What is Dual Diagnosis in Substance Abuse Treatment?

Dual diagnosis, also known as co-occurring disorders or comorbidity, is a prevalent diagnosis when someone has both a substance use disorder (SUD) and a mental health issue. About half of individuals with SUD also struggle with mental health disorders. Either one can cause the other or can make the other disorder worse. While it can complicate the recovery process, treatment and management are possible with the right therapies.  

Understanding Dual Diagnosis: Definition and Importance

Dual diagnosis in substance abuse is when the person has a mental health disorder and substance use disorder simultaneously. When these disorders occur together, the symptoms of each can be worse. Untreated mental health disorders can cause or worsen substance abuse. Often, individuals will use drugs or alcohol to self-medicate mental health issues or stress. When substance use increases, mental health problems may also increase, creating a vicious cycle.

Treatment for dual diagnosis is vital for successful recovery. Both disorders need to be addressed simultaneously to prevent relapse. It can address the root cause of addiction and help individuals learn healthier ways to manage their symptoms instead of turning to substance abuse.

Common Co-Occurring Disorders in Dual Diagnosis

Dual diagnosis includes an addiction and one or more mental health disorders. While many emotional issues can have a strong impact on a person’s addiction issues, such as low self-esteem, grief, guilt, stress, and anger management issues, these are usually considered symptoms rather than disorders. When referring to co-occurring disorders, a mental health diagnosis is what leads to the above symptoms. The most common co-occurring disorders in dual diagnosis include:

• Generalized Anxiety Disorder (GAD). Symptoms of GAD include experiencing frequent and recurring anxiety or panic attacks. The person may also struggle with sleep disturbances, restlessness, and functional impairment.
• Bipolar Disorder. Individuals with bipolar disorder may be especially vulnerable to substance abuse. This mental illness can cause uncontrollable, severe episodes of depression and mania caused by chemical imbalances.
• Post-Traumatic Stress Disorder (PTSD). Individuals who experience trauma or severely stressful events may develop PTSD. They can experience severe anxiety, depression, night terrors, and flashbacks.
• Depression. This mental health condition can be temporary or chronic and is characterized by a low mood or loss of interest in activities that last most of the day, nearly every day for at least two weeks. Individuals can experience disturbed sleep, hopelessness, poor concentration, and feelings of guilt or low self-worth.

The Connection Between Mental Health and Substance Abuse

According to reports published in the Journal of the American Medical Association, about 50 percent of individuals with severe mental health disorders are also affected by substance abuse. Individuals with mental health disorders such as anxiety, depression, or PTSD may use drugs or alcohol to self-medicate their symptoms. If the person engages in frequent substance abuse, they may develop a dependence and eventually addiction to the substance. Using drugs and alcohol can also make mental health symptoms worse, perpetuating a vicious cycle.

Substance abuse can also trigger pre-existing mental health disorders. Alcohol and drug use can eventually lead to dramatic changes in the brain structure and chemistry. When the delicate balance of hormones and biochemicals in the brain is thrown off, they can begin to experience symptoms of mental health disorders. They may turn to more substance abuse in an attempt to quell these symptoms, making both disorders worse.

Research also shows that common risk factors can contribute to both mental illness and substance abuse. Both disorders are caused by overlapping factors such as genetics and environment. For example, stress from trauma in childhood can contribute to the development of a substance use disorder, a mental health disorder, or both. Genes also play a role as both disorders can run in families.

Signs and Symptoms of Dual Diagnosis

Dual diagnosis in substance abuse symptoms will vary from person to person depending on the type(s) of mental health disorder and which substances are being abused. Some common signs and symptoms of dual diagnosis include:

• Experience anxiety or panic attacks.
• Social withdrawal from friends, family, and those who offer support.
• Severe tension or worry
• Angry, violent, or reckless behavior.
• Changes in appetite or weight.
• Changes in sleep patterns, either not sleeping or sleeping too much.
• Intense feelings of despair, hopelessness, and worthlessness.
• I was experiencing delusions, paranoia, or hallucinations.
• Inability to concentrate.
• Extreme mood swings.
• Dramatic shifts in energy levels.
• Decline in work or school performance, due to mental health symptoms or substance abuse.
• I was using drugs or alcohol as a coping mechanism for any of the above symptoms.
• Inability to stop using drugs or alcohol, even when wanting to.
• Negative consequences due to drug or alcohol use.
• Spending large amounts of time thinking about, obtaining, using, or recovering from drug or alcohol use.

Challenges in Treating Dual Diagnosis

One of the biggest challenges in treating dual diagnosis is the person accepting that their mental health issues and substance use struggles are linked. Treating dual diagnosis is complex in itself as well. Overlap of symptoms related to mental health disorders and addiction can make diagnosis difficult. It is critical that both conditions be treated simultaneously and not all substance abuse facilities have the capability of treating dual diagnosis. Patients need to choose a facility that meets their needs and can treat mental health disorders along with their substance use disorder. Individuals with co-occurring disorders also have a higher risk for relapse, which can require long-term and robust treatment strategies.

Effective Treatment Approaches for Dual Diagnosis

Dual diagnosis treatment will include addressing mental health conditions and substance use disorders concurrently. Clinicians will work with patients to help them understand how each disorder affects the other and provide them with the right treatment strategies to manage both. For dual diagnosis treatment to be effective, the person must stop using addictive substances. Some people may need to start with medical detox to help them wean off drugs and alcohol safely while managing withdrawal symptoms which usually result in early relapse.

Depending on the severity of symptoms, the person may enter inpatient or outpatient dual diagnosis treatment afterward. Therapies used in dual diagnosis in substance abuse treatment can include medication, behavioral therapy, psychotherapy, support groups, and life skills programming.

The Role of Integrated Care in Dual Diagnosis Treatment

The most effective treatment programs will include a variety of therapies that address the body, mind, and spirit. Integrated treatment strategies help address both disorders at the same time. Along with early detection, integrated treatment can improve outcomes for individuals with co-occurring disorders. Integrated care in dual diagnosis combines medication, mental health therapy, education, and social interventions to create an individualized program that addresses each person’s needs. Programs can also include aftercare support, life skills programming, and help individuals find the resources to live on their own after rehab, such as finding a place to live and a job.

How WhiteSands Treatment Can Help with Dual Diagnosis

WhiteSands Treatment offers mental health treatment for patients struggling with drug or alcohol abuse and addiction. Our facility treats patients who present with a primary diagnosis of addiction/substance use disorder. However, clinicians are trained and equipped to treat co-occurring disorders and offer dual diagnosis treatment. Primarily, we treat patients with the following dual diagnosis:

• Anxiety disorders
• Depression
• Bipolar disorder
• PTSD

Our programs are personalized and can include a combination of medication-assisted treatment (MAT), medical detox, individual therapy, group therapy, family therapy, educational programs, holistic therapies, and aftercare options. If you have noticed a mood disorder and substance abuse in yourself or a loved one, WhiteSands Treatment can provide the best chance at recovery. Please give us a call today at (877) 855-3470 to learn more about our dual diagnosis programs or to start the intake process. 

If you or a loved one needs help with abuse and/or treatment, please call the WhiteSands Treatment at (877) 855-3470. Our addiction specialists can assess your recovery needs and help you get the addiction treatment that provides the best chance for your long-term recovery.