A person with a dual diagnosis is one who suffers from a both a mental disorder and a substance abuse problem. According to statistics, almost half of all people with a severe mental disorder are affected by substance abuse, and 29 percent of all people diagnosed as mentally ill abuse either alcohol or drugs. Often the psychiatric problem occurs first followed by an attempt to feel better through self-medication with drugs or alcohol. Other times the alcohol or drug dependency occurs first and leads to depression, anxiety and more severe emotional and mental problems. Whatever the case may be, a patient’s chances of recovery from either disorder are miserably slim unless both disorders are simultaneously treated.
What Is Dual Diagnosis
In the 1980s, doctors began to more clearly identify dual diagnoses in patients. This led to the rise of the term, “dual diagnosis,” which became more popular throughout the 1990s. “Dual diagnosis” simply means the occurrence of more than one disorder in the same patient. Usually, it is even more specific, referring to at least one mental health disorder and at least one substance use disorder.
As an example, a patient with a bipolar disorder diagnosis and an addiction to alcohol would be said to have a dual diagnosis. Someone with post-traumatic stress disorder and an addiction to opiates would have a dual diagnosis. Either problem can develop first, although one is frequently a consequence of the other, and abusing substances often worsens mental health problems.
However, clinicians today prefer to use a newer term: “co-occurring disorder.” Both terms refer to similar things, but “dual diagnosis” has fallen out of favor. In fact, according to SAMSHA, the occurrence of both mental health and substance abuse disorders in the same patient is now called co-occurring disorders.
It is very common for substance use and mental health disorders to occur in the same patient, for a variety of reasons. According to the National Alliance on Mental Illness (NAMI), addiction is a problem for up to 50 percent of people with diagnosed mental health conditions. Almost 29 percent of everyone with a mental health diagnosis will abuse alcohol or drugs at some point, maybe to deal with their symptoms—and many don’t get treatment. Along these lines, about six out of 10 people with substance use disorders also have a mental health disorder.
What Is Co-occurring Disorder
As of 2014, a nationwide survey concerning health and drug use found that 7.9 million Americans experience both a substance use disorder and a mental disorder at the same time. More than half of them, about 4.1 million, are men.
Experiencing a substance or alcohol use disorder is more likely for someone with a mental health disorder than it is for someone with “normal” mental health. It is sometimes very difficult to diagnose co-occurring disorders, because the symptoms are complex, may vary in severity as to both disorders, and may confound each other. Often, people receive treatment for one problem, while the other goes untreated—and this means the existing treatment isn’t likely to succeed.
This treatment gap can happen because both substance use disorders and mental health disorders can have psychological, biological, and social components. It may also be that diagnosing providers are less experienced with either substance use or mental health disorders, or that symptoms are overlapping, or that overarching physical health issues that obscure other problems present and must be dealt with before anything else.
Whatever the reason for “missing” co-occurring disorders, the result of leaving them undertreated, untreated, or undiagnosed can include higher rates of incarceration, homelessness, physical illness and disease, and even suicide and other causes of death.
Integrated treatment is best for people with co-occurring disorders. This kind of treatment allows practitioners to deal with both substance use and mental health disorders simultaneously, typically saving money, time, and leading to improved outcomes. To more effectively identify and treat co-occurring disorders, it is essential to build capacity and increase awareness. Quick detection and early treatment can enhance treatment outcomes and improve quality of life for patients.
Dual Diagnosis Versus Co-occurring Disorders
“Co-occurring disorders” simply means more than one disorder happening in the same patient at the same time. This is preferable to the term “dual diagnosis,” because “dual” suggests only two problems, which can be limiting. Many patients don’t cope with two easily diagnosable problems. Instead, co-occurring disorders suggests that there is a spectrum of issues in both the realms of mental health and substance use.
The Need for Dual Diagnosis Treatment: Drug Addiction and Anxiety Disorder
Anxiety is a common emotion that some people feel every day, but anxiety disorders are much more severe and have serious consequences on a person’s ability to live a normal life. That’s why some people who suffer from an anxiety disorder such as General Anxiety, Panic Disorder, Post Traumatic Stress Disorder (PTSD), Social Phobia or Obsessive Compulsive Disorder (OCD) will attempt to self-medicate their symptoms by turning to alcohol or drugs. This may provide a temporary escape, but the substance abuse will inevitably increase the severity of their anxiety symptoms.
Drug addiction can also include prescription drug abuse. Long-term use or abuse of certain drugs prescribed for anxiety symptoms can lead a person to develop an addiction. Whatever the drug of choice is, a person suffering from drug addiction and an anxiety disorder will need dual diagnosis treatment in order to overcome both disorders.
The Need for Dual Diagnosis Treatment: Drug Addiction and Bipolar Disorder
Bipolar disorder is a psychiatric illness that can seriously impact a person’s life. Also known as manic depression, bipolar disorder creates extreme shifts in a person’s mood and energy that range from mania to depression. Bipolar disorder and alcohol/drug addiction often go hand in hand, and the symptoms of each disorder overlap is such a way that’s it can be very difficult to recognize that both an addiction and bipolar disorder co-exist. Once both disorders have been identified, dual diagnosis treatment will be the most effective way to treat the symptoms of both disorders and help the patient manage their bipolar disorder without depending on drugs or alcohol.
The Need for Dual Diagnosis Treatment: Drug Addiction and Depression
Like bipolar disorder, the symptoms of depression and drug addiction are so similar that it may be difficult to know where one disorder begins and the other one ends. Many people will turn to drugs to self-medicate their depression symptoms and others will develop severe depression as a result of using drugs over time. No matter which comes first, drug addiction and depression puts a person in a vicious cycle that can be effectively ended through dual diagnosis treatment. Properly addressing and treating the depression symptoms will be the only way a patient can begin the journey to drug addiction recovery.
How to Choose a Dual Diagnosis Treatment Facility
A good dual diagnosis treatment facility will address all issues relating to the mental illness and the substance abuse problem. It should provide treatment for drug and alcohol use, behavioral addictions, codependency patterns, mental health, trauma issues, eating disorders, sexual addiction, family functioning, social relationships, physical health and fitness, diet and nutrition, vocational and education needs, and legal problems.
Without comprehensive treatment, a person suffering from bipolar disorder, depression or an anxiety disorder will inevitably continue the unending cycle of self-medicating their mental illness symptoms through substance abuse. If you know someone who has dual diagnose symptoms, encourage them to seek treatment at a dual diagnosis drug rehab where they can be properly diagnosed and effectively treated.