Understanding Dual Diagnosis
What Is Dual Diagnosis?
Dual diagnosis is a term used to describe a person living with both a substance use disorder (SUD) and a mental health disorder.
However, it is used to describe any combination of these challenges. For example, anxiety disorders and alcohol use disorder (AUD), bipolar disorder alongside opioid addiction, schizophrenia and prescription drug abuse, and more. Any combination of diagnosed mental illness with substance use can constitute a dual diagnosis.
Which Disorder Comes First in a Dual Diagnosis?
There is no set order of which comes first between substance abuse and mental health problems.
For some, mental health disorders can inform alcohol abuse and drug use to cope with their effects, leading to unhealthy coping strategies and developing into addiction over time. However, others may be exposed to addictive substances in daily life, with addiction bringing mental health issues. Regardless of which came first for any individual, exploring how to treat substance abuse problems and mental health needs in tandem is crucial to creating a comprehensive treatment plan.
What Is the Best Example of a Dual Diagnosis?
Anxiety disorders and alcohol addiction are both common, and many of those living with one may also live with the other, with the National Institute on Alcohol Abuse and Alcoholism (NIAAA) exploring the unique relationship between AUD and common anxiety disorders like generalized anxiety disorder, social anxiety disorder, and panic disorder.
Feelings of persistent anxiety can lead to a restless mind, with alcohol used to calm and sedate these thoughts. As a person uses alcohol more often or at increasing quantities to achieve the same effects, addiction can develop. However, the use of alcohol can also replace the development of other coping strategies, leading to alcohol feeling like one of the only ways to cope with anxiety, even as alcohol use counterproductively increases these anxious feelings.
For those in high-stress professions, especially first responders, military personnel, or medical professionals, post-traumatic stress disorder (PTSD) can be common. They can inform the use of drugs or alcohol in an attempt to self-medicate these challenges, leading to dual diagnosis and the need for professional, personalized support at a dedicated treatment center.
Are Co-Occurring Disorders and Dual Diagnosis the Same?
Dual diagnosis describes a combination of substance abuse disorders with mental health conditions, whereas co-occurring disorders is a more general term that describes a combination of any two substance abuse or mental health conditions, but not necessarily one of each.
Those living with dual diagnosis can also be described as having co-occurring conditions. However, co-occurring mental disorders are also possible without substance abuse, such as living with a personality disorder and depression. A combination of two psychiatric disorders can also describe co-occurring disorders, where dual diagnosis would not.
Are Comorbidity and Dual Diagnosis the Same?
Comorbidity is a clinical term used to describe the occurrence of two simultaneous medical conditions, and is not limited to the scope of mental health and addiction.
Those living with dual diagnosis or co-occurring disorders can also be described as comorbidity, but this term can also be used to describe the presence of any two diseases or conditions simultaneously in a more umbrella term.
Signs & Symptoms
What Are Early Warning Signs of a Dual Diagnosis?
Some potential early warning signs of developing dual diagnosis conditions include:
- Using drugs or alcohol to cope with stress
- Becoming secretive about substance use or the intentions behind substance use
- Persistent anxiety, depression, and mood swings
- Compromised hygiene and self-care routines
- Increased feelings of anxiety, depression, paranoia, or anger when not using substances
- Inability or unwillingness to tend to personal or professional responsibilities
Each person’s journey with both mental health and addiction will be unique. Discussing potential signs, concerns, and treatment options with a trained professional is the best way to explore each unique situation and develop a personalized treatment approach. Working with a professional treatment facility like Harmony Grove Behavioral Health to explore holistic needs and strategies can be essential to acting on early warning signs of dual diagnosis.
What Risk Factors Can Cause a Dual Diagnosis?
Dual diagnosis can come from many sources, from a genetic predisposition to addiction or mental health disorders to stressful environments that bring persistent anxiety. Environments that regularly expose a person to substances, and may even celebrate or romanticize substance use, can also introduce risk for dual diagnosis, especially when a person is exposed to multiple of these stresses.
Other risk factors can include underlying traumatic experiences, chronic stress without self-care or healthy coping skills, or the availability of addictive substances.
What Are Common Dual Diagnosis Symptoms?
