What Is a Dual Diagnosis?

Dual diagnosis is a term used to define when a person has a mental health disorder and a substance use disorder at the same time. Combined co-morbidities confer specific hurdles for diagnosis and treatment. Commonly, those in the midst of a dual diagnosis will struggle because the symptoms of one condition are often amplified by the other. The need for a more nuanced understanding of the relationship between mental illness and addiction is a growing understanding in medicine and psychology.

Dual diagnosis treatment is called for since it requires simultaneous treatment of both conditions rather than addressing them individually. The necessity of specific integrated care, especially when we compare the spectrum of treatment and care for them, cannot be emphasized enough.

Why Do Substance Use Disorders and Mental Disorders Occur Together?

An examination into what is causing the Substance Use Disorders (SUDs) and mental health issues that occur concurrently provides perspective by looking at the root causes for both. This association has several factors that are interlinked together and responsible for this:

Substance Use as Mental Health Treatment

Substance use often starts as a coping mechanism for self-medication in many people. Some people with existing mental health diagnoses do not seek help or opt for alcohol, drugs, or substances to self-medicate their symptoms of anxiety, depression, PTSD, and so on. The relief is only temporary as they turn towards a substance use disorder that exacerbates another mental health issue.

Mental Health Conditions: A Byproduct of SUD

Conversely, over numerous years, indulging in substances can lead to an individual developing a psychological disorder. Parallelly, chronic exposure of mental organs to chemicals results in radical changes in their biochemistry that can cause conditions such as depression, anxiety, or psychosis, which are caused by abuse of substances. Substance misuse and mental health disorders may precede the onset of a worsening of the mental health disorder and produce a loop of worsening symptoms.

Shared Risk Factors

Genetics, trauma, and stress, among others, are all factors affecting the risk of mental illness and addiction that appear to overlap but are not the same. A personal history of experiencing a mental illness or substance use disorder increases the probability that an individual will have both. For example, significant life stress, such as abuse or loss, can lead to both mental health concerns and substance use as a coping strategy.

Common Mental Health Issues and Addiction

Mental health conditions often occur together with addiction. The most common co-occurring disorders are:

Attention-Deficit Hyperactivity Disorder (ADHD)

People with ADHD might be fidgety and unable to stop their wandering thoughts, so they self-medicate (alcohol or stimulants). This may result in a co-occurring diagnosis of ADHD and substance use disorder. The treatment for this combination requires the convergence of behavior therapy and medication management to manage both.

Bipolar Disorder

Substance abuse is met with Bipolar Disorder (altogether, a state where an individual has sudden mood changes from high to low). In other words, Bipolar Disorder enhances the susceptibility to substance abuse, and during manic episodes, risky behaviors, including drug indulgence, are likely to be undertaken. The potential depression caused by this disorder can lead to self-medication. These patients specifically need complete treatment for both bipolarity and addiction, with an emphasis on mood control and substance use.

Borderline Personality Disorder (BPD)

BPD with its signature of dramatic mood swings and poor relationship functioning. BPD is usually associated with substances as a way to help cope with all of the emotions and interpersonal problems that arise with this diagnosis. Couples treatment for BPD and substance use disorder is multifaceted, often using Dialectical Behavior Therapy (DBT) in combination with addiction counseling.

Depression

Depression is probably the most common mental illness linked with addiction. Individuals with depression might take drugs for low emotional or hopeless feelings. After a while, substances may make the depressive symptoms worse and create a vicious circle. The treatment of dual diagnosis for depression and addiction promotes mental health as well as addiction recovery through the use of medication and therapy combined.

Dual Diagnosis Risk Factors

• Genetic Predisposition. Co-occurring conditions can be inherited through the genetic predisposition of a family history of mental illness and/or substance abuse.
• Trauma and Abuse. A background in trauma or abuse is a risk for both mental health conditions and substance use disorders, as substances may be used to medicate underlying emotional pain.
• Early Onset of Drug Use. Substance use at a young age can have negative consequences during brain development, thus putting one more at risk for addiction and mental health recovery from disorders.
• Chronic Stress. Life stress or exposure to environmental triggers (low social support/financial straits) could lead to the development of mental health problems resulting in substance abuse.

Warning Signs of a Co-Occurring Disorder

Warning Sign	Description
Mood Swings	Sudden changes in mood, sometimes from anxiety to depression, irritability to euphoria, may be an indication of some mental health or substance problem.
Isolation and Withdrawal	Withdrawn from people or activities under feeling ashamed or guilty of substance use or mental health struggles.
Inability to Control Substance	Continuing to use substances while failing in attempts to stop relates to dealing with emotional or mental distress.
Sleep Disturbances	All the significant changes in sleep background, such as insomnia or sleeping too much, are often due to the interplay of mental health and substance use.
Declining Performance	Falling performance in work, school, or personal responsibilities because of the negative influences of co-occurring disorders on one’s daily functioning.

Treatment for Dual Diagnosis

Dual diagnosis means treating the substance use disorder and the mental health problem at the same time. Integrative treatment for dual diagnosis aims to break the vicious cycle of these two conditions and treat the root of both conditions holistically.

Therapy

Therapy is central to managing dual diagnosis. CBT, specifically, is a beneficial treatment for co-occurring disorders because it allows the individual to become aware and change distorted feelings about their mental health and addiction connection to substance use. Other useful tools in dual diagnosis treatment include Dialectical Behavior Therapy (DBT), trauma-focused therapy, and contingency management.

Medication

Medication is essential in dual diagnosis treatment. Medication can help regulate mood and alleviate symptoms of things like depression, bipolar disorder, or anxiety in mental health conditions. Medication-Assisted Treatment (MAT) is used to treat substance use disorders, specifically opioid addiction, by minimizing cravings and eliminating withdrawal symptoms.

Rehab as Part of Dual Diagnosis Treatment

Dual-diagnosis rehab facilities focus on the recovery of the whole person. They provide a safe environment for detox, therapy, and education on managing both disorders concurrently. Dual-diagnosis therapy programs are designed to treat substance abuse and mental illness simultaneously. 

Treatment will depend on the level of individual situations, with intensive inpatient or outpatient rehab care being provided at a significant rehab. Therapy will often include a combination of group and individual treatment incorporating psychoeducation about coping methods and relapse prevention. This is done to equip individuals with tools for long-term management of addiction and mental health.

FAQ’s

1. How should a dual diagnosis be treated?

An integrated approach that addresses addictions and mental health conditions concurrently is necessary for the most successful dual diagnosis treatment process. To give the client the most outstanding and complete care possible, this instead includes a mix of therapy, medicine, and rehabilitation services, all coordinated under one roof.

2. Is it possible to receive multiple diagnosis treatment at home?

It is not possible to treat the majority of patients with severe co-occurring disorders at home. Most benefit from professional treatment in rehab, where they can receive round-the-clock care and extensive assistance.

3. How prolonged is dual diagnosis treatment?

Dual diagnosis treatment length can be based on conditions and the state in which the patient progresses. It is usually several months afterward, and ongoing aftercare will ensure you reach a sustainable solution to your problems.

4. Do dual-diagnosis rehab facilities exist?

Yes, there are specialist rehabilitation facilities that treat mental health issues in addition to substance use disorders. These facilities provide comprehensive treatment plans that target both problems at once.

5. What consequences may an untreated dual diagnosis have in the long run?

Addiction problems and mental health conditions may increase if dual diagnosis is left untreated. Physical health issues, a higher risk of suicide, and trouble sustaining relationships or keeping a job are all possible outcomes of this. Long-term recovery depends on early therapy.