What Is a Dual Diagnosis?

The terms "dual diagnosis" or "co-occurring disorders" describe a condition where an individual struggles with both a psychiatric disorder and a substance use disorder (drug addiction or alcoholism).

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According to the American Psychiatric Association, dual diagnosis is a term used for an individual who suffers from both a substance abuse disorder and another mental health disorder. 

The DSM-5 has replaced the phrase ‘dual diagnosis’ with ‘co-occurring disorders’. The DSM-5 states that dual diagnosis or co-occurring disorder is when “an individual meets the diagnostic criteria for a substance use disorder in addition to an independent mental health disorder within a 12 month period”.

Addiction, on the other hand, is a chronic disease that can affect anyone regardless of occupation or social status. Addiction is defined as continued use of alcohol and/or drugs despite the harm it causes to your health, relationships, finances, work, etc. According to SAMHSA’s 2018 National Survey on Drug Use and Health, approximately 9.2 million adults in the United States have a co-occurring disorder.

Signs of a Co-Occurring Disorder

Sometimes, it may be difficult to know exactly what you are experiencing when looking at your symptoms at face value. The following questions might help to determine whether a person is suffering from co-occurring disorders.

  • Do you have long-term trouble with your emotions or moods?
  • Are addictions an issue for you, such as gambling addictions?
  • Do you get so mad that you throw things or hurt yourself physically?
  • Is it difficult for you to stop using alcohol or drugs even though it’s putting a strain on your relationships, family, job, school work, and activities?
  • Do you often feel worthless and like nothing in life is going to get better?
  • Do you think about dying or killing yourself when things get really bad?

Also, have friends or family talked about your drinking or drug use problem? Of course, that doesn’t necessarily mean you have an addiction or co-occurring disorders. But, if those around you have noticed a problem, it is best to assess the situation. 

(It’s important to know that other disorders that can cause this behavior might include bipolar disorder, anxiety disorder, ADHD, and clinical depression.)

The Connection Between Psychiatric Disorders and Substance Abuse

Simply put, having a dual diagnosis means that an addict’s mental state is unstable due to psychiatric illness and/or the use of mind-altering substances. No matter what a person’s dual diagnoses are, however, there must always be a strong emphasis on both mental health and drug rehabilitation given the complex nature of dual diagnosis patients’ needs.

When dual diagnosis treatment patients first enter a program, they may be suffering from some level of agitation and/or depression. This may come as a result of some form of withdrawal due to the cessation of drug use by addicted dual diagnosis patients. For example, an alcohol use disorder can cause inflammation in the brain, which can lead to mood disorders. 

Peer pressure and substance availability are two of the most common reasons co-occurring disorder patients turn to drugs/alcohol. In order to break this pattern, dual diagnosis treatment programs use a variety of methods involving cognitive behavior therapy, interpersonal psychotherapy, transference-focused psychotherapy, etc., during dual diagnosis treatment sessions.

What is the Dual Diagnosis Treatment Model?

The model of the dual diagnosis program includes both addiction treatment and mental health disorder treatment. This model of treatment works to address this comorbidity by treating both conditions simultaneously. Otherwise, relapse rates tend to remain quite high because patients are unable or unwilling to fully recover mentally before trying to kick their drug habits.

This dual diagnosis model has proven successful enough that it forms the basis for many dual diagnosis rehab programs today. In a dual diagnosis treatment program, no matter what a person’s co-occurring disorders are, there must always be a strong emphasis on mental health rehabilitation given the complex nature of dual diagnosis patients.

Can a Dual Diagnosis Program Prevent Relapse?

A dual diagnosis program can help people become free from addiction and manage their mental health symptoms. But it cannot stop a person from relapsing. Relapse prevention is not only a matter of which type of program a person enters. It is also a matter of the individual’s personality, coping skill development, and willingness to continue moving forward. 

Not everyone is a good candidate for dual diagnosis treatment programs because the psychiatric aspect of dealing with a dual diagnosis can be very difficult. For this reason, dual diagnosis rehab centers provide treatment in an environment where the patient feels comfortable and at ease.

