Dual Diagnosis

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It is not uncommon for someone living with a substance use disorder to also have a mental disorder present. In fact, these conditions co-exist pretty frequently, around half of those who are diagnosed with a substance use disorder will also have a mental health disorder at some point in their lives and vice versa. This is known as a dual diagnosis.

When a dual diagnosis is present, it is important that both conditions are treated in order to increase the chances of an all-around successful recovery. In some cases, it can be challenging to pinpoint a dual diagnosis as substance use disorders often induce psychiatric symptoms. This blog post will explore what a dual diagnosis is, the relationship between drug or alcohol addiction and mental health issues, and treatment options available for those with a dual diagnosis.

What Is a Dual Diagnosis?

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A dual diagnosis is when someone has a psychiatric disorder alongside a co-occurring substance abuse disorder. When someone is living with a dual diagnosis, they will experience the symptoms of both the mental disorder and substance abuse problem. These different symptoms can create negative effects on an individual's life, such as problems at school or work, re-occurring issues in relationships with friends or loved ones, and difficulty maintaining day-to-day life tasks. Studies have found that 50% or more of people living with a substance abuse disorder are also living with co-occurring psychological, emotional, or psychiatric disorders.

The dual diagnosis concept can be used to define an array of co-occurring disorders. For example, it can be used when broadly speaking about an alcohol use disorder with depression, or it can be used to specify a severe mental illness, such as psychosis, which is present alongside a substance abuse disorder.

The Link Between Substance Abuse and Mental Illness

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The relationship between mental illness and substance abuse is complicated. Many mental health disorders, such as anxiety or depression, are closely linked to drug abuse, however, it does not necessarily mean that one caused the other. Although, substance misuse of methamphetamine or marijuana can cause psychotic side effects and alcohol can increase symptoms of anxiety or depression.

Researchers have explored a number of possibilities as to why a dual diagnosis occurs. Possibilities include:

  • Substance abuse problems and mental disorders can be caused by common risk factors, such as genetics, stress, or trauma. Research has found that genetic factors are 40-60% responsible for an individual's susceptibility to addictive disorders.

  • A substance use disorder can alter an individual's brain chemistry. These changes within the brain can cause a person to develop a mental health problem or can exacerbate an already existing mental disorder.

  • Individuals can also engage in drug and alcohol abuse as a form of self-medication. It is not uncommon for people to use alcohol or other drugs as a means of relaxation. Individuals with mental disorders may use substances as a temporary fix, but unfortunately, this is all it is, temporary. Engaging in drug abuse as a coping mechanism can induce substance misuse and can increase symptoms of a co-occurring mental health disorder.

People who are using substances as a form of self-medication increase their chances of developing an addiction or dependency. As they consume alcohol or drugs, they will eventually need more of the same substance to feel the same effects that they once did, this is because they will build a tolerance to the substance as they continue to use it - an early sign of a substance abuse disorder.

Common Mental Health Disorders and Addiction

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There are a few common mental health disorders that typically present themselves within a dual diagnosis. In some cases, these mental disorders can be the underlying cause of substance use disorders. For example, it can be due to an individual using drugs to self-medicate. This highlights the importance of ensuring a treatment plan for a dual diagnosis includes treatment of both a mental health condition and substance use disorder. Some common mental disorders that are linked to drug abuse include:

Bipolar Disorder

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Bipolar disorder is recognized by severe and intense mood swings that often shift between periods of extreme highs and periods of extreme lows. As with many different types of mental health problems, bipolar disorder is a risk factor for substance abuse disorders. In fact, research has found that around 60% of people with bipolar disorder had a history of substance abuse. It can be tempting to self-medicate as a source of temporary relief from manic episodes or emotional situations for those with bipolar.

Attention Deficit Hyperactivity Disorder (ADHD)

People who are living with ADHD may feel more inclined to abuse substances as a coping mechanism. There have been several studies that show a strong relationship between alcohol and drug abuse and ADHD. The disorder is found to be five to ten times more common in adults living with an alcohol use disorder than adults without the condition. Additionally, around 25% of adults who are in treatment for substance abuse have AHDH as a co-occurring disorder. Individuals living with ADHD tend to have more behavioral problems and be more impulsive, and both of these can contribute to substance abuse.

Depression

Depression is one of the most common mental disorders in the United States. Around 1 in 10 adults have reported suffering from depression. Many individuals with the condition use substances to try and self-medicate. However, the adverse side effects of a comedown, after an intense high, can be intensified for those living with a pre-existing depressive condition.

