As intuitive as the term “dual diagnosis” may seem, it doesn’t mean having two mental health conditions. Dual diagnosis (also referred to as a co-occurring disorder) is used when someone experiences a mental illness and a substance use disorder simultaneously. Therefore, “dual diagnosis” is not a diagnosis but a specific combination of diagnoses.
But this seems like a rarity, right? What are the odds that a person experiences both a substance use disorder and a mental illness? Of the 21 million people in the U.S. with a substance use disorder, 8 million also live with a mental illness. In other words, it’s not an exception-it’s much more common than you think.
Does One Cause The Other?
While mental health conditions may not directly cause substance use disorders (and vice versa), it is possible. Those with mental illness are more susceptible to addiction-substance abuse is twice as prevalent among adults with mental illness because of the desire to self-medicate symptoms. Some people with mental illness may not even know that their substance use constitutes a disorder.
However, alcohol and drugs can worsen the symptoms of mental illness. And prolonged use of substances increases the underlying risk for mental illness. Individuals with mental illness consume roughly 38% of all alcohol, 44% of all cocaine, and over half of all opioid prescriptions in the U.S. The more severe the mental illness, the greater the likelihood a person will also use substances.
While it can be difficult to know if one condition causes the other, or even which “came first,” there is often a clear connection between them.
What Should I Do?
Addiction and mental illness on their own are difficult to overcome. But when they’re in concert, they’re even more challenging. Mental health professionals may not know how to help you or may not think you can be helped. But you can be. You need to find the right treatment. Here are a few examples:
- Psychotherapy is an important piece of dual diagnosis treatment as it helps you learn how to cope without using substances. Specifically, motivational interviewing can help a person change their addictive behaviours. This type of therapy involves a mental health professional helping a person determine whether substance use aligns with their goals, values and what “healthy living” means to them.
- Inpatient rehabilitation is an option if you want to receive medical and mental health care 24/7. These centres offer therapy, support, medication, and health services.
- Supportive housing is a residential treatment centre designed to help people who are newly in recovery avoid relapse. These centres provide support, but they are usually not run by mental health professionals, so research carefully before choosing one.
While choosing your treatment plan, it’s important to remember that the best treatment would integrate care for both diagnoses. Each condition should be considered primary and receive intervention at the same time. The days of “I can treat your bipolar disorder once you stop drinking” are over.
Talk to your therapist if you are already in treatment for a mental health condition and think you might have a substance problem. Let your therapist know you want to be treated for both conditions simultaneously. While no standard dual diagnosis intervention exists, mental health professionals can use best practices to individualize your treatment. And it’s essential to work with a therapist who is willing to do that.
It’s also helpful to find others who understand what you’re going through and connect with them. You can do this by participating in a support program such as Alcoholics or Narcotics Anonymous. If you live with a dual diagnosis, it’s nice to know that you are not alone.
Because dual diagnosis or co-occurring disorders is not a special case for select people, it’s a common issue many faces. And while it is an incredibly challenging issue, you can get better with proper treatment and support.
Things To Understand About Dual Diagnosis
The signs of a dual diagnosis vary significantly between individuals. Generally, symptoms will depend on the type of substance abuse as well as the severity of the co-occurring condition.
Symptoms of a dual diagnosis include:
- Sudden changes in general behaviour
- Difficulty managing daily tasks and responsibilities
- Avoiding events or social activities that were once enjoyed
- Neglecting health and hygiene
- Delusional thinking or cognitive impairments
- Refusal to seek or comply with treatment
- Mentions of thoughts of suicide or suicidal behaviours
- Erratic and impulsive behaviours
- Issues managing finances
- Poor performance at school or work
Inpatient VS Outpatient Dual Diagnosis
Understanding inpatient vs. outpatient care is important to ensure you get the best care possible for your needs. The main difference between inpatient and outpatient programs is whether or not you stay overnight in the hospital or treatment centre.
While there is a clear difference between inpatient and outpatient addiction recovery, there is a small grey area that you should be aware of. Occasionally, physicians or health care professionals assign a patient “observation status” while determining whether hospitalization is required. This allows doctors more time to evaluate you and make the most appropriate decision. While this typically will not last more than 24 hours, there are instances where a patient may need observation status for more than 24 hours.
Another main difference in the inpatient vs. dual diagnosis treatment centres is the type of personnel overseeing treatment. Primary care physicians are traditionally considered outpatient providers, as their services are usually provided during a single visit. On the other hand, specialists like mental health providers or addiction counsellors are considered inpatient providers, as their services typically require longer, more intensive care.
Now that you understand the difference between inpatient and outpatient care, you may be wondering which one is best for your needs.
Dual Diagnosis Treatment Options
Although these problems often occur together, this does not mean that one caused the other, even if one appeared first. In fact, it can be hard to figure out which came first. Researchers think that there are three possibilities as to why they occur together:
- Common risk factors may contribute to both mental disorders and substance use disorders. These factors include genetics, stress, and trauma.
- Mental disorders can contribute to drug use and substance use disorders. For example, people with mental disorders may temporarily use drugs or alcohol to try to feel better. This is known as self-medication. Also, mental disorders may change the brain to make it more likely to become addicted.
- Substance use and addiction can contribute to the development of a mental disorder. Substance use may change the brain in ways that make you more likely to develop a mental disorder.
What Are The Treatments For Dual Diagnosis?
Someone with a dual diagnosis must treat both conditions. You need to stop using alcohol or drugs for the treatment to be effective. Treatments may include behavioural therapies and medicines. Also, support groups can give you emotional and social support. They are also a place where people can share tips about dealing with day-to-day challenges.
If you need to find a place that feels comfortable and supportive, let Roots Through Recovery‘s experienced clinicians and case management team work with you to help determine your next steps. We want you to have choices that will give you and your loved ones the best outcomes. Give us a call at (562) 304-9592 right now.