A person can be diagnosed “dual diagnosis” when they suffer from a substance use disorder and mental health disorder at the same time. These two conditions are often known as “comorbid” conditions. The terms “dual diagnosis” and “comorbid” imply that the addictions and mental health problems mutually affect one another. In most cases, these conditions are treated separately. Dual diagnosis patients, however, often benefit from having both conditions recognized and treated together.
Dual diagnosis treatment programs are designed to help individuals who suffer from two or more mental health issues. Generally, treatment providers aim to address the conditions on their own. However, experienced practitioners recognize that mental health disorders and addictions impact each other profoundly. As such, they aim to keep in mind that either disorder may influence the treatment of the other disorder. During dual diagnosis rehab, for instance, clients withdraw from drugs and alcohol while developing new coping tools to deal with cravings and triggers. Clinicians also provide therapy for clients to help them deal with underlying mental health disorders, which are often the most common source of cravings and triggers.
What Does “Dual Diagnosis” Mean?
The term “dual diagnosis” is a clinical term. Psychiatrists and other physicians who have the ability to make official diagnoses decide who is dual diagnosis. When they diagnose clients with substance use disorders as well as other mental health conditions, then a person meets the criteria for being dual diagnosis. In some cases, they may use the term “co-occurring disorders” or “comorbidity.”
The reason that the term “dual diagnosis” is used is that people who only suffer from addiction have different treatment needs from those who suffer from addiction and mental health problems. Dual diagnosis treatment is designed to meet the needs of those clients. Dual diagnosis treatment varies considerably, however. It can depend on the type of mental health condition a person has. In most cases, however, it is designed to reduce the intensity of psychiatric symptoms and help clients develop better strategies and healthier coping tools for dealing with their addictions.
Frequency of Dual Diagnosis
It may be surprising to learn that roughly half of all people with addictions are dual diagnosis. In fact, the National Institute on Drug Abuse has conducted studies that show that 50% of all people with substance use disorders have co-occurring mental health conditions. Moreover, these same studies showed that the reverse is true: among people with mental health disorders, 50% suffer from some degree of drug or alcohol addiction.
Unfortunately, dual diagnosis treatment remains somewhat rare, despite comorbidity being so common. Even though roughly 8.5 adults in the United States were diagnoses with co-occurring disorders in 2017, only 51% received any kind of treatment. Among those who did receive treatment, most only received treatment for one of their conditions. According to a report by the Substance Abuse and Mental Health Services Administration, only 8.3% of dual diagnosis clients actually received treatment for all of their mental health conditions.
Common Mental Health Disorders for Addicts
A person can develop any mental health disorder alongside an addiction. In many cases, individuals suffer from mental health conditions before developing a problem with drugs and alcohol. They may turn to psychoactive substances as a way of self-medicating and obtaining relief from the symptoms of their mental illness. In other cases, their addiction and the lifestyle around it lead to the development of mental health conditions. Addiction, withdrawal, and the negative consequences that come from substance abuse can all exacerbate pre-existing emotional problems and trigger mental breakdowns.
The most common mental health disorders that dual diagnosis individuals suffer from include:
- Bipolar disorder. Individuals with bipolar disorder tend to vacillate between manic states and depressive states. They may turn to drugs and alcohol to help them balance their moods and energy levels.
- Depression. Individuals with depression are likely to seek out substances that offer euphoric effects or improve their energy levels.
- Anxiety and panic attacks. Alcohol, as well as many other drugs, reduce anxiety levels and reduce inhibitions. It is also common for sufferers to abuse prescription anti-anxiety medications, such as Xanax. While these drugs may be helpful when used as prescribed, they are highly addictive and can actually cause intense “rebound” anxiety when misused.
- Post-traumatic stress disorder. Trauma is one of the most common environmental factors that cause addiction. Moreover, regularly abusing drugs and alcohol leads to risk-taking behavior that can result in additional trauma.
- Borderline personality disorder. Among people treated for addiction, approximately 35% – 73% suffer from personality disorders. Aside from borderline personality disorder, other common conditions for people with substance use disorders include avoidant, paranoid, and antisocial personality disorders.
- Schizophrenia. Individuals with schizophrenia have significantly higher rates of SUDs than the general population,
- Eating disorders. Drugs and alcohol are often used as coping tools for people with eating disorders. In some cases, drug and alcohol abuse can lead to the development of unhealthy eating habits and dangerous relationships with food.
