What Is Dual Diagnosis?

Dual diagnosis goes by many names: comorbidity, co-occurring disorders, comorbid disorders. Whatever you choose to call it, this condition describes when an individual is diagnosed with two simultaneous disorders. Often, these two issues are intertwined somehow. Dual diagnosis is extremely common among addicted individuals, as mental disorders often go hand-in-hand with them. According to the National Alliance on Mental Illness, 7.9 million Americans suffer from dual diagnosis.

If you or someone you love is suffering from dual diagnosis, it is important to understand all the underlying causes of this condition and to be aware of how they may interconnect. In addition, different treatment options may be necessary for a safe, effective recovery from dual diagnosis, so it is also necessary to make sure this type of care is received by an individual with this condition.

You can call 800-996-6135(Who Answers?) now to learn more about dual diagnosis or to be connected with detox programs that can effectively treat this issue. Our treatment advisors are available any time, night or day, to take your call.

Dual Diagnosis Defined

Having an addiction and a mental illness is considered a dual diagnosis.

According to the Centers for Disease Control and Prevention, dual diagnosis or comorbidity is defined by the diagnosis of two separate diseases, illnesses, or disorders in the same person at the same time. The term itself implies that they coexist and also that they are interlinked in that one may have helped to bring about the other. In the case of substance abuse, dual diagnosis commonly refers to the frequent diagnoses of addiction and mental illness in the same individual.

When dual diagnosis is identified by a medical practitioner, it is important to realize that specialized treatment will be required, especially during detox. The withdrawal symptoms experienced during medically assisted detox can be uncomfortable, even though the patient will be treated to minimize the intensity of these symptoms. Painful or frightening symptoms can cause psychological issues to worsen, so specific treatment options will often be necessary.

Drug Addiction and Other Mental Illnesses

Addiction itself is a mental illness, as defined by the National Institute on Drug Abuse. When a person becomes addicted to drugs or alcohol, it changes the way their brain works, which can cause them to behave and think differently. As such, it is not uncommon for individuals who are addicted to substances to also suffer from mental disorders.

People who suffer from a substance use disorder are twice as likely as the general population to also suffer from a mental disorder. The reverse of this statement is also true: people who suffer from mental disorders are twice as likely to become addicted to drugs as people who don’t (NIDA).

Mental illnesses and substance use disorders often co-exist because one can easily lead to the other.

When a person is addicted to drugs and alcohol, other mental disorders can develop as a result.

• Withdrawal from stimulants can cause temporary psychosis. While it does subside, some people experience renewed symptoms months or even years later.
• Marijuana abuse has been known to increase the risk of psychosis in vulnerable users (NIDA for Teens).
• Using drugs can create high highs but also low lows. Some individuals develop depressive or anxious symptoms as a result of their substance abuse, which can sometimes result in a full-blown mental disorder.

When an individual suffers from a mental disorder, they experience a higher risk of addiction.

• Many individuals with mental disorders try to self-medicate with the use of drugs and alcohol, hoping to alleviate their symptoms as least for a while. Unfortunately, this often backfires and causes an addiction.
• Mental illness, trauma, and other psychological disorders are serious risk factors for addiction. The more risk factors a person has, the more likely any substance abuse on their part could become addictive.

As you can see, there is a serious risk of dual diagnosis among the drug-abusing population. If you or someone you love is suffering from addiction, it is extremely important that tests are done to confirm or deny the presence of comorbidity.

How Do I Know I Have Dual Diagnosis?

You must consult a physician in order to find out for certain if you have dual diagnosis. However, if you are a substance abuser and have been for a long time, it is a likely possibility. This is why doctors always check for symptoms of mental disorders during addiction treatment. For example, the National Library of Medicine states that all individuals going through opioid detox must be screened for depression, as these two disorders often occur simultaneously.

You may be likely to have two comorbid disorders if you are

• Experiencing severe psychological and/or behavioral symptoms
• No longer in control of your actions, thoughts, emotions, etc.
• Experiencing dangerous thoughts and actions (such as suicidal thoughts)
• A simultaneous drug user
• A long-term drug user

Still, it is absolutely paramount that you are examined by a doctor before you can determine if you have dual psychological syndromes like addiction and a substance use disorder.

How Are These Disorders Treated?

