance use disorders.

Genetics

Mental health disorders and substance use disorders often run in families. In fact, multiple genes increase the risk of developing either of these conditions.

Environmental Factors

Stress, trauma, and adverse life experiences increase the vulnerability to developing both mental health disorders and substance use disorders.

Mental Health Contributing to Substance Use

People with anxiety disorders and other mental health conditions often use drugs and alcohol as a form of self-medication for symptom relief, which may work on the surface momentarily but make both conditions much worse in the end.

Substance Use Contributing to Mental Health Disorders

Drugs and alcohol can affect the way the brain works, which may lead to many different types of mental health problems. Greater substance use over time can worsen the general symptoms of a mental health disorder.

Diagnostic Challenges of Dual Diagnosis

Diagnosis is often complicated in dual diagnosis, given that symptoms of the mental health disorders somewhat interlink with symptoms of substance use disorders. Many symptoms of one condition often just imitate or worsen the other; this complicates distinguishing between conditions by health providers.

Diagnosis for both conditions can be determined through comprehensive screening tools utilized by healthcare providers. It is vital that individuals be as open as possible during these evaluations, as the answers will determine the correct dual-diagnosis treatment plan.

Nuview understands the challenges of dual diagnosis and offers personalized treatments, targeting the unique requirements of the individual, that help untangle those intertwined symptoms and show a clearer path to recovery.

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Treatment Options for Dual Diagnosis

Dual diagnosis treatment addresses both conditions, the mental health disorder and the substance use disorder, at the same time, taking into consideration how each problem influences the other. Nuview provides integrated dual diagnosis treatment that fosters long-term recovery.

Behavioral Therapy

• Cognitive Behavioral Therapy (CBT): Empowers patients to recognize and alter negative thought patterns that are embedded in both their mental health and their substance use concerns.
• Dialectical Behavioral Therapy (DBT): Emphasizes the behavioral management of intense emotions in relation to reducing harmful behaviors like substance use or self-harm.
• Group Therapy: It provides a friendly atmosphere whereby one can share experiences and learn from others' challenges.

Medication

Both the symptoms of mental health and substance use disorders can be treated using medication. For instance, the drug bupropion (Wellbutrin®) is effective in treating both major depression and nicotine dependence.

Support Groups

Support groups offer a safe space to connect with peers who have faced similar struggles. They provide emotional and social support, offering advice and encouragement throughout the recovery journey.

Coping Strategies and Support

Coping with dual diagnoses is often challenging. However, it's possible for individuals to manage the symptoms of their conditions and reduce the risk of relapse with the right strategies. Nuview focuses on equipping individuals with practical tools for ongoing recovery.

Mindfulness and Relaxation Skills:

Skills including meditation and deep breathing can reduce levels of stress, thus preventing emotional triggers.

Routine Physical Activity:

The habit of routine physical activity works to improve mood and decrease cravings for substances.

Building a Support Network:

It must be ensured that regular contact with friends, family, and support groups is part of one's emotional and social support during recovery.

When to Seek Professional Help

First and foremost, recognizing the need for professional intervention is crucial in addressing dual diagnosis. When you or someone you know is troubled with a mental health disorder and substance use, early help should be sought.

When to Reach Out:

• Difficulty managing symptoms of various mental health disorders, such as extreme mood swings, anxiety, or depression
• Ongoing substance use despite negative consequences in personal, social, or professional life
• Increased feelings of isolation or hopelessness
• Physical health declining due to substance use

Here at Nuview, we make available specialized dual diagnosis treatment targeting the etiology of both conditions and offer a path toward recovery.