Understanding Dual Diagnosis: Mental Illness and Substance Abuse

Dual diagnosis is a term used to describe a person with a mental health disorder and a substance use disorder. It is quite common for people who are addicted to drugs or alcohol to have a dual-diagnosis or co-diagnosis disorder. Interactions of the two conditions can worsen both, and treatment should address both addiction and depression at the same time. For example, an alcoholic with depression, anxiety, and antisocial disorder suffers from a dual diagnosis.

The patient can only suffer from one of each type of disorder, for example, a paranoid schizophrenic with cocaine addiction also suffers from a dual diagnosis. A person with dual diagnosis has a mental disorder and a problem with alcohol or drugs. About half of people who have a mental disorder will also have substance use disorder at some point in their lives and vice versa. Very often they started drinking to help overcome the symptoms of depression. And it helped, for a while, but then alcohol consumption increased because it stopped calming the symptoms of depression.

This led to an addiction to alcohol, as well as to the original problem of just depression. Others may have drunk for a long time and became depressed because they acquired an alcohol dependence. Alcohol is a known depressant, and consuming too much alcohol at a time, or relying on it for a long period of time, will greatly aggravate depression. If the patient only has signs of depression, that condition can be treated more easily than if the same person is also struggling with depression and PTSD or panic disorder at the same time. This complicates treatment, as both conditions need to be identified and treated, along with substance use addiction.

For others, they may only have a single mental illness, such as bipolar disorder, even though they are addicted to alcohol and opioids. The treatment protocol may be different for each of the substances because they affect different and separate regions of the brain. TMS therapy for depression could also treat addiction. Alcoholism and depression are often compared to the chicken and egg analogy in that people tend to wonder what developed first—alcoholism or depression—and rightly so. Alcoholism and depression go hand in hand like no other.

For some, depression is the main condition and alcoholism develops when an individual begins to abuse this substance as a coping mechanism for depression. Others, however, develop alcoholism and, in turn, begin to experience symptoms of depression due to that alcohol intake. Either way, when alcoholism and depression occur at the same time, it is a dual diagnosis and will likely require thorough treatment to overcome it. Patients with dual diagnosis have one or more mental disorders (including anxiety disorder, depression, etc.) The possibilities are almost endless, as you can imagine. When considering the most common dual-diagnosis disorders, it is also necessary to diagnose all possible combinations of mental health and addiction. Dual diagnosis rehabilitation centers face the unique challenge of treating multiple disorders without aggravating any course of treatment. That is why it is imperative to never overlook the signs of a mental health or behavioral problem with regard to an individual's long-term dependency recovery plan. A person diagnosed with substance abuse and another mental disorder may be particularly challenged by the social difficulties of a dual diagnosis.

An article published in Psychology Today states that “Compared to people who have a single disorder, those with a combination of disorders may experience more serious medical and mental health challenges and may also require longer treatment periods. A dual diagnosis carries a whole set of unique problems, and understanding these issues is key to treatment and recovery. To be properly analyzed, the person should consult a specialist experienced in the treatment of dual diagnosis. Conversely, it is common for people with mental illness to develop behavioral disorders outside of substance abuse, such as gambling addiction, sex addiction, or shopping addiction. Posttraumatic stress disorder (PTSD) can develop after a person experiences one or more traumatic events such as natural disaster, terrorism, loss of loved one, combat or sexual abuse among others. Although dual diagnosis treatment makes treatment more complex even in severe situations recovery is possible with the appropriate treatment program. The good news is that addiction treatment centers that specialize in dual-diagnosis disorders have the expertise and staff to get to the root of all present problems and work effectively with patients to overcome them. It is important to note that the Family Medical Leave Act (FMLA) ensures that employees even those on temporary contracts can take time off from work for the purpose of being with their families or receiving medical treatment for a dual diagnosis.

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