Borderline Personality Disorder

A borderline personality disorder affects an individual's pattern of behavior, moods, and self-image. People often experience an alternative and distorted view of reality and themselves. Like many mental disorders, especially personality disorders, people with borderline personality disorder may use substances as a means of coping.

Anxiety Disorders

The most common mental disorder in the United States is a generalized anxiety disorder, affecting around 18% of adults. People living with the disorder are most likely to use drugs to help manage their symptoms. Benzodiazepines are a highly addictive prescription medication that is used to treat anxiety disorders, there is an increased risk of individuals abusing and becoming addicted to the medication.

Eating disorders

Individuals living with eating disorders may use drugs that suppress their appetite. Often, eating disorders stem from experiences of trauma or stressful experiences, similar to risk factors for addictive disorders.

Post Traumatic Stress Disorder (PTSD)

Once a person has developed PTSD, their brain releases and produces fewer endorphins than before. This can increase the chances of a person turning towards substance abuse to experience feelings of happiness. Research found that nearly 75% of veterans or soldiers who have experienced violent or traumatic events reported repetitive alcohol abuse.

Obsessive Compulsive Disorder (OCD)

OCD causes intrusive and often upsetting thoughts that cause the performance of behaviors to help ease any anxiety that is due to these thoughts. Researchers have repeatedly found a strong connection between OCD and drug abuse. A recent study found that 70% of people living with OCD reported behavioral addiction symptoms. Similarly to other mental disorders, this connection can be due to a number of factors, such as self-medication or overlapping risk factors.

Treatment for Dual Diagnosis

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It is paramount that those living with a dual diagnosis receive an integrated treatment plan that ensures both conditions are being treated simultaneously. Whether the substance abuse or mental disorder was present first, an effective and long-term recovery plan should cover treatment for both disorders by the same treatment provider. The form of treatment you receive is dependent on the specific issues that you may be facing. Some common elements of dual diagnosis treatment are:

Detoxification

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The first step in any substance abuse treatment is detox. Inpatient and medical detox are highly recommended as it allows your body to rid itself of toxins in a safe and comfortable environment. During medical detox, you will receive 24/7 care and support to help aid in any emotional or physical side effects. When someone suddenly stops taking a substance, it is likely that they will experience withdrawal symptoms. At times, these can be uncomfortable and difficult to manage. However, with the right help, these can be managed and suppressed.

Inpatient Treatment

If you are living with a mental illness and a co-occurring drug or alcohol abuse disorder, then you have the option of attending an inpatient rehabilitation center where you will receive medical, health, and emotional support and services. One of the most important aspects of treatment is that you will always have immediate access to medical and clinical professionals from the early stages of your recovery and throughout.

Prescription Medications

Prescription medications, such as psychiatric medication, are useful for aiding in treating symptoms of different psychiatric disorders. There are certain types of medication that can also be helpful in minimizing withdrawal symptoms that are experienced throughout the detoxification process.

Psychotherapy

Treatment programs all consist of some form of psychotherapy. Cognitive-behavioral therapy (CBT) has been proven to be the most effective in treating those with a dual diagnosis as it teaches patients different coping mechanisms and aids mental health by changing unhealthy and ineffective thinking patterns that can contribute to the increase of experiencing substance abuse.

Another important aspect of treatment is to ensure that an aftercare plan has been discussed. A common form of aftercare is the attendance of support groups. Support groups allow for individuals with similar experiences to share negatives and positives. They offer individuals a chance of being part of a long-lasting supportive community.

Treatment at Vida Recovery

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At Vida Recovery, we understand how difficult it can be to ask for help. Whether it be for an alcohol or drug addiction, we want to make your transition to recovery as smooth as possible. When receiving treatment for a dual diagnosis, it is important that an integrated approach is taken to ensure that all aspects of both conditions are treated. When joining us, rest assured you are being cared for by a team of expert medical professionals who have aided in the successful recovery of countless individuals.

We know that mental disorders and substance abuse differ in everyone so offer each patient an individualized treatment plan that addresses their different emotional, medical, social, and psychological needs. We provide our patients with effective and evidence-based strategies that are empirically based on derived treatment interventions and science.

We offer drug addiction treatment through a partial hospitalization program (PHP) as well as an intensive outpatient program (IOP). PHP is best suited for those who have recently experienced detoxification or an inpatient program. We can provide a structured and extensive comprehensive care plan to further your support. Alternatively, our IOP may be the best fit for those who have other commitments and obligations. We can support and help you to manage everyday life and recovery while living in the comfort of your own home.

If you believe you or a loved one is living with a substance abuse disorder or a dual diagnosis, call us today to discuss options and we can help you determine which of our programs is the best fit for you.

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