What Does It Mean to Have a Dual Diagnosis?

It is not uncommon for someone who is struggling with substance abuse and dependence to also have a mental health issue. More than half of individuals with drug or alcohol addiction have a co-occurring mental health disorder as well, which is referred to as dual diagnosis. Treatment programs in these cases can be complex and proper diagnosis is needed for successful recovery. Here we will help you understand what it means to have a dual diagnosis and how to get effective treatment for your best chance at long-term abstinence from drug and alcohol abuse.

Understanding Dual Diagnosis: A Comprehensive Definition

Dual diagnosis is a type of comorbidity and refers to when a person has a substance use disorder and one or more mental health disorders at the same time. When these disorders occur simultaneously, they can worsen the other and make recovery more challenging. However, sobriety is possible when dealing with dual diagnosis when the person receives the right treatment approach.

Substance abuse and mental health are intricately connected. They both affect similar areas of the brain which can lead to one worsening the symptoms of the other. Sometimes, individuals with a mental health disorder may use drugs or alcohol to cope with their symptoms. Not only does this type of self-medication mask the symptoms, but it can also make their mental health disorder worse. Substance abuse can also alter brain structure and chemistry which are responsible for mood regulation.

Substance abuse and dependence can also trigger or worsen pre-existing mental health disorders. Not everyone who uses drugs or alcohol will develop health issues, but if a person is predisposed, such as someone with a family history of mental illness, symptoms can be triggered by substance abuse. Sometimes, eliminating drugs or alcohol is enough to alleviate mental health symptoms like anxiety or depression, but in other cases, substance abuse changes brain structure and chemistry long-term.

Research has found that common risk factors, such as genes and environment, contribute to both mental health disorders and substance use disorders. Both disorders also share similar protective factors, which can include strong family connections and good self-esteem, which reduce the chance of either disorder occurring. This means that a person can develop both disorders simultaneously, independently from one another, but they can continue to worsen the other’s symptoms.

Common Mental Health Disorders Associated with Dual Diagnosis

Co-occurring disorders are quite common in addiction cases. The most common mental health disorders that occur with substance use disorders include:

• Generalized anxiety disorder (GAD)
• Attention deficit hyperactivity disorder (ADHD)
• Post-traumatic stress disorder (PTSD)
• Clinical Depression
• Bipolar Disorder
• Borderline personality disorder (BPD)
• Schizophrenia

Substance Abuse and Its Role in Dual Diagnosis

Even though dual diagnoses occur together, it does not necessarily mean one causes the other. However, there is a clear connection that substance abuse can play a role in the development of mental health disorders or worsening symptoms. Substances, including alcohol, marijuana, cocaine, and methamphetamines, cause changes to the brain structure and its ability to produce, regulate, and absorb biochemicals responsible for mood. Drugs and alcohol can cause temporary euphoria and relaxation, however, once the initial high wears off, the person can experience a comedown with feelings of anxiety and depression. The person may use it again in an attempt to offset these negative feelings.

Also, when people use substance abuse as a way to self-medicate mental health symptoms, they are only putting a temporary band-aid on it. The longer they do not healthily address their mental health, such as through therapy, the worse their mental health symptoms will become as well. Drugs and alcohol affect the reward system of the brain, so as the person continues to abuse substances, their brain craves more and more of that experience becoming dependent and may eventually develop a substance use disorder.  

Symptoms and Signs of Dual Diagnosis

Dual-diagnosis symptoms vary from person to person, depending on the type of substance dependence and type(s) of mental health disorders present. Many symptoms of mental health disorders overlap with substance use disorder, which is what makes dual diagnosis challenging to diagnose. One of the biggest signs of drug or alcohol dependence is the inability to stop using even when wanting to. If the person is engaging in repeated substance abuse along with mental health symptoms such as anxiety, depression, confused thinking, extreme mood changes, or paranoia, they may have a co-occurring disorder. Some other signs and symptoms of dual diagnosis include:

• Withdrawal from friends and family
• Using substances under risky situations
• Inability to control substance use
• Developing tolerance and withdrawal symptoms
• Feeling the need to use the drug to be able to function
• Sudden and dramatic mood changes
• Feelings of anxiety, depression, despair, or hopelessness
• Paranoia and/or hallucinations
• Dramatic shifts in energy levels
• Changes in sleep patterns

The Importance of Accurate Diagnosis

Many symptoms of substance use disorder can look similar to some mental health disorders which can make dual diagnosis go easily undetected. A trained and experienced clinicians can discern and diagnose co-occurring disorders accurately. With accurate diagnosis, the person can receive treatment for both disorders simultaneously and increase the chances of successful recovery. Without an accurate diagnosis, the person may only be treated for one disorder, letting the other one go unchecked. Someone who is only diagnosed with a mental health disorder may continue to abuse drugs or alcohol because they are not aware they have a problem. Or someone with a diagnosed substance use disorder may not get treated for an underlying mental health condition and quickly relapse when they experience the same symptoms they were attempting to cope with by using drugs or alcohol.

Challenges in Treating Dual Diagnosis

One of the biggest challenges in treating dual diagnosis is accurate diagnosis. Symptoms of substance use disorder can look quite similar to mental health disorders. Without simultaneous treatment for dual diagnosis, the person’s risk for relapse is much higher. Treatment for dual diagnosis is also more complex and can be longer. Often, individuals with dual diagnosis find it difficult to accept the reality that their struggles with mental health and substance use are connected. Also, it can be difficult to find mental health services that address both psychiatric and substance abuse issues at the same time. Treatment is also only effective if substance abuse is stopped, which is difficult on its own without professional treatment.

Effective Treatment Approaches for Dual Diagnosis

The most effective treatment for dual diagnosis is an integrative approach that addresses both substance dependence and mental health simultaneously. Programs should be personalized for each individual and include a variety of therapies to address all aspects of their addiction. Through evidence-based treatments such as cognitive behavioral therapy (CBT), psychotherapy, support groups, and medication management, individuals with dual diagnosis can learn coping skills and strategies to manage their symptoms. They can also learn and overcome their unique root cause of addiction. Inpatient treatment may also be needed for dual diagnosis treatment.

How WhiteSands Treatment Can Help with Dual Diagnosis

WhiteSands Treatment offers mental health treatment for both inpatient and outpatient treatment programs. Our highly skilled clinicians are trained to diagnose and address dual diagnosis. We provide all patients with personalized comprehensive recovery programs that will uncover the root causes of addiction and use the right therapies that effectively treat mental health disorders. Programs at WhiteSands are designed to teach the right tools and skills to manage dual diagnosis while aftercare programs support patients as they transition back to their daily lives.

If you would like more information about our recovery programs or to find dual diagnosis near you, please give us a call today at (877)855-3470.

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.