Dual Diagnosis Rehab: What Dual Diagnosis Is & Treatment Options Available
Dual diagnosis is very common among people who are struggling with a substance use disorder. Dual diagnosis is when someone has both a mental health condition and a substance use disorder at the same time. These conditions often require integrated rehabilitation to successfully manage. In this article, we will explore what dual diagnosis is, the causes and symptoms of dual diagnosis, and the treatment options available for people struggling with this condition. Finding the best dual diagnosis rehab center is vital for a person suffering from a co-occurring disorder.
What Is Dual Diagnosis?
Dual diagnosis, also referred to as co-occurring disorders or comorbidity, is a term used to describe when a person suffers from both mental illness and addiction. For example, someone who has both major depressive disorder and is addicted to alcohol would be considered to have a dual diagnosis. Any combination of one or more mental health conditions and one or more addictions is considered a dual diagnosis.
What Causes Dual Diagnosis?
There is not one known cause of dual diagnosis. Oftentimes one condition causes the other; for example, someone who is struggling with depression may turn to alcohol to cope with their symptoms. Over time, this person begins to become dependent on alcohol to feel better and ends up becoming mentally and physically addicted to alcohol. On the other hand, someone may be dealing with a substance addiction and develop a mental health disorder like depression or anxiety as a result.
Additionally, one disorder may trigger another underlying condition and cause it to arise from dormancy. For example, someone may already have underlying anxiety, and the use of alcohol results in this anxiety turning into a crippling disorder. It’s also important to note that having a mental health disorder can sometimes increase a person’s chance of developing addiction and vice versa.
The following are contributing factors that often play a role in dual diagnosis:
Experiences: Some life experiences can increase a person’s chance of developing an addiction and/or mental health condition. These include chronic illnesses and ingesting particular substances in high quantities. Abusing drugs at a young age can also influence someone’s likelihood of struggling with mental illness and/or addiction.
Genetics: People who have immediate family with mental illness and/or substance use disorders have a higher likelihood of developing these conditions themselves than people who don’t have close relatives with these disorders.
Chemical makeup: Some individuals are wired in a way that makes them more prone to develop a mental health disorder or become addicted to substances. This can be due to several reasons including brain functioning, injuries, and early childhood lifestyle.
Home environment: People who grow up and/or live in a home where drugs and alcohol are regularly abused may be more likely to abuse substances themselves. Also, people who are exposed to certain situations such as abuse may be more likely to develop both addictions and mental health disorders.
Abuse and trauma: Trauma and abuse can also increase someone’s chances of struggling with addiction, mental illness, or both. Natural disasters, physical abuse, emotional abuse, sexual abuse, and other trauma can all contribute to a person’s increased risk of dual diagnosis.
What Are the Symptoms of Co-occurring Disorders?
When considering the symptoms of dual diagnosis, you must first take into account the symptoms of addiction and mental illness separately.
Common symptoms of addiction include:
- Withdrawal from friends and family
- Disinterest in things usually enjoyed
- Lying or hiding how much of a substance is being used.
- Trouble keeping up with work, school, or other responsibilities due to substance use
- Relationship problems due to drug use
- Using more substances than intended
- Spending excessive amounts of money on substances and struggling with finances as a result
- Increased tolerance to substances abused
- Continued abuse of substances despite the consequences
- Withdrawal symptoms are experienced when the substance is not in the system
Additionally, while every mental health disorder varies in its symptoms, common symptoms someone may experience when dealing with mental illness include:
- Extreme mood swings
- Excessive sadness
- Feeling depressed
- Withdrawal from friends and family
- Decreased interest in things that were previously enjoyed
- Low energy
- Appetite and sleep changes
- Unusual behavior that is peculiar to the person
- Heightened sensitivity in terms of emotions
- Trouble with concentration and memory
People with a dual diagnosis usually display several of these symptoms at the same time. The specific type of addiction and mental health condition will determine the exact symptoms someone will experience. And, as you can see, many symptoms of addiction are similar to those of mental illness, which can make it difficult to determine if a person is struggling with one or both types of conditions. It’s important to be evaluated by a trained medical professional when determining if you have a mental health condition, substance use disorder, or both.
