Dual Diagnosis Treatment for Addiction and Mental Health
The term dual diagnosis means the diagnosis of two mental health disorders or substance abuse problems. People who suffer from dual diagnoses often experience signs and symptoms of both conditions simultaneously.
People dealing with dual diagnosis disorders face unique challenges. On top of addiction, they are also likely to struggle with depression, anxiety, and other mental health problems. This opens them up to relapse and poor treatment outcomes.
This makes it important to find the best and most effective treatments and dual diagnosis rehab centers possible. These providers should be well-informed about dual diagnosis mental health treatment.
What is a Dual Diagnosis Disorder?
A dual diagnosis disorder occurs when someone has both a mental health and substance abuse problem. (1)
These other mental health disorders can include:
- Anxiety disorders
- Depression
- Attention-deficit hyperactivity disorder (ADHD)
- Bipolar disorder
- Post-traumatic stress disorder
- Borderline personality disorder
- Schizophrenia (2)
Over 24 million people in the United States reported severe psychological distress, with 21.3 percent of this population experiencing active substance abuse/dependence disorders. (3) Substance use disorders include alcohol addiction, drug addiction, and opioid addiction.
Why Do Substance Use Disorders and Mental Disorders Occur Together?
Although these problems often occur together, they don’t always happen simultaneously. Sometimes, one appears first, while the other follows later. People with substance use disorders are at particular risk for developing one or more primary conditions or chronic diseases.
Research suggests three possibilities that could explain why SUDs and other mental disorders may occur together:
- Common risk factors can contribute to both SUDs and other mental disorders. An estimated 40–60 percent of an individual’s vulnerability to substance use disorders is attributable to genetics. Environmental factors like stress or trauma cause genetic changes that are passed down through generations. (2) (4)
- Mental disorders can contribute to substance use and SUDs. Studies found that people with a mental disorder may use drugs or alcohol as a form of self-medication. Although some drugs may temporarily help with some symptoms of mental disorders, they make the symptoms worse over time. (2)
- Substance use and SUDs can contribute to the development of other mental disorders. Substance use may trigger changes in brain structure and function that make you more likely to develop a mental disorder. (2)
Throughout adolescence, the brain undergoes significant development. The circuits responsible for executive functions like decision-making and impulse control are among the final to mature. This makes adolescents more vulnerable to drug use and the onset of substance use disorders. (4)
Studies have shown that mental illness might come before a substance use disorder. (4)
Common Mental Health and Addiction Issues
Several common mental health issues often coexist with addiction.
People suffering from:
- Depression
- Anxiety
- Bipolar disorder
- PTSD
- ADHD
- Schizophrenia
are more likely to develop addictions, such as alcohol abuse, later in life.
The presence of co-occurring mental health disorders and substance use disorders can make recovery from addiction more difficult. Both substance use disorders and other mental illnesