In many ways, a dual diagnosis is the most common diagnosis in addiction treatment centers. Yet, most of the time, people are unaware of their conditions. Not to mention that when substance abuse and mental illness co-occur, it makes the diagnosis even more challenging.
While some people blame substance use disorders on mental health disorders, others do the same the other way around. And, although science has recognized a clear connection between the two, it’s impossible to certainly say that addiction is triggered by mental illness or that substance abuse leads to mental illness.
Regardless of the reason, understanding a dual diagnosis and the treatment model is key to a successful recovery journey.
Table of Contents
- 1 What is the Dual Diagnosis Model of Treatment?
- 2 Mental Health Disorders Linked to Substance Abuse
- 2.1 1. Attention-Deficit Hyperactive Disorder (ADHD)
- 2.2 2. Bipolar Disorder
- 2.3 3. Borderline Personality Disorder
- 2.4 4. Depression
- 2.5 5. Eating Disorders
- 2.6 6. Generalized Anxiety Disorders (GAD)
- 2.7 7. Obsessive-Compulsive Disorder (OCD)
- 2.8 8. Posttraumatic Stress Disorder (PTSD)
- 2.9 9. Schizophrenia
- 3 Why Co-Occurring Disorders Need Different Treatment
- 4 Getting a Dual Diagnosis
- 5 Finding Dual Diagnosis Treatment Programs
What is the Dual Diagnosis Model of Treatment?
Many people with a substance use disorder (SUD) also suffer from a co-occurring mental health disorder. This is what we know as a dual diagnosis. The dual diagnosis model of treatment involves an integrated treatment plan that addresses both conditions simultaneously.
According to the National Survey on Drug Use Health (NSDUH), almost 45% of people with addiction have a co-occurring mental health disorder.
An integrated treatment plan for a dual diagnosis should use different therapeutic techniques and approaches proven effective at treating mental health disorders and substance abuse. Some of these include:
- Cognitive-behavioral therapy (CBT) helps explore a person’s thoughts and beliefs to change their behavior.
- Dialectical behavioral therapy (DBT) helps reduce negative actions and behaviors.
- Contingency management provides small incentives to patients who maintain positive behaviors.
- Motivational interviewing helps patients increase their motivation to make positive changes in their treatment.
- Support groups for people with co-occurring disorders help patients build a sense of fellowship.
What is an Example of Dual Diagnosis?
A dual diagnosis is anything but rare. At least 8.4 million adults in the US have a mental and substance use disorder. A few examples of dual diagnosis could be:
- Having a mental health disorder leading to alcohol and drug use.
- A substance use disorder that leads to a mental illness diagnosis.
- When alcohol or drug misuse worsens or alters the course of a person’s mental illness.
What is the Difference Between Comorbidity and Dual Diagnosis?
While comorbidity, dual diagnosis, and co-occurring disorders are terms often used interchangeably, they’re some differences between these terms. Comorbidity also implies an interaction between the illnesses that can worsen the course of both. On the other hand, co-occurring disorders describe various diseases that commonly occur with drug abuse or alcohol addiction. For example, liver cirrhosis and alcoholism are an example of co-occurring disorders.
Mental Health Disorders Linked to Substance Abuse
A few mental health disorders are known alongside a substance use disorder when it comes to dual diagnosis. Often, these mental illnesses are the underlying cause of addiction. Although, that’s not necessarily always the case.
1. Attention-Deficit Hyperactive Disorder (ADHD)
People with ADHD are more likely to turn to substance abuse to cope with their symptoms. Even people with a prescription to treat ADHD can develop a stimulant addiction as many of these drugs can be habit-forming.
2. Bipolar Disorder
Roughly 50% of people with bipolar disorder also struggle with addiction. Because bipolar disorder is a highly misunderstood disorder, lots of people start self-medicating with drugs or alcohol. However, long-term substance abuse can worsen manic episodes and bipolar symptoms.
3. Borderline Personality Disorder
Different studies point out the link between BPD and addiction. At least two-thirds of people with BPD turn to substance abuse at some point in their lives to cope with symptoms.
Estimates say at least 1 in 10 adults in the United States suffers from depression. At first, undiagnosed individuals might turn to alcohol or drugs to self-medicate. However, evidence shows alcohol and drugs significantly worsen depression, and the recovery can be devastating.
5. Eating Disorders
Not everyone links eating disorders with mental illness or substance abuse. But people struggling with eating disorders often turn to drugs to suppress their appetite. Unfortunately, that also exacerbates their mental health symptoms and makes their condition worse.
