When an individual suffers from addiction combined with a mental health condition, such as depression or anxiety, this is known as a dual diagnosis (also known as co-occurring or comorbid disorders). Dual diagnosis is widespread among those who engage in substance abuse, and treatment demands integrated care to address both conditions simultaneously.
Frequently, one disorder intensifies the other—for example, a person with depression may turn to substance use as a way to self-medicate. Unfortunately, this is, at best, a temporary solution and can rapidly devolve into worsening mental health. Conversely, substance abuse itself can cause depression and anxiety to the extent that these symptoms can become diagnosable as a genuine disorder.
There is no single medical explanation as to why mental health conditions and substance abuse so often co-occur. However, most experts believe that a blending of biological, developmental, and environmental factors unite in a way that can contribute to both conditions.
Unfortunately, people who experience mental illness and substance abuse often suffer from symptoms that are more severe and unyielding to treatment than symptoms for individuals who suffer from only one disorder.
Dual Diagnosis Assessment
During a clinical evaluation for a potential dual diagnosis, health providers and addiction specialists gather information and examine many factors, including answers to the following questions:
Does the patient…
…meet criteria for at least one psychological condition?
…have a history of substance use that has adversely affected their health, family, relationships, school, work, etc.?
…pose a potential threat to the safety and well-being of themselves or others?
…have resources and a reliable support system available to them?
…display the motivation to participate in rehab and, ultimately, seek long-term recovery?
Signs and Symptoms of Related Disorders
Mental health and substance abuse often co-exist together, but the symptoms can usually, but not always, be distinguishable. Common signs and symptoms of a mental health disorder include the following:
- Feelings of hopelessness, helplessness, worthlessness, guilt, shame, and fear
- A loss of interest in daily activities
- Adverse changes in appetite, weight, or sleep patterns
- Lack of energy, fatigue, lethargy, sleep disturbances
- Racing, intrusive thoughts and impaired concentration
- Increased irritability and agitation
- Risky and impulsive behavior
- Suicidal or homicidal thoughts or actions
Signs, symptoms, and behaviors associated with substance use and addiction include the following:
- An inability to control substance use
- Cravings for drugs or alcohol
- The development of tolerance, meaning more of a substance is needed to achieve the sought-after effects
- Symptoms of withdrawal onset when the person attempts to reduce substance use or quit altogether
- Life is revolving around substance use and time spent acquiring, using, and recovering from that use
- Neglect of important obligations such as school, work, family, relationships, and finances.
Treatment for Dual Diagnosis Disorders
Suffering from a mental health condition in conjunction with a substance use disorder can be especially challenging. However, through participation in intensive treatment, such as behavioral interventions and group support, motivated individuals will likely find that recovery is indeed possible.
Behavioral therapies may include the following:
Cognitive-behavioral therapy is a technique that seeks to reduce problematic thoughts, feelings, beliefs, and practices and replace them with healthier, more positive, and productive thoughts and behaviors.
Integrated group therapy is another therapeutic method that relies heavily on peer support and intends to address symptoms of mental health disorders and substance abuse simultaneously.
Treating a person with a dual-diagnosis often includes the use of medication in addition to psychotherapy, depending on the forms and severity of the mental health or substance use disorder. For example, anti-depressants are often administered to relieve depression or anxiety. Other medications for those undergoing detox can reduce the likelihood of severe effects, such as seizures.
Inpatient Dual Diagnosis Treatment
Depending on the severity of the mental health issue or addiction, an individual may benefit from a partial hospitalization program (PHP) or inpatient program. Due to the complex nature of a dual diagnosis, many people who experience co-occurring disorders will require continual, long-term support from multiple health providers, such as general practitioners, therapists, psychiatrists, or counselors.
Inpatient programs require the person to remain in a safe, secure facility, usually for several weeks or months. Inpatients are given a structured daily schedule, which may include process groups, substance abuse education, group support, experiential activities like art and music therapy, open social time, and more.
PHP rehab programs are typically more intensive than outpatient programs. Still, they are different than residential in that participating persons receive treatment during the day and return to a private residence at night. PHP offers more flexibility than inpatient, but less than outpatient.
If you or someone you love is suffering from substance abuse and co-occurring mental health condition, we urge you to contact us as soon as possible to discuss treatment options. Discover how we help those who need it most begin the journey to recovery!