The concept of “dual diagnosis” is still relatively new in the world of addiction treatment. Until the turn of the millennium, people who had addiction problems and people who had mental health issues were treated separately, even if both addiction and mental problems occurred in the same person. In fact, mental health treatment would commonly be withheld until that person has completely become sober. Today, we know that addiction and mental health disorders often go hand in hand, and this is known as a dual diagnosis, or a co-occurring disorder.
How Is the Treatment Different?
We now know that people who have a co-occurring disorder are best treated by blending substance abuse and mental health treatment together. Instead of seeing them as two separate issues, they are regarded as part of a continuum. Various clinicians have now been trained specifically in this type of treatment.
According to the U.S. Department of Health and Human Services’ Office of Applied Studies, there were some 4 million people in this country who had a dual diagnosis in 2002. Unfortunately, only 12% of them received the help they needed to address both conditions. Those who meet the diagnostic criteria for an addictive disorder as well as a mental health disorder can be classed as a “Dual Diagnosis Client” once they seek treatment. For treatment to then be effective, it must consider both. As such, patients can expect that:
1. Their mental health treatment to run parallel to their addiction treatment, offered by specially trained staff
2. Psycho-therapeutic medication, including anti-anxiety medication and antidepressants, is used to treat co-occurring disorders.
3. They are supported through therapy that builds self-confidence and self-esteem, rather than being aggressively confronted.
4. Their treatment strategy is completely inclusive of their loved ones and support network.
Before the 1990s, patients would always receive “sequential treatment”. At that time, the understand was that addiction rehabilitation and mental health treatment should be kept separated. Hence, if someone suffered from alcoholism but also from depression, they would have to go through detox and rehab first. As time went on, however, it became clear that relapse rates were far higher with sequential treatment, and a new approach was developed.
How a Dual Diagnosis Is Made
In order for someone to have a dual diagnosis, they will first be assessed according to the criteria in the most recent DSM (Diagnostic and Statistical Manual of Mental Disorders). The DSM is a guideline from the American Psychiatric Association that is designed to support mental health professionals in diagnosing and treating patients.
Only a qualified therapist, counselor, psychologist, physician, or psychiatrist is able to make a dual diagnosis. For many, this diagnosis comes as a huge relief, as it often gives them a kind of light bulb moment of understanding. The same is true for their loved ones. Overall, putting a name to something often means it can be treated as well.
The reality is that recovering from both an addiction and a mental health disorder is incredibly hard. In fact, recovering from one of the two is challenging, let alone from two. However, it can be done with the right support.
Signs and Symptoms of Dual Diagnosis
While you can only be diagnosed by a trained and qualified professional, you can look through the agreed signs and symptoms to determine whether you may have a co-occurring disorder.
The most common signs of an addiction are:
1. Abandoning loved ones in favor of a new crowd or activities
2. Struggling to maintain professional or educational responsibilities
3. Stealing or lying in order to fund the addiction
4. Sleeping all day and staying up all night
5. Frequently trying to stop the addictive behavior but going through relapse
6. Expressing regret or guilty about the compulsions
7. Increasing the doses of the substance they are addicted to
8. Going through withdrawal if the dose is lowered or stopped altogether
Meanwhile, the symptoms of a mental health disorder to look out for include:
1. Withdrawing from loved ones and refusing support or friendship
2. Having delusions or even hallucinations
3. Expressing feelings of worthlessness, hopelessness, or despair for at least two weeks
4. Having compulsions to maintain order and going through complicated rituals to alleviate feelings of anxiety
5. Having trouble staying in employment, keeping a house, or having friendships due to mood swings and behavioral problems.
6. Having dramatic changes in energy levels and mood
7. Using substances in order to cope with stress or to manage moods
It should be noted, however, that the only way to be certain whether there is a co-occurring disorder is to speak to a specialist who is trained in these conditions. Those who want to enter rehab and have a dual diagnosis should also look for a center that specializes in this. During an intake conversation, it will be determined what the right plan of action is for you. While reaching out is the hardest step, it is necessary if you are to get on the road to recovery.
Treatment Options for Dual Diagnosis
Every person is a unique individual, and thus require unique, individualized treatment. This is true for all conditions, and particularly for a dual diagnosis. After all, the range of different mental health issues is incredibly large, and the way this relates to a substance abuse problem is incredibly complex. Common mental health disorders include mood disorders (bipolar, major depression), anxiety disorders (OCD, PTSD, generalized anxiety), personality disorders (antisocial disorder, borderline personality disorder), and eating disorders (anorexia, binge eating, bulimia).
Why Is Treatment Needed?
Most people who suffer from an addiction, whether they have a dual diagnosis or not, are in denial. Add to this a mental health condition, and this denial often becomes stronger. In addition, people with a dual diagnosis often stop looking after themselves, become increasingly isolated, and more. Usually, they feel that they need drugs or alcohol just to cope with daily life.
In order to heal, you must have trust, hope, and the right help. It is difficult to place any kind of trust in others, but you can have a team of professionals around you who are there to make sure your story becomes a success story. Nobody should have to live their life addicted and mentally ill, and help is out there to ensure you can live a happy, healthy life instead.