Understanding Dual Diagnosis: Mental Illness and Substance Abuse

Dual diagnosis is the experience of a substance abuse disorder and mental health issue existing simultaneously. This is often referred to as a co-occurring disorder and it is more prevalent than many might think. While dealing with either one of these issues individually is difficult enough on its own, the presence of a co-occurring disorder can exacerbate symptoms and worsen a person’s overall health.

Both addiction and mental health disorders have their own unique symptoms that present a variety of challenges in everyday life. When the two exist together, they often impact one another, worsening symptoms of both conditions. This frequently leads to additional complications that can make the treatment process more complex.

Understanding the Link Between Mental Health and Addiction

When it comes to addiction and mental health issues, many wonder which came first. This is different for everyone, but the most common ways co-occurring disorders develop are:

• Substances are used to self-medicate for symptoms of mental health: An undiagnosed mental health disorder can be difficult to manage. Without proper support and resources, a person may look for relief through other outlets. Drugs and alcohol are commonly misused in an attempt to self-medicate for symptoms of mental health disorders, and although it may provide temporary relief, it often causes the symptoms to worsen over time.
• Substance abuse can trigger an underlying mental health disorder: A mental health disorder can develop for a variety of reasons. Family history, chemical imbalances, environmental factors, and life experiences can all be triggers. In some cases, these factors exist without causing a mental health disorder to develop. With the introduction of mind and mood-altering substances, these underlying risk factors can be turned on, leading to the development of mental health symptoms that may not have been present otherwise.

Regardless of which presents itself first, it can be difficult to diagnose co-occurring disorders because symptoms can vary based off the type of substance abused and what mental health disorder is present. Instead of identifying this through symptoms, it is easier to identify warning signs through behavioral changes and reflection on past experiences. Some questions you can ask include:

• Are substances used to cope with difficult thoughts, memories, or feelings?
• Are there consistent changes to mood when substances are used?
• Is there a family history of substance abuse or mental health disorders?
• Are symptoms of mental health disorders present even when the person is sober?
• Is there a history of trauma that is unresolved?
• Has the person previously been diagnosed with a mental health disorder or addiction?

There are a variety of mental health disorders that may coexist with substance abuse, but the most commonly experienced co-occurring disorders are depression, anxiety, and bipolar disorder. It is not uncommon to also observe borderline personality disorder, post-traumatic stress disorder, and schizophrenia in those who struggle with addiction.

Dual-Diagnosis Treatment: Treating Mental Health and Addiction Together

The most effective way of treating co-occurring disorders is through a combined approach. Because mental health and addiction are closely intertwined, treating one without the other will inevitably lead to relapse. Treating both disorders simultaneously is more effective in helping a person develop healthy coping mechanisms and can improve recovery outcomes. Treatment may include any of the following:

• Detox
• Withdrawal symptom management
• Medications
• Individual and group therapy
• Behavioral therapies
• Lifestyle changes
• Support groups
• Aftercare

There are a plethora of treatment options available, but that does not make them all equally effective. Finding a program that has experience with dual diagnosis and is equipped to handle a person’s unique needs is critical to their successfulness. Some aspects of treatment to consider include:

• Does the treatment program address mental health and addiction simultaneously?
• Does the program create individualized treatment plans and allow clients to become actively involved in it?
• Are clients taught healthy coping mechanisms and lifestyle changes to support sobriety?
• Are clients provided with education about mental health and how it is related to specific issues?

Dual diagnosis treatment provides clients with the ability to understand how drugs and alcohol impact their mental health and the opportunity to work with a professional to discuss the role it plays in their own lives. Special counseling designed to address a person’s unique experiences and individual circumstances is vital to success. This can be accomplished in group settings as well, helping clients connect with others who share similar experiences.

For many, treatment of co-occurring disorders can be roller-coaster of experiences, but with proper treatment and support, it is possible to overcome many of the challenges clients face. Dual-diagnosis is a critical component of recovery and following it with aftercare can ensure a person’s mental health needs are continuously taken care of and addressed. A combination of medication and therapy are often utilized to help clients maintain sobriety long-term.

References
https://www.helpguide.org/articles/addictions/substance-abuse-and-mental-health.htm
https://www.psychologytoday.com/us/blog/the-anatomy-addiction/201110/what-is-dual-diagnosis