The fact that dual diagnosis patients must face their co-occurring conditions simultaneously has led to some debate regarding whether or not all patients will benefit from dual diagnosis treatment. Though no one method is foolproof, when combined with comprehensive holistic care addressing both mental health and addiction issues, dual diagnosis rehab offers hope where there once seemed to be none.

Which Therapy Approaches Can I Expect in a Dual Diagnosis Program?

Different dual diagnosis programs will use different therapies. The types of psychotherapies that dual diagnosis patients may benefit from may include the following:

Specific cognitive behavioral techniques can help dual diagnosis patients become aware of their own feelings and learn how to control them. Therapists work with the patient to understand how certain thoughts, emotions, and actions relate to one another.   

By learning more about their own behaviors, dual diagnosis patients can improve their coping skills and avoid negative patterns that might lead to relapse. A skilled dual diagnosis rehab counselor will take into account a patient’s individual needs in the process.

To address the dual nature of the disease, dual diagnosis rehab programs will staff therapists who are trained in areas such as psychiatry, psychology, addiction counseling, and more. This allows them to work with dual diagnosis patients from various angles—ensuring they get all of their treatment needs to be met in one place.

Sometimes, dual diagnosis patients need ongoing care in order to prevent relapse. The goal of dual diagnosis treatment is to help patients achieve and maintain emotional stability so they can avoid triggers that might cause them to use drugs or alcohol again.

How Common is Dual Diagnosis?

Dual diagnosis is a recurring component of substance abuse rehab. Not only do dual diagnosis treatment programs have to battle mental health issues, but these patients also have to fight against addictions. 

People receiving treatment for mental health disorders also often suffer from addictions to the following types of substances:

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Why Are Mental Health Stigmas Common?

Mental health stigmas repeat throughout social circles and media. These stigmas keep people from getting timely and effective treatment. Dual diagnosis is one of the most common forms of mental health stigma today.

There is no clear line showing which came first, and it often varies on a case-by-case basis. Mental illness does not always cause substance abuse: sometimes substance abuse comes before mental illness develops. 

The two conditions exist together at an alarmingly high rate among America’s population. Dual diagnosis programs can be very helpful in understanding this complexity as well as overcoming some major barriers to recovery such as lack of acceptance within society and rehabilitation centers alike. The obstacles of receiving treatment can be frustrating, but dual diagnosis treatment at Kingsway Recovery can help break down these barriers.

Mental Health Statistics in New Jersey

From September 29 to October 11, 2021, 28.6% of adults in New Jersey reported symptoms of anxiety and/or depressive disorder, compared to 31.6% of adults in the U.S. The share of adults in New Jersey with any mental illness was 16.4% in 2018-2019, which was lower than the U.S. share (19.9%).

Consequently, deaths due to drug overdose also increased from over 72,000 deaths nationally in 2019 to over 93,000 deaths in 2020. The recent uptick in substance use and related deaths disproportionately affected many people of color, although non-people of color continue to account for the largest share of deaths due to drug overdose per year. 

In 2020, there were 2,551 opioid overdose deaths in New Jersey, which accounted for 89.9% of all drug overdose deaths in the state. Suicide is one of the leading causes of death in the U.S. and has increased in almost every state over time, making it a serious public health concern. 

Mental Illnesses Treated Through a Dual Diagnosis Program

This dual diagnosis treatment program at Kingsway Recovery has extensive experience in recovery support, detoxification, and overall rehab to address these types of dual diagnosis patients. We offer treatment for various mental health disorders in combination with substance abuse rehab.

Anxiety and Addiction

Anxiety can be described as a form of stress that is mental at its root, while addiction is physical. Unfortunately, anxiety disorders are the most common mental health concern in the United States. According to the National Alliance on Mental Illness (NAMI), over 40 million adults in the U.S. (19.1%) have an anxiety disorder. Meanwhile, approximately 7% of children aged 3-17 experience issues with anxiety each year. Most people develop symptoms before age 21. For dual diagnosis patients suffering from dual recovery, anxiety can be a significant factor.

Depression and Addiction

Depression is one of the most prevalent mental health conditions. About 21 million U.S. adults (8.4% of the population) had at least one major depressive episode in 2020. People of all ages and all racial, ethnic, and socioeconomic backgrounds experience depression, but it does affect some groups more than others.