Some of the most common dual diagnosis symptoms include anxiety, depression, mood swings, persistent worry, and irritation when not using drugs or alcohol.
Isolation from friends, family, and loved ones is also common. Strained personal relationships, living a more secretive lifestyle, persistent low energy, sudden onset of financial challenges, and an increase in risk-taking behaviors can all also be common in those living with both a serious mental illness and addiction.
What Are Early Signs That Immediate Action Is Needed?
One early sign to pay attention to is the reason behind using addictive substances. Using drugs or alcohol as a means to cope with stress can birth an unhealthy relationship and expectation with these substances at the expense of other, healthier coping strategies.
Likewise, an increase in feelings of anxiety, depression, self-isolation, and mood swings can also indicate the need for change and support. Contacting a professional treatment facility about how to support a loved one can help prevent drugs or alcohol from being used as a self-destructive coping strategy.
Diagnosis and Tests
What Tests Are Used to Determine a Dual Diagnosis?
There is no traditional test for determining a dual diagnosis. Rather, it is a series of interviews, individual therapy sessions, and mental health assessments to explore a person’s use of addictive substances, mental health needs, and the intersection between the two.
Dual diagnosis also isn’t typically diagnosed in a single instance. Rather, working with professionals over time to explore the effects of substance use and addiction, as well as explore underlying mental health needs, is typically required.
Can My Primary Healthcare Provider Determine If I Have a Dual Diagnosis?
While a primary healthcare provider can do initial evaluations for addiction and mental health disorders, they will typically have a referral to a specialist in addiction and mental health services for further evaluation.
Specialized care is crucial in overcoming dual diagnosis. These challenges are very personal and affect individuals in different ways. Personalized care with mental health specialists and addiction specialists is crucial to curating a plan to address a person’s unique experiences and needs in dual diagnosis treatment, addressing the specific substances used, mental health needs, and personal experiences with both.
Should I Seek a Specialist to Determine if I Have a Dual Diagnosis?
Yes. Dual diagnosis is complicated, and if you or your loved one is exhibiting potential signs of both mental health disorders and substance use disorder, a specialist can help you explore your needs, goals, and options for overcoming these challenges and to better understand how they may continue to inform each other in daily life.
Specialists can also help you adjust your treatment plan in response to new stresses or discoveries throughout the healing process.
Dual Diagnosis & Relationships
How Can a Dual Diagnosis Affect Relationships?
Both addiction and mental health disorders can compromise communication, trust, and breed feelings of anger, frustration, and resentment between loved ones and important relationships.
While the effects of both these challenges can feel very isolating, the effects of addiction and mental health disorders are never truly isolated in a single person. Emotional strain can be common across individuals and entire families. Coupled with potential financial or legal challenges associated with substance use, support and dedication to healing these relationships is important.
What Should Loved Ones Know About a Dual Diagnosis?
The most important thing for loved ones to remember is that addiction and mental health disorders are not a product of a lack of willpower or any kind of moral failing. A person is not using drugs or alcohol to hurt anybody intentionally, but rather feels trapped in a cycle of use themselves.
Many of those living with addiction may realize the need to stop, but are compelled to continue using despite negative consequences. Seeing addiction as a disease separate from the person, and mental health disorders as a condition affecting a person rather than the person themselves, is paramount to exploring change, forgiveness, and healing from these challenges together.
How Can I Support a Loved One With a Dual Diagnosis?
Educating yourself about addiction and mental health needs, exploring addiction treatment options alongside a person, and working with professionals to set healthy boundaries, model self-care and positive change, and work together on communication and understanding are crucial parts of supporting a loved one as they put in the hard work to overcome dual diagnosis.
What Strategies Help in Early Intervention?
Familiarizing oneself with risk factors and warning signs of dual diagnosis conditions, reaching out to local detox, inpatient, and outpatient treatment facilities to learn about treatment options and amenities, and locating support groups both for yourself and a loved one can all support early intervention and transition to effective professional care.
Management and Treatment
How Is Dual Diagnosis Typically Treated?
Dual diagnosis is treated through a combination of various evidence-based and holistic strategies, ranging from managing withdrawal symptoms during detoxification to cognitive-behavioral therapy (CBT), psychotherapy, support groups, experiential care, and individual therapy.
