Also referred to as comorbidity, dual disorder, and co-occurring disorder, a dual diagnosis represents a complex mental and physical health condition in which a patient receives treatment for both substance abuse and a mental health disorder. When one of the dual-diagnosis disorders overwhelms the symptoms of the second disorder, determining which type of disorder developed first can be difficult. Because of the uncertainty of a dual diagnosis, devising a treatment plan requires a different approach than the approach used to treat just one mental health condition.
The number of dual diagnosis cases has grown since scientific research revealed the presence of the mental health condition. In 2020, the National Alliance of Mental Health (NAMI) estimated more than 17 million Americans lived with a dual disorder. This means nearly seven percent of the adult population in the United States struggles with both substance abuse and a severe mental health condition such as acute anxiety.
Substance abuse represents a medical condition in which a patient cannot control the consumption of alcohol and/or drugs. The abuse of drugs includes banned substances and prescription medications. Abusing drugs produces several negative symptoms that result in problems that develop at work. home, and school.
Patients that live with substance abuse continue to use harmful substances even though health issues arise. Substance abuse is one type of a mental health condition that negatively impacts the functioning of the brain.
Mental health conditions such as a mood disorder are the second half of the potentially life-threatening condition called dual diagnosis. The American Psychiatric Association has defined a mental illness as a “health condition involving changes in motion, thinking and behavior.
A wide variety of combinations can develop that lead to a dual diagnosis. Substance abuse of alcohol and opioids represent the two most diagnosed types of addiction. One of the most frequent types of dual diagnosis conditions is the combination of alcohol abuse and acute anxiety disorder. Trauma symptoms, which mental health experts diagnose as post-traumatic stress disorder (PTSD), often lead to a dependency on abusing banned drugs such as cocaine and fentanyl to dull the emotional pain.
On the other hand, an addiction to alcohol and an illegal drug can result in the development of a severe mood disorder, such as bipolar disorder.
Constant consumption of alcohol and/or a banned substance dramatically alters the composition of the brain, which triggers the symptoms associated with mental health illnesses like major depressive disorder and social anxiety disorder. The most significant obstacle for therapists to overcome involves determining which developed first, a mental illness or a dependency on alcohol and/or an illegal substance.
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Detecting the signs of a dual diagnosis requires therapists to separate the two contributing mental health issues. Diagnosing substance abuse typically is the first step in the treatment process.
Substance abuse patients develop a wide range of harmful symptoms that include physical signs such as nausea, tremors, and insomnia. Treating a substance abuse disorder often requires a focus on detoxification which, if mishandled, can lead to the development of severe physical side effects. Abrupt personality changes and a tendency to participate in risky activities represent two emotional signs of a substance abuse disorder. Treating substance abuse first can minimize the negative consequences of living with a mental illness.
The symptoms of mental illness can be more difficult to detect because of the lack of physical indications that a patient lives with mental issues. Confusion, exaggerated expressions, and an inability to concentrate on a task are common signs of a mental illness. However, the abuse of alcohol and/or a banned drug can mask the symptoms of a mental illness. Wild mood swings indicate the presence of a mood disorder, while eating and/or sleeping problems might be associated with a traumatic event.
As an article in Psychology Today stated, “Compared to individuals who have a single disorder, those with a combination of disorders may experience more severe medical and mental health challenges and may require longer treatment periods.” Mental health care providers should treat substance abuse and mental illness simultaneously to reach the best outcome for a dual-diagnosis patient.
However, treating a dual-diagnosis patient can be challenging because of determining which mental health condition developed first. Although treating two disorders simultaneously has shown to be an effective strategy to help patients, treating the mental health condition that developed first can automatically diminish the severity of symptoms that develop because of the presence of the second mental health condition.
For example, let’s assume a patient became addicted to an opioid such as heroin. After a short time passes, the patient developed a mood disorder. Treating the heroin addiction through detoxification reduces negative withdrawal symptoms, which coincides with less serious symptoms that are associated with the mood disorder. Treating the addiction first has a positive cause and effect on the negative symptoms that developed because of the mental health illness.
On the other hand, a military veteran returns from duty having witnessed events that leave deep emotional scars. The emotional scars lead to the abuse of alcohol to mask the pain of emotional distress. A therapist treating this form of a dual diagnosis can make progress by focusing on the emotional scars that developed because of witnessing traumatic events. When the negative symptoms of a mental health condition like PTSD begin to wane, a patient might become less reliant on alcohol to ease the emotional pain.
Although difficult to diagnose and even more challenging to treat, a dual diagnosis can be such a disruptive force that it irrevocably damages personal and professional relationships.
Working with a California licensed therapist at our San Diego facility is an excellent place to begin the journey toward recovery. Our therapists have the experience and the proper professional credentials to treat both substance abuse and mental illness simultaneously. To learn more about how to overcome a dual diagnosis, contact the Detox Center of San Diego today.
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