Dual Diagnosis

dual diagnosis

What makes an individual choose to use drugs? What element causes one person to become an alcoholic when others do not succumb to the disease of alcoholism?

While genetics have been shown to play some part in addiction diseases, there is often another element that contributes to addiction in a significant manner. That element is the presence of underlying psychological disorders or diseases that have been left unchecked and undiagnosed. When an individual chooses to begin the recovery process, it is imperative that a qualified psychologist investigates the presence of a Dual Diagnosis.

Drug Addiction Is a Mental Health Disorder

In order to fully understand the concept of a Dual Diagnosis, it must be fully understood that addiction is also a mental health disorder.

The National Institute on Drug Abuse defines addiction as a chronic, relapsing brain disease marked by specific behaviors. The symptoms can be different for everyone, but typically will include the inability to stop taking drugs despite harmful effects, and withdrawal symptoms when the drugs are not ingested.

The withdrawal symptoms places drug addiction on the physical side of the diagnosis spectrum as well, but the psychological addiction is treated via various mental health programs.

Dual Diagnoses Are Common Among Addicts

According to the National Institute of Mental Health, individuals who suffer from drug or alcohol addiction are twice as likely to have co-existing psychological disorders as the general population. The opposite is also true. Individuals who suffer from certain diagnoses of a psychological nature are twice as likely to also suffer from addiction issues.

The link between the two statistics is obvious, although there is no clear evidence that one causes the other. There are two primary theories as to why the commonality has occurred, however.

Drug Use Can Create Symptoms of Other Mental Health Issues

Many drugs have side effects that mimic psychological and mental health disorders. For instance, long-term marijuana use has been linked to an increase in psychosis. Long-term cocaine addiction can cause paranoia. These side effects of the drug use may be permanent even after an individual has stopped abusing drugs, and therefore they must be treated as co-existing conditions.

Simply treating the drug addiction, but leaving a Dual Diagnosis untreated greatly increases the chances of an individual suffering relapse.

Undiagnosed Psychological Conditions May Contribute to Drug Abuse

When an individual suffers from a mental health issue, he or she may feel the need to “self-medicate.” This can be especially true for those individuals whose mental health condition is undiagnosed. If the conditions have not been properly identified as a Dual Diagnosis, those suffering from co-occurring disorders may not recognize that anything is wrong. They feel as though their feelings are “normal for them,” and there is nothing that can be done about them. They may also believe that everyone feels as they do. If they are surrounded by high-risk environments or people in their lives who use drugs, taking drugs to alleviate their sadness or anxiety will also feel like a normal and appropriate solution.

Someone who has been properly diagnosed may be treated with prescription medications for anxiety, stress or depression. When this occurs, there is a chance that he or she will misuse their prescriptions and develop a serious dependence on the drug. As the dependence increases, so does the body’s tolerance to the drugs that have been prescribed. This can easily lead to addiction.

How Is a Dual Diagnosis Discovered?

Proper evaluation is incredibly important when it comes to treating the whole person. Taking a holistic approach to addiction treatment is the first step to finding any possible co-existing conditions. At a quality treatment center, the recovering addict will undergo a series of psychological tests to get to the root of the addiction issue. These tests will help the staff of the treatment center develop a program that might include:

  • Cognitive Behavioral Therapy
  • Alternative therapies
  • One-on-one therapy
  • Proper medication for underlying issues

Why Is Treatment Important?

The availability of Dual Diagnosis treatment can make the difference between someone getting clean and sober for a short period of time, and that same individual remaining sober and healthy for the rest of his or her life.

If recovering addicts are surrounded by caring and trusted individuals in a residential setting, they may feel safe, secure and loved. During this time, they are drug- and alcohol-free, and they have a few weeks or months where the stress and weight of the world has been removed from their shoulders.

When individuals leave the treatment center, they return to their prior environment. They return to the same environment that overwhelmed them prior to entering rehab. If a recovering addict suffers from an undiagnosed anxiety disorder, he will become overwhelmed and begin to feel the same panic that he experienced previously. The cycle of drug abuse can easily begin again in a Dual Diagnosis situation.

However, if that recovering addict is properly diagnosed with his anxiety disorder while in treatment, he can leave rehab with the proper prescription medication, detailed instructions for its use, and an education specific to the risks involved. In addition, the individual will have undergone psychological counseling and developed ways to better deal with both his addiction issues and anxiety disorder. By keeping the anxiety under control, he is more likely to find happiness on the other side of a Dual Diagnosis.

Dual Diagnosis Treatment Center

What Types of Mental Health Disorders Are Common?

Mental health disorders can range from mild to severe. Many of the disorders commonly seen in a Dual Diagnosis situation are related to stress, trauma or psychosis.

An individual may suffer from:

  • Post-traumatic stress disorder
  • Extreme stress or anxiety
  • Bipolar disorder
  • Schizophrenia
  • Anorexia or other eating disorders
  • ADHD or ADD
  • Borderline personality disorder
  • Depression

The most common undiagnosed disorders are generally related to depression or anxiety, as the symptoms of these disorders are not easily recognized and are often hidden due to shame. Many people are reluctant to seek help simply because they feel sad or nervous.

A Dual Diagnosis Can Affect Anyone

Drug abuse does not discriminate. Likewise, mental health and psychological disorders do not discriminate. A Dual Diagnosis condition can affect men or women of any race, age or religion. It can devastate the lives and families of the wealthy or the poor. Addiction and mental health disorders do not affect only those with medical insurance or jobs.

The availability of care may contribute to the frequency of co-occurring disorders in some populations and demographics; however, the condition itself can affect anyone.

The Substance Abuse and Mental Health Services Administration, a division of the U.S. Department of Health and Human Services, released the findings of a study conducted to ascertain the treatment and environmental status of individuals in the workplace. They found that roughly 10 percent of working Americans between the age of 18 and 64 years had a substance abuse issue in the year prior to the study. They also discovered that roughly 10 percent of workers had experienced serious psychological issues during that same time frame. An overlapping 2.6 percent had co-occurring issues. Other findings of the study revealed:

  • Men were more than twice as likely to have substance abuse issues than women.
  • Women were twice as likely to have mental stress or related disorders than men.
  • About 2.9 million working adults reported Dual Diagnosis conditions.
  • Sixty percent of those who acknowledged a Dual Diagnosis condition received treatment for either condition.
  • Less than five percent of these individuals received treatment for both conditions when they entered a treatment center.

Treating an individual with a Dual Diagnosis is a comprehensive, team effort between the consulting clinical team, the staff of a treatment center and the afflicted individual. It is possible to properly diagnose and treat these conditions, giving the recovering addict a greater chance of finding peace on the other side of his or her addiction and mental health issues.

Ian Wolds

By Ian Wolds
Clinical Director