- Impulse control disorders. Drug and alcohol addiction are related to other impulse control disorders, including gambling addiction, sex and love addiction, and even video game addiction. In many cases, these behavioral addictions are especially triggered when a person is intoxicated.
All of these mental health problems respond well to treatment. However, it is difficult to treat any of these while a person continues to abuse drugs and alcohol. For this reason, it is critical to pursue both types of treatment simultaneously.
Symptoms of Comorbid Conditions
Mental health professionals, psychiatrists, and physicians are the only people who can officially diagnose a substance use disorder or mental health condition. However, it is important for close friends, family members, and other loved ones to be aware of the common signs of mental health disorders and addictions. Having the ability to recognize the warning signs is critical for being able to help your addicted loved one. After all, if no one notices there is a problem until it is too late, that individual will never even have a chance to see a mental health professional and get diagnosed.
The signs and symptoms of being dual diagnosis are similar in many respects to the symptoms of substance use disorders and mental health disorders. The main difference, however, is that these two sets of symptoms occur together in the same individual. Symptoms of dual diagnosis conditions include:
- Rapid changes in behavior
- Isolating from relationships with friends, family members, or loved ones
- Engaging in dangerous or risky behavior
- Difficulty managing everyday tasks
- Neglecting grooming or personal hygiene
- Unexplained health problems
- Losing control over substance use habits
- Using drugs or alcohol in unsafe conditions
- Change in peer group
- Suffering from difficult withdrawal symptoms
- Building a high tolerance for a substance
- Requiring drugs or alcohol to function normally
If you or a loved one is exhibiting any of the above signs, it is likely that they need help. Contact your physician or mental health professional, or reach out to a rehab that specializes in dual diagnosis treatment, such as NuView Treatment Center.
How Does Mental Illness Cause Addiction?
When a person suffers from a mental health disorder, they generally experience significant cognitive and emotional difficulties. In many cases, their mental illness can cause profound inner turmoil and suffering. In severe cases, it may even make it difficult to function at all while performing everyday tasks. As a result, people with mental illness may seek relief in the form of drugs and alcohol. When a person uses drugs and alcohol to relieve the symptoms of their emotional distress, this is known as self-medication.
It is true that drugs and alcohol can offer temporary relief. Many recreational substances reduce anxiety, reduce pain, and even help people feel more connected to each other. However, over the long run recreational drugs and alcohol are likely to have the opposite effects. In fact, the withdrawal symptoms that occur after a period of intoxication are often more severe than the symptoms of mental illness. Over the long term, drug and alcohol abuse exacerbates the symptoms of a person’s mental health conditions. Ironically, though, this can lead a person to abuse drugs and alcohol even more — since these substances continue to offer short-term relief.
As time passes, mental illness and substance abuse can form a vicious cycle, with each condition driving the other. As mental illness becomes worse, individuals become more dependent on drugs and alcohol. Their addiction, in turn, leads to the intensification of their underlying mental health disorder.
Benefits of Dual Diagnosis Treatment
Dual diagnosis treatment is essential for individuals with comorbid conditions. Even if a dual diagnosis client receives high-quality addiction treatment, they are likely to relapse if they do not treat their mental health disorder at the same time. Quality addiction treatment entails addressing all possible sources of relapse triggers. Depression, anxiety, and other mental health disorders are some of the most common sources of relapse triggers. By addressing these underlying issues, the likelihood of returning to drugs and alcohol is reduced.
It is far easier to treat a mental health disorder when a person is not abusing drugs and alcohol. Substance abuse worsens the symptoms of depression, anxiety, and other mood and personality disorders. Intoxication can make it difficult for a person to do the difficult introspection and problem-solving that talk therapy requires. Perhaps more concerningly, recreational drugs can interfere with prescription medications that are meant to alleviate the symptoms of mental health disorders. Treating mental illness without addressing a substance abuse problem is simply not effective.
Dual diagnosis clients face complicated circumstances. As complex cases, they require far more intensive treatment than other clients. During dual diagnosis treatment in outpatient rehab, clients can enjoy the following benefits:
- Getting the treatment necessary for getting sober from alcohol or drugs
- Getting therapy to help them deal with their mental health condition
- Working with a therapist to better understand the connection between their addiction and mental health issue
- Address the root causes of their mental health disorder and their co-occurring addiction
- Develop new coping mechanisms for their mental health problem
- Recognize and avoid triggers associated with relapse
- Develop a strong relapse prevention plan
Long-Term Risks of Self-Medication
Using drugs or alcohol to treat an underlying mental health condition may be tempting for many people. Drugs and alcohol can make difficult emotions far easier to deal with in the short term. However, over the long run self-medication can be extremely dangerous. By putting a bandaid over the problem, a person may never actually deal with their issue. While they are numb to the symptoms, their underlying problem may get steadily worse. Moreover, substance abuse itself is likely to make mental health and emotional issues worse. Alcohol, for instance, can help people deal with their anxiety while they are intoxicated — but as soon as alcohol withdrawal begins, anxiety skyrockets. The result is a vicious cycle that leads to severe addiction.