There is no one treatment for overcoming dual diagnosis. Rather, each person will have their own personal set of best practices and strategies to address the effects of mental health disorders and addiction in tandem, depending on their unique experiences, personal goals, and the challenges they face. Working with professionals and making adjustments to your treatment plan on your journey is all part of an effective healing process.
What Is a Dual Diagnosis Treatment Program?
These programs are dedicated to both mental health and addiction treatment, and blend evidence-based therapies with support from addiction specialists, mental health care professionals, and peer support groups to explore healing from all angles for a holistic approach to change.
What Are the Types of Dual Diagnosis Treatment?
Dual diagnosis treatment typically comes in two areas: evidence-based treatment modalities like cognitive-behavioral therapy, and holistic healing options, like experiential therapy programs to explore new perspectives in healing.
However, dual diagnosis is best treated with open-ended, personalized options. There is no single treatment for dual diagnosis, and working with a professional treatment facility like Harmony Grove Behavioral Health to explore both the evidence-based treatment options available as well as addictional amenities, experiences, and holistic healing options is part of successful treatment. Likewise, combined individual and group therapy is often used for personalized treatment and access to a supportive community in healing.
Are Integrated Treatment Options the Best for a Dual Diagnosis?
Yes, integrated treatment options are a great way to approach dual diagnosis, combining effective mental health treatment and substance use treatment into a single program that addresses these challenges in tandem.
Not only are integrated treatment options recommended, but treating one condition without the other can lead to an increased chance of relapse and gaps in personal healing strategies. Treating addiction without addressing underlying mental health needs can make it difficult to manage emotional needs and goals, with many falling back on substances due to underdeveloped coping strategies for addressing mental health disorders.
Likewise, treating mental health disorders without addressing the role that drugs or alcohol play in mental health can lead to a rocky healing journey, as these substances continue to negatively impact mental health and compromise these healing efforts.
FAQs
Is Autism a Dual Diagnosis?
No, autism is not a part of dual diagnosis, as it is not considered a mental health disorder.
How Common Is Dual Diagnosis?
Dual diagnosis is more common than many may realize. Approximately 36.5% of those living with any form of substance use disorder are also living with dual diagnosis, making addressing mental health and addiction in tandem paramount for effective healing.
Can Dual Diagnosis Be Prevented?
It is possible to prevent the development of addiction and treat the effects of mental health disorders before they develop into dual diagnosis. However, there is no way to guarantee preventing it, but reducing the risk is always possible.
Being aware of the signs, risk factors, and more is crucial. However, there is nobody immune to developing addiction or mental health disorders, but there is nobody who is ever beyond healing and change. Nobody is “too addicted” that they cannot pursue change, so whether you are working to prevent dual diagnosis or beginning your treatment for these conditions, change is always possible.
What Is the Most Common Comorbidity With ADHD?
Anxiety disorders, depression, and sleep disorders are common in those living with ADHD.
However, alcohol use is also possible, as well as addiction to prescription drugs, even those prescribed to address the effects of ADHD, such as stimulants like Adderall.
Is Dual Diagnosis a Disability?
Addiction is classified as a disease, and can be considered a disability under the literature of the Americans with Disabilities Act (ADA).
Can My Addiction and Mental Health Disorders Be Cured?
There is no simple “cure” for addiction or mental health disorders. However, while each person’s journey in healing will be unique, change is always possible.
Effective, personalized care, support groups, and ongoing hard work are all part of the journey. While medication to address specific challenges is also possible, such as to manage feelings of anxiety or specific challenges in addiction recovery, no medication can replace the hard work necessary to make lasting change. Rather, engagement in healing communities and a commitment to ongoing care are all part of overcoming mental health disorders, addiction, and their effects.
Overcoming mental health disorders, addiction, and the effects of each in dual diagnosis treatment is challenging, but never impossible. We at Harmony Grove Behavioral Health offer personalized and effective outpatient care to help support your healing journey while managing the effects of each on your daily life. We champion the healing potential of community and togetherness to bring the healing community of Houston, Texas, together in solidarity, supporting your journey overcoming dual diagnoses while exploring new ideas, perspectives, and therapies in effective treatment. To learn how we can create an outpatient program for you, or for more information on our healing methods and opportunities, call to speak to us today at (713) 564-6468.