Treatment for dual diagnosis must be tailored to address the needs of each individual patient. Managing dual diagnosis recovery requires an awareness that these individuals are affected by both internal factors (such as mental illness) and external factors (alcohol/drugs). Because recovery from co-occurring disorders is complex, most patients require a combination of medication and talk therapy – dual diagnosis treatment – over an extended period.

Schizophrenia and Addiction

Schizophrenia is a mental illness that can be described as a psychotic disorder. Symptoms such as delusions, hallucinations, lack of motivation, etc., may lead dual patients into abusing drugs in an attempt to self-medicate. 

The relationship between schizophrenia and drug addiction is so complicated that dual diagnosis treatment is often required. Drug abuse not only worsens the patient’s condition, but it also increases the risk of getting schizophrenia in people with a family history of mental illness.

PTSD and Addiction

PTSD (Post Traumatic Stress Disorder) is a mental health disorder that can co-occur with addiction. PTSD can affect anyone; however, the risk of developing PTSD increases dramatically for those who have been exposed to violence or natural disasters. PTSD affects 3.6% of the U.S. adult population—about 9 million individuals. 

Many dual diagnosis patients turn to drugs as a way to self-medicate a dual diagnosis after experiencing a traumatic event such as a hurricane or earthquake. Dual diagnosis treatment focuses on helping individuals understand that addiction is always present and preventing relapse. Furthermore, dual diagnosis treatment helps those with addiction understand the importance of medication-assisted recovery.

OCD and Addiction

OCD (Obsessive Compulsive Disorder) is characterized by repetitive, unwanted, intrusive thoughts (obsessions) and irrational, excessive urges to do certain actions (compulsions). 1.2% of U.S. adults experience OCD each year. 

The National Institute of Mental Health (NIMH) classifies OCD as a type of anxiety disorder that can trigger dual diagnosis mental health issues such as depression, self-mutilation, substance abuse, etc. Those who suffer from dual diagnosis OCD should seek dual diagnosis treatment in order to understand the connection between obsessive-compulsive behavior and substance abuse.

ADHD and Addiction

ADHD (Attention Deficit Hyperactivity Dis­order) is characterized by inattention, hyperactivity and impulsivity. An estimated 4.4% of adults aged 18-44 have ADHD.

It is important to understand how ADHD, bipolar disorder, and depression can affect one another when seeking dual diagnosis treatment for these conditions. Those with ADHD are more likely to abuse alcohol, stimulants, and narcotics.

The Benefits of Psychotherapy

The benefits of psychotherapy for dual diagnosis are the optimal treatment for dual diagnosis because it helps with both mental health and addiction. Psychotherapy can help make dual diagnosis sufferers more self-aware, reduce depression and anxiety symptoms, and help dual patients with cognitive issues.

Here are some of the positives of psychotherapy, which is used in dual diagnosis:

  • The patient will meet with their therapist between once a week and 3 times a week.
  • Psychodynamic therapy deals with how the past affects the present situation.
  • It also deals with how defenses protect against feelings.
  • Negative emotions are brought to light so they can be resolved so they don’t add to any addictions or other.

Channel Your Growth Through Kingsway Recovery Center

Co-occurring disorders are treatable. Dual diagnosis treatment is a comprehensive approach that addresses the dual issues of substance abuse and mental illness. If you need help finding dual diagnosis resources, take the first step.

It’s never too late to get help and start healing. We also offer dual diagnosis programs that can be provided in an outpatient setting as well. If this sounds like a great option for you, contact Kingsway Recovery today.

References

https://www.nami.org/About-Mental-Illness/Mental-Health-Conditions/Anxiety-Disorders#:~:text=Anxiety%20disorders%20are%20the%20most,develop%20symptoms%20before%20age%2021https://www.kff.org/statedata/mental-health-and-substance-use-state-fact-sheets/new-jersey/#-mental-illness-prevalence-https://www.nj.gov/health/chs/https://www.mhanational.org/issues/ranking-stateshttps://www.njha.com/media/638857/Mental-Health-Toll-COVID-19.pdfhttps://www.drugabuse.gov/drug-topics/trends-statistics/infographics/comorbidity-substance-use-other-mental-disordershttps://www.samhsa.gov/medication-assisted-treatment/medications-counseling-related-conditions/co-occurring-disorders