Common Mental Health Conditions That Coincide with Addiction
In a survey conducted by the National Survey on Drug Use and Health, it was found that more than eight-million people ages 18 and older struggle with co-occurring disorders in the United States. While any mental health condition can co-occur with a substance use disorder, there are some mental health disorders that are more commonly associated with a dual diagnosis. These include:
- Anxiety disorders including generalized anxiety disorders, panic disorder, and obsessive-compulsive disorder (OCD)
- Major depressive disorder
- Bipolar disorder
- Dysthymic disorder
- Antisocial personality disorder
- Post-traumatic stress disorder (PTSD)
- Borderline personality disorder
- Narcissistic personality disorder
- Avoidant personality disorder
- Attention deficit hyperactivity disorder (ADHD)
Additionally, eating disorders such as anorexia and bulimia are commonly found in a dual diagnosis.Some of the most frequently seen co-occurring mental health and substance use disorders include the combination of:
- Alcohol and schizophrenia
- Alcohol and panic disorder
- Cocaine and depression
- Poly-drug use with borderline personality disorder
Why Self-Medication Can Be Dangerous
Self-medication is when someone struggling with a mental health disorder uses drugs, alcohol, or other addictive substances to cope with the symptoms. This can be dangerous, especially for people with several mental illnesses. To begin, self-medicating can cause the symptoms of the mental health condition to become exacerbated. For example, if someone drinks alcohol to relieve anxiety, the anxiety is often heightened when the alcohol wears off.
Additional dangers of self-medication include:
- The development of an addiction to the substance used to self-medicate
- Increased mental health symptoms when not using the substance
- Erratic behavior that can result in self-harm or harming another person
- A developed tolerance to the substance being used
If you are self-medicating with drugs or alcohol, it’s important to seek help to prevent worsened symptoms or additional dangers. Let’s look at the treatment options available for individuals struggling with a dual diagnosis.
Treatment for Dual Diagnosis
Integrated treatment is the most common form of rehabilitation recommended for addressing and managing dual diagnosis. Integrated treatment is when all disorders are treated simultaneously. This type of rehab program is considered the most successful approach for co-occurring disorders, as only treating one disorder often does not provide long-lasting results.
Integrated treatment can be offered in both an inpatient and outpatient setting, with an inpatient program being the best course of action for most people. The following are components that are typically part of an inpatient alcohol and drug rehab center for dual diagnosis:
Medically supervised detox program
A medical detox program is when a person goes through a detox period that is medically supervised. These programs are often held in a treatment center or hospital setting and require patients to stay at the facility for as little as 24 hours or as long as several weeks. During a detox program, a person’s withdrawal symptoms are monitored and treated with medication or other remedies. They may also be given medication to help manage mental health symptoms.
Evaluation and diagnosis
Once someone has successfully withdrawn from substances and is cleared to progress to a treatment program, they will first go through a clinical evaluation. During this evaluation, a trained medical professional will assess the patient’s condition and determine the disorders they are dealing with. Using this assessment, a diagnosis will often be made to help guide the treatment facility in devising a treatment plan for the person.
Development of a personalized treatment plan
Next, a personalized treatment plan will be made that caters to the patient’s specific conditions, needs, and goals. The treatment plan will incorporate multiple therapies and other medical approaches to dual diagnosis.
A large part of inpatient dual diagnosis treatment is the use of various types of therapy. Common therapies someone may experience while in treatment include:
- Family therapy
- Individual therapy
- Group therapy
- Behavioral therapies
- 12-step groups
- Other research-backed therapies
The type of therapy prescribed will depend on the unique individual. For example, if someone with a dual diagnosis is struggling to remain sober due to their home life, they may undergo family therapy to address the situation with all individuals involved.
Individuals in treatment for dual diagnosis are often prescribed medications to assist in the treatment of mental health and substance use disorder symptoms. Medication may also be used to reduce cravings for substances. These medications are prescribed by a physician and their use is closely monitored by a medical team.
In addition to the treatment methods also discussed, various other types of treatment may also be integrated into a person’s recovery plan. Additional treatment modalities may include:
- Animal-assisted therapy
- Motivational interviewing
- Rational emotive behavior therapy
- Contingency management
- Music therapy
- Wilderness therapy
- 12-step programs
- Experiential therapy such as art therapy or poetry therapy
Once someone has successfully completed an inpatient dual diagnosis program, they will likely be recommended to continue on in an aftercare program. An aftercare program can consist of an outpatient treatment program as well as sober living. The type of aftercare services a person participates in will also be based on their unique needs and conditions. The goal of aftercare plans is to continue recovery from co-occurring disorders and prepare individuals for returning to independent life.
Finding a Treatment Program for Dual Diagnosis
There are several options available for people suffering with dual diagnosis. Different insurance policies will cover specific dual diagnosis rehab centers depending on what type of insurance you have and what state you are in. The most appropriate approach to treatment will depend on a person’s specific condition and needs. While there is currently no cure for substance use disorders and mental health conditions, there are several research-backed treatment modalities that can effectively address and help manage these conditions.
When looking for a dual diagnosis treatment program, you should ensure the rehab facility you choose offers personalized treatment plans that integrate various forms of therapy. If you would like help finding the best treatment program for you or a loved one, contact one of our dedicated treatment specialists today.