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Dual Diagnosis

What is Dual Diagnosis in Addiction?

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According to the Mental Health Services Administration, someone with a dual diagnosis has both a substance abuse problem and a mental disorder. Having a dual diagnosis is a common scenario.

Around half of the people with mental health or mood disorders will have a substance use disorder during their lifetime, and vice versa. When the two conditions interact, it can make them both worse.

Dual diagnosis treatment centers provide a treatment plan for both disorders simultaneously. 

If someone has anxiety and an alcohol use disorder, just treating one isn’t going to give the best outcomes. Both relate to one another and contribute to each other, so both need to be considered in dual diagnosis treatment.


Substance Abuse and Co-Occurring Mental Health Disorders

When someone has a substance use disorder or SUD, it affects their behavior and brain. An inability to control their substance use, whether it’s prescription medications, alcohol, or illegal drugs, is the defining characteristic of a SUD. Symptoms range from somewhat mild to severe. Substance use disorders are also known as addictions.

Around half of all people with a substance use disorder will also experience a co-occurring mental health disorder.

There are some possibilities that researchers currently highlight as to why it’s so common to see addictions and mental disorders occurring together.

  • There are common risk factors contributing to substance use and mental disorders. For example, both can have a familial component, and genetics can be a risk factor. Environmental factors like a history of trauma can also lead to genetic changes that are passed down and contribute to someone developing a substance use or mental health disorder.
  • Mental disorders can contribute to the use of substances. We have available a lot of research highlighting that people with mental health issues frequently turn to the use of alcohol or drug abuse to self-medicate. While temporarily self-medicating with substances can provide relief, the symptoms worsen over time. There are also changes in the brains of people with mental disorders that could increase the rewarding effects of drugs or alcohol, raising the likelihood they continue using substances.
  • A third reason why co-occurring disorders might be common is the effects of the substances. A SUD can change the function and structure of the brain, making a person more susceptible to the development of a mental disorder.


The Most Common Co-Occurring Disorders

Below are some mental health disorders that tend to occur most often with substance abuse.

  • Generalized Anxiety: The symptoms characterizing generalized anxiety disorder include recurring, frequent anxiety or panic attacks. Other symptoms can include sleep problems, functional impairment, and restlessness. Someone with ongoing anxiety may turn to drugs or alcohol to try and relax or make them more social.
  • Eating: Bulimia, anorexia, and other eating disorders often require dual diagnosis treatment with addiction treatment. Someone with an eating disorder could use diet pills or stimulants to try and help with weight loss. Someone with a co-occurring eating and substance use disorder may have body dysmorphic disorder too.
  • Bipolar: A serious mental illness that can lead to severe periods of mania and depression. Self-medication may be something an individual with bipolar does to try and relieve some of the intensity of their episodes. Substance use can worsen bipolar symptoms. 
  • Depressive: Depression and drug addiction or alcohol dependence can require an integrated treatment approach. Depression is one of the most common types of psychiatric illness. Mental health symptoms can include low mood, fatigue, loss of interest, and suicidal thoughts or behavior.
  • Post-Traumatic Stress: PTSD can develop after you experience an extremely stressful and scary situation. Someone with PTSD might have flashbacks and avoidance symptoms, and they could turn to drugs or alcohol to try and find relief.
  • Personality: There are a number of diagnosable personality disorders, such as borderline personality disorder. It’s difficult for people with BPD and other personality disorders to maintain healthy relationships, which could contribute to substance abuse.
  • Attention Deficit: ADHD is something that you might receive a diagnosis for in childhood or young adulthood. Someone with ADHD could abuse prescription stimulants for the treatment of ADHD. As with other co-occurring disorders, substance use could also stem from an attempt to self-medicate and cope with symptoms.


Dual Diagnosis

What is a Dual Diagnosis?

A dual diagnosis is when someone receives a substance use disorder diagnosis and at least one other mental health condition. Signs of a co-occurring disorder can include:

  • Sudden changes in behavior
  • Problems managing responsibilities and daily tasks
  • Avoiding things once enjoyed
  • Neglecting personal hygiene and health
  • Cognitive impairment
  • Social isolation 
  • Non-compliance with treatment
  • Thoughts or mentions of suicidal behavior
  • Impulsivity
  • Erratic behavior
  • Engaging in risky behaviors 
  • Problems managing finances
  • Poor performance at work or school


Dual Diagnosis Disorders Treatment

In a dual diagnosis treatment center, the focus is on helping with all of a patient’s mental health diagnoses. Until relatively recently, the common belief was that alcohol or drug misuse could be treated separately from mental health disorders.

Clinicians, mental health professionals, and researchers have since realized that’s not the most effective treatment for long-term recovery. 

For example, if someone gets substance abuse treatment but not treatment for their symptoms of depression or obsessive-compulsive disorder, they’re likely to relapse.

  • Integrated care and dual diagnosis treatment seek to reduce the negative side effects of mental health disorders. 
  • That in and of itself can help improve someone’s functionality in their daily life and reduce their urge to self-medicate.
  • Dual diagnosis treatment might include a combination of medication and therapy approaches. 
  • Patients with co-occurring disorders also often receive group therapy and individual therapy. Support groups help create a strong social support network.
  • An effective dual diagnosis treatment program will provide equal care to the addiction and the co-occurring psychiatric issues.

The specific setting in which someone receives this type of care can vary depending on their needs.

  • For many people with complex diagnoses, a residential treatment program is advantageous. 
  • Residential treatment provides structure, supervision, and safety. 
  • People in residential inpatient programs often find that they can focus entirely on their treatment and recovery because they’re away from the stresses of their everyday environment. They can participate in behavioral therapies and mental health treatment without distraction. 
  • Treatment options are also available, from intensive outpatient programs to individual therapy on an outpatient basis.
  • Medication management is almost always part of treating co-occurring disorders. Medications may include pharmaceuticals to reduce drug cravings and withdrawal symptoms, antidepressants, and sometimes antipsychotic medications.
  • Programs might include family therapy and services because dealing with dual disorders is incredibly challenging for loved ones. 
  • An aftercare plan and support following the initial stage of treatment are critical to helping lower the risk of relapse and making sure patients follow a well-planned continuing therapy strategy. 

Overall, a dual diagnosis treatment center looks at the individual holistically. Treatment plans address all of a person’s needs, not just their use of drugs or alcohol.

If you’d like to learn more about treatments for dual diagnosis in Southern California, reach out to the specialized team of providers at The Right Time Recovery today by calling 800-630-1218.