Dual Diagnosis and Addiction Treatment
Every year, millions of people around the world suffer from substance abuse disorder (SUD). Unfortunately, many of them also suffer from co-occurring mental health disorders and challenges. In fact, the 2018 National Survey on Drug Use and Health revealed that more than 9 million U.S. adults experienced mental issues and SUD at the same time. Up until the 1990s, people who had mental health and substance abuse issues typically received treatment for one condition at a time. Today, individuals with SUD that have co-occurring mental health issues receive a dual diagnosis. Nonetheless, dual diagnosis remains frequently misunderstood and requires treatment focused on managing both the mental health and addiction-related diagnoses.
Understanding Dual Diagnosis
Because everyone’s mental health and addiction experiences are different, clients can arrive in treatment with many different dual diagnoses. Nonetheless, researchers know that mental health challenges and addiction often make both challenges more severe and more challenging to treat. Three reasons for this are:
- Mental health challenges and addiction have common risk factors which include genetics, stress, and trauma.
- Mental health challenges often contribute to drug use and SUD.
- Substance use and addiction can contribute to the worsening of an underlying mental health challenge.
Often, people suffering from depression, bipolar disorder, anxiety, OCD and other mental health and psychiatric disorders use drugs or alcohol to feel better. This “self-medicating” can lead to an unhealthy dependence on drugs and alcohol, which, in turn, can lead to SUD. In a similar way, mental health challenges can make individuals more susceptible to addiction and substance abuse.
Signs and Symptoms of Dual Diagnosis
Despite the prevalence of dual diagnosis, most people do not know the signs and symptoms of mental health challenges and substance abuse that occur at the same time. While symptoms can vary widely depending upon the mental health issue and type of substance used, certain physical indicators and behavior patterns may signal a need for professional intervention.
Symptoms of Substance Use Disorder include:
- Withdrawal from friends and family
- Sudden changes in behavior
- Engaging in risky behavior
- Loss of control over substances
- Using substances in secret or in dangerous conditions
- Feeling like you need drugs or alcohol to function
- Bloodshot, glazed eyes and dilated pupils
- Poor physical coordination
- Dramatic changes in habits or priorities
Symptoms of a mental health condition can include:
- Extreme mood swings
- Problems with concentration
- Thoughts of suicide
- Avoiding friends, family, and social activities
- Dramatic changes in eating and sleeping habits
- Long-lasting sadness or irritability
- Excessive fear, worry, anxiety
According to reports published in the Journal of the American Medical Association, 37% of people who abuse alcohol and 53% of people who abuse drugs also have at least one serious mental illness. Moreover, 29% of people that are mentally ill abuse alcohol or drugs. You might need to seek professional intervention if you or a loved one:
- Use drugs and alcohol to feel better
- Drink or use drugs to alleviate depression
- Feel anxious and worrisome when sober
- Drink or use drugs to cope with unresolved trauma or abuse
Challenges of Dual Diagnosis
- The first and perhaps most difficult challenge regarding dual diagnosis is denial. It’s not easy for people to admit that they’re addicted to drugs and alcohol. It’s also difficult for people to accept and admit that they have a mental health challenge. As a result, instead of seeking help, many people with dual diagnosis ignore their problems and hope they go away. Over an extended period of time, this makes both conditions more difficult to treat.
- Living with an addiction and a mental health issue at the same time can lead to a high risk of self-harm. A 2009 study that analyzed 3,433 men and women aged 18-65 years for two years revealed that individuals with dual diagnosis are more likely to commit suicide than people without.
Treatment Takes Longer to Complete
- Rehabilitation for drug and alcohol abuse takes a considerable amount of time. In fact, rehab for severe SUD can take years to complete. But when combined with a mental health condition, the length of treatment often increases greatly. In fact, in some cases, the time needed for rehabilitation doubles.
Difficulty Pinpointing Symptoms
- In dual diagnosis, identifying the root causes of symptoms is a grueling and time-consuming. That’s because it’s hard to know where the symptoms are coming from. Are they related to a client’s mental health, or are they related to a client’s SUD? For example, a client suffering from erratic behavior and mood swings could be experiencing symptoms of drug abuse, but could also be showing signs of schizophrenia, bipolar disorder, manic depression or anxiety. Not knowing the root cause of the symptom makes treating symptoms more challenging.
Other dual diagnosis challenges include:
- Environmental factors triggering health conditions
- Misdiagnosing substance abuse as a mental health issue or vice versa
- Physical effects on the body caused by both conditions (i.e. heart and blood disease, lung disease, stroke, Hepatitis B and C, nutritional and metabolic diseases)
- Emotional effects on the body caused by both conditions (i.e. stress, disconnectedness, suicidal thoughts and behavior, lower self-esteem, increased anxiety, and depression)
- Relapse and temptation to self-medicate
Although a dual diagnosis comes with many challenges, treatment is possible.
Treatment Options for Dual Diagnosis
The National Survey on Drug Use and Health (NSDUH) estimates that 45% of people in the United States struggle with a dual diagnosis. With so many people having a dual diagnosis, it’s paramount that rehabilitation facilities effectively treat it.
Historically, clients with dual diagnoses received sequential treatment. This treatment focused on treating one condition at a time. Often, these treatments did not occur at the same facility and were not related to each other.
Parallel or integrated treatment now treats both conditions simultaneously.
The SAMHSA recommends integrated treatment, which combines care for a client’s mental health and substance abuse challenges. Clients receive treatment for both disorders at the same time and in the same facility. Psychiatrists and clinical staff trained in mental health and substance abuse provide treatment.
Integrated Residential Treatment
During integrated residential treatment, clients live onsite as they receive treatment. Often, inpatient rehabilitation works best for clients with a severe dual diagnosis.
Once admitted, clients undergo detox. During inpatient detoxification, medical staff monitor clients 24 hours a day. Depending upon the severity of the addiction, they may administer medications to help wean a person off the substance and lessen the effects of withdrawal.
After detox, psychotherapy, often cognitive-behavioral therapy (CBT), begins. CBT helps dual diagnosis clients learn how to better cope and change unhealthy patterns and ways of thinking. Eventually, as clients learn to manage both disorders, they attend self-help and support groups.
Integrated Outpatient Treatment
In many ways, integrated outpatient treatment mirrors the inpatient experience, but instead of living onsite at the rehab facility, outpatient clients receive treatment while living at home or with family members or friends.
During this time, clients attend individual therapy sessions alongside group counseling and other therapeutic activities. While outpatient treatment can be just as effective as inpatient treatment, it is often recommended with individuals with a less severe dual diagnosis.
Holistic Solutions for a Better You
Here at Solution Based Treatment & Detox, we understand the connection between mental health and drug or alcohol addiction. Whether you or a loved one are battling with addiction, mental health or both, we can connect you with solutions to help you reach long-term recovery. Call our offices today at 706-253-1414. We are available 24 hours, 7 days a week.
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