Dual diagnosis is treated differently than addiction on its own in that it requires more intensive care. This care starts with detox treatment, which usually needs to occur in an inpatient center for individuals with dual diagnosis.

A study published in Psychiatric Quarterly states that individuals with high psychiatric severity fare better in inpatient treatment.

• These facilities usually provide more treatment options, including additional behavioral therapies. Holistic treatments are also more likely to be found in inpatient centers than in outpatient centers.
• Inpatient facilities provide 24-hour care in a controlled environment. People who are going through treatment for addiction and other mental disorders often thrive in a restricted environment. Here, they will not be tempted to return to substance abuse. In addition, they will be in a place that provides them with order and consistency, which can be effective for recovery.
• Inpatient centers ensure that patients will never be alone, which is paramount for individuals with intense mental disorders. While patients are still given time to reflect by themselves, help is never far away when it is necessary.

Another stipulation changes the way dual diagnosis patients are treated. These disorders must be treated simultaneously, partly because they are so intertwined as to require care that addresses both issues. According to the SAMHSA, an undertreated co-occurring disorder increases one’s risk for homelessness, legal issues, and death.

Medications are effective for treating dual diagnosis patients.

• Certain medications can be effective for addiction treatment or for minimizing withdrawal symptoms. Some patients may be weaned off their drug of abuse with the help of medications while other individuals may be stabilized with them.
• Other pharmacological options may be used to treat mental disorders and their symptoms. For example, some patients may need antidepressants if they are struggling with major depression or a similar disorder.
• Doctors in a detox or rehab center will ensure that any medications prescribed can be taken safely with one another if multiple drugs are prescribed to the same individual at the same time.

Behavioral therapies are also extremely beneficial for dual diagnosis patients.

In fact, these treatments are the most utilized in addiction recovery (NIDA).

• Behavioral therapies can take one’s substance use and mental illness into account at the same time. A therapist can also ensure that the patient is able to work on both issues simultaneously.
• Certain behavioral therapies can help patients learn how their substance abuse helped lead to their mental illness or vice-versa. Cognitive-behavioral therapy (CBT) uses the learning process to allow patients to recognize the reasons behind their substance abuse and to work through any trauma or psychological issues associated with it.

Holistic treatments can sometimes be effective for dual diagnosis patients as well.

These programs can include:

• Yoga
• Meditation
• Animal therapy
• Art therapy
• Dance therapy
• Massage therapy
• Tai Chi
• Acupuncture

Some individuals may choose holistic treatment instead of evidence-based care, although the most effective programs normally utilize both options.

Treatment for both disorders can start in detox. Patients will be medically assisted in the process of withdrawal, which can be uncomfortable and, at times, even severe. However, there is always time to lay the groundwork for recovery from both issues at the start of addiction treatment. Remember, though, detox itself is NOT a treatment for addiction or for mental illness. Instead, it is a treatment for drug dependence and is usually the first step in one’s recovery from a substance use disorder.

How Can I Find Help for Dual Diagnosis?

You are not alone. There are many different treatment paths for your recovery, and a large number of them will begin with detox. Most individuals in this situation will require intensive inpatient detox because it is the safest option for early recovery from dual diagnosis. Afterward, you will need to transition into some sort of rehab or another addiction treatment program in order to complete your recovery.

We are always available to help addicted individuals seek the care they need to recover. If you or someone you love has dual diagnosis, it is doubly important that you receive the right care. Call 800-996-6135(Who Answers?) now to discuss your situation with one of our treatment advisors.

Sources

1. National Alliance on Mental Illness. (2017). Dual Diagnosis.
2. Centers for Disease Control and Prevention. (2018). Comorbidities.
3. National Institute on Drug Abuse. (2018). Understanding Drug Use and Addiction.
4. National Institute on Drug Abuse. (2018). Comorbidity: Substance Use Disorders and Other Mental Illnesses.
5. National Institute on Drug Abuse. (2015). Marijuana & Psychosis. 
6. U.S. National Library of Medicine. (2016). Opiate and Opioid Withdrawal. 
7. The Psychiatric Quarterly. (1993). Inpatient vs outpatient treatment for substance dependence revisited.
8. Substance Abuse and Mental Health Services Administration. (2016). Co-Occurring Disorders.
9. National Institute on Drug Abuse. (2018). Treatment Approaches for Drug Addiction.