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What is Dual Diagnoses?

Many people suffering from a substance use disorder also have an existing mental illness. This is known as a dual diagnosis or co-disorder and it affects around 45 percent of Americans.


People with a dual diagnosis require a specialized, integrated treatment plan that treats both disorders as interconnected mental health issues.


There are some mental health disorders that are most commonly seen alongside addiction. Often, these mental illnesses can trigger substance abuse, particularly if they are untreated.


Common mental illnesses that co-occur with substance abuse include:


Attention-Deficit Hyperactivity Disorder (ADHD)


ADHD is a mental health disorder that is typically diagnosed during childhood but can last into adulthood. People with ADHD usually have difficulty concentrating, and have problems with paying attention and controlling their impulses. Stimulants are the primary medication used to treat ADHD. However, stimulants are highly addictive when not used as prescribed. People with ADHD can easily become addicted to stimulants, especially if they are not being adequately treated for their disorder.


Bipolar Disorder


Bipolar Disorder is a serious mental illness characterized by extreme mood swings. People with bipolar disorder will experience frequent manic highs followed by episodes of depression. About half of people with bipolar disorder also struggle with some form of addiction. As with any other mental illness, it is tempting to self-medicate. People with bipolar disorder find temporary relief from their symptoms by using drugs, alcohol, or both.


Borderline Personality Disorder (BPD)


BPD is a personality disorder that affects a person’s self-image and ability to regulate and control their emotions and behavior. Substance use disorder and BPD often occur together, and over two-thirds of people with BPD have used drugs or alcohol to self-medicate at some point in their lives.


Depression


Millions of Americans suffer from depression, and many will try to self-medicate with substances in order to soothe their symptoms. The impact on levels of serotonin in the brain after the effects of the drugs and alcohol have worn off can have a devastating effect on people with a depressive disorder.


Eating Disorders


People with eating disorders have an unhealthy preoccupation with food. Some may restrict how much they eat, and others may be unable to control how much they eat. People with anorexia nervosa or bulimia nervosa, in particular, will often use drugs, both prescription and illicit, that suppress their appetite. People with eating disorders commonly abuse prescription stimulants, as well as illicit stimulants like methamphetamine.


Generalized Anxiety Disorder (GAD)


GAD is the most common mental health disorder in the U.S. People with GAD often abuse drugs and alcohol to soothe the symptoms of their anxiety. Benzodiazepines are a highly addictive type of medication used to treat anxiety disorders. Due to their addictive pharmacology and how often they are prescribed, they are among the most commonly abused drugs by people with GAD.


Obsessive Compulsive Disorder (OCD)


People with OCD experience a number of uncontrollable obsessions and compulsions. Examples include an irrational fear of germs and a compulsion to clean frequently and constantly. People with OCD often suffer from depression and anxiety as a result of their primary mental illness. As a result, they may turn to alcohol and drug abuse to soothe their symptoms.


Post-Traumatic Stress Disorder (PTSD)


A person with PTSD has lower levels of endorphins in their brain. This makes them more likely to turn to substances in order to feel happy and calm. Alcohol abuse, in particular, is common amongst people with PTSD.


Symptoms of Co-Occurring Disorders


It can be difficult to determine whether someone struggling with addiction has a mental illness. Symptoms of mental illness and addiction may overlap. In order to make an accurate diagnosis for mental illness, the person should have no drugs or alcohol in their system at the time of assessment. Although there are different symptoms for each mental health disorder, there are some general signs that may indicate a mental illness is present.

These include:

  • Poor eating and sleeping habits

  • Listlessness, and lack of interest in hobbies and activities that were once important

  • Extreme mood swings

  • Feeling fearful and anxious for no clear reason

  • Difficulty focusing and concentrating

  • Irritability

  • Decreased or increased libido

  • Lack of attention to personal hygiene

  • Hallucinations, paranoia, or delusions

  • Engaging in risky, impulsive behaviors

  • Suicidal thoughts or suicide attempts


The symptoms of substance use disorder will also differ depending on the substance being abused. However, there are general symptoms that can indicate a drug or alcohol addiction.


Warning signs of substance use disorder include:

  • Being unable to stop using drugs or alcohol, even if they want to

  • Withdrawal symptoms when substance use is stopped

  • Difficulty functioning without using the substance

  • Isolating from friends and family

  • Increased tolerance and needing larger amounts of the substance to feel effects

  • Engaging in risky behavior

  • Spending a lot of time getting and using substances

  • Erratic behavior and mood swings

  • Conflict and difficulty in relationships


Co-occurring disorders will often feed off each other and worsen symptoms. When substance abuse is not treated, the symptoms of mental illness can become debilitating. It is vital that co-occurring disorders are treated so that the individual can work on living a fulfilling, healthy life.


Treatment for Dual Diagnoses


While some people become addicted to drugs or alcohol before being diagnosed with a mental illness, others may develop an addiction while already suffering from a mental health disorder. Regardless of which comes first, it is crucial that treatment is tailored to treat both disorders simultaneously.


In the case of a dual diagnosis, the best means of treatment is at an inpatient rehab center that specializes in treating both mental illness and substance use disorder. Going to inpatient rehab for dual diagnosis treatment is ideal because of the high level of round-the-clock care received. On-site clinicians will be able to help the patient with any physical and mental ailments caused by their addiction.


The goal of dual diagnosis treatment is to help the patient learn how to maintain sobriety while managing the symptoms of their mental illness. This is accomplished through medication, counseling, and behavioral therapy.


Therapy for treating dual diagnoses include:

  • Cognitive behavioral therapy (CBT): This is a practical type of talk therapy that helps the patient understand their thoughts in order to change their behavior and have better coping skills.

  • Dialectical behavioral therapy (DBT): This is primarily used to treat borderline personality disorder, but is also effective in treating some other personality disorders. DBT helps the patient reduce self-harming behaviors and replace them with practical, positive coping mechanisms.

  • Support Groups: Support groups such as Alcoholics Anonymous and Narcotics Anonymous are types of therapy groups of like-minded individuals that help and encourage each other to maintain sobriety.

Help for a Co-Occurring Disorders


It can be difficult and even debilitating to live with one or even multiple co-occurring disorders. However, recovery is possible. Many treatment centers specialize in treating co-occurring disorders. With the right, tailored treatment plan, it is possible to live a happy, healthy, and fulfilling life.



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