Other dangers of self-medication include:
- Feeling like one’s mental illness is worse when one doesn’t have access to drugs or alcohol
- Preventing a person from seeking help
- Developing a physical tolerance to drugs or alcohol, leading to a desire to use more
- Becoming addicted to a psychoactive substance
What Does A Dual Diagnosis Treatment Plan Look Like?
There are many different types of dual diagnosis treatment. Quality outpatient rehabs offer a type of treatment known as integrated treatment. Integrated treatment programs evaluate and assess clients for mental health disorders as well as co-occurring substance use disorders. They also are likely to offer a variety of other resources and support services that dual diagnosis clients sometimes need. These can range from employment assistance, socialization support, and even assistance with finding housing.
During integrated treatment, clients attend an outpatient rehab on a regular basis. How frequently they attend depends on the severity of their conditions, their level of flexibility, and how well they are currently functioning in their everyday lives. Outpatient rehabs offer multiple levels of care since both mental health and addiction problems exist on a wide spectrum. During treatment sessions, clients take part in both medical and therapeutic interventions for both conditions simultaneously.
Most outpatient rehabs emphasize group therapy, but individual therapy also often makes up an important share of a treatment plan. Quality treatment centers utilize a diverse range of distinct therapeutic techniques. Evidence-based treatment modalities that often form the core of an integrated treatment plan include:
- Cognitive-behavioral therapy (CBT). This type of talk therapy is one of the most well-studied and evidence-based. It involves working to change underlying beliefs and thoughts, as a way of ultimately changing behavior patterns.
- Dialectical behavioral therapy (DBT). DBT, which is based on some of the same principles of CBT but incorporates elements of acceptance and mindfulness, has been shown to be very effective at treatment borderline personality disorder. It can also reduce self-harm, suicidal ideation and behavior, and substance use.
- Motivational enhancement. This therapeutic approach helps improve the motivation of clients who are enrolled in treatment programs. This not only makes them less likely to drop out of their rehab, but less likely to relapse as well.
- Contingency management. Contingency management is a pragmatic approach that involves providing clients with incentives for engaging in healthy, positive, or desirable behaviors.
- Mutual support groups. Support groups are designed to help people build a strong peer support network. There are many support groups for distinct mental health problems, as well as support groups for addiction. 12-step programs like Alcoholics Anonymous and Narcotics Anonymous are often recommended.
Dual Diagnosis Treatment at NuView Treatment Center
Outpatient treatment centers for addiction make use of a wide range of treatment modalities and therapeutic techniques to help people recover from addictions and comorbid mental health disorders. It is important to find an outpatient rehab that offers the type of dual diagnosis treatment you need. Quality outpatient treatment centers help people address comorbid mental health conditions and other issues that may be influencing their substance use disorder. Different individuals also require different levels of care, so it is crucial to enroll in an outpatient rehab that offers a continuum of care.
NuView Treatment Center is an outpatient treatment center located in West Los Angeles. At NuView Treatment Center, we offer outpatient treatment programs for all levels of care. Our programs, which are run by highly trained and compassionate addictions specialists, make use of the latest evidence-based therapies. Our programs include:
- Partial hospitalization programs (PHPs)
- Intensive outpatient programs (IOPs)
- Outpatient programs (OPs)
- Aftercare planning
Whether you’re trying to get sober for the first time or working to rebuild your life after graduating from a residential treatment program, NuView Treatment Program is here to work with you. After an initial evaluation, our treatment team designs an individualized treatment plan for every client. We believe that addiction treatment should not be one-size-fits-all. At NuView Treatment Center, every client gets therapeutic care specifically tailored to them. Our masters-level clinicians believe in compassionate treatment and putting the client first. In any of our outpatient programs, clients not only develop the skills and tools they need to get sober and stay sober, but they take positive steps toward rebuilding their lives.
If you are ready to make a change and get the help you need, reach out to NuView Treatment Center today.