6. Generalized Anxiety Disorders (GAD)
The most common mental health condition in the US is generalized anxiety, affecting at least 18% of adults. People who suffer from anxiety are more likely to turn to alcohol for their symptoms. In addition, benzodiazepines can help treat anxiety, but they’re highly habit-forming, leading to a chain of substance abuse and addiction.
7. Obsessive-Compulsive Disorder (OCD)
People feel that having an irrational fear of germs or the need to constantly clean is part of someone’s personality. But OCD is an actual mental illness that can be pretty debilitating. Those who struggle with OCD tend to experience anxiety and depression, leading to drug or alcohol abuse.
8. Posttraumatic Stress Disorder (PTSD)
According to the US Department of Veterans Affairs, almost 75% of veterans and soldiers report alcohol abuse. PTSD causes the brain to produce fewer endorphins, making them more likely to seek stimulants or alcohol to feel happy. However, substance use worsens their PTSD symptoms, which in return starts a vicious cycle.
Schizophrenia causes hallucinations and delusional thinking, both common symptoms in people with addiction. When someone with schizophrenia uses drugs or alcohol, they risk worsening their symptoms, leading to potentially deadly situations.
Why Co-Occurring Disorders Need Different Treatment
People with a mental health disorder are twice as likely to suffer from a substance use disorder. Likewise, people with drug or alcohol addiction are more likely to develop a co-occurring mental health disorder. The reason for a different form of treatment is because it’s essential to address both conditions simultaneously. Neglecting to do this can worsen one of the disorders and interfere with someone’s progress.
How to Recognize a Dual Diagnosis
At first, recognizing a dual diagnosis can be challenging. A mental health professional must complete a health assessment to decipher whether or not there are indications of a dual diagnosis.
The most common warning signs of a dual diagnosis include:
- Sudden changes in behavior
- Difficulty managing daily responsibilities
- Avoiding social activities
- Neglecting health and hygiene
- Cognitive impairments
- Disillusioned thinking
- Refusal to comply with treatment
- Suicidal thoughts or suicidal ideation
- Erratic and impulsive behaviors
- Poor performance at school or work
Getting a Dual Diagnosis
At first, getting a dual diagnosis can be challenging. Not everyone will have the resources and tools for an accurate diagnosis, mainly if a substance abuse disorder is present. It’s widespread for people with addiction to go to rehab without treating underlying mental health conditions. In this case, it’s common for these individuals to relapse shortly after completing treatment.
Specialists suggest that addressing mental illness or substance abuse separately will not be an effective treatment solution. That is why a dual diagnosis can provide the treatment team with the information needed to draft a comprehensive treatment plan that addresses both conditions simultaneously.
When someone receives a dual diagnosis, it’s essential to have a course of action immediately after. Otherwise, there’s a risk that the person will start to self-medicate with drugs, alcohol, and other substances in the hopes of improving their condition. However, self-medication can worsen mental illness and affect someone’s health.
Treatment for dual diagnosis can provide them the resources to start caring for their behavioral health and substance abuse.
Finding Dual Diagnosis Treatment Programs
The key to treat a dual diagnosis is to find a treatment that targets both disorders – rather than a treatment that treats them separately. In most cases, the best course of action is to find an inpatient rehab center that offers a structured and safe environment.
Inpatient rehab for a dual diagnosis is ideal because of the level of care patients receive. Frequently, people with co-occurring disorders arrive in distress and poor general health. The combination of substance abuse and mental illness requires strategic and ongoing mental health and addiction professionals.
When choosing a dual diagnosis treatment center, find one specializing in co-occurring disorders and address health care. While scouting potential centers, ask these questions to help you make an informed decision:
- Do you offer individualized treatment plans?
- Is therapy structured to treat a dual diagnosis?
- Are patients evaluated by a licensed psychiatric professional or physician before admission?
- Are both disorders viewed as interconnected health issues?
- How do you handle relapse?
- Does your facility offer aftercare or referral services?
These questions will help you understand how the program is structured. Your chosen rehab should provide you with a treatment plan that outlines several therapies if medication-assisted treatment is part of the plan and the different activities that will take place throughout the program.
In addition, it’s essential to learn more about the level of involvement they expect from family members. Some rehab centers will include family therapy as part of patients’ treatment plans to help heal and address broken family relationships.
Lighthouse Recovery Institute is one of the few dual diagnosis rehab centers in South Florida. To start, please give us a call at 866-308-2090 today and speak with an admissions specialist to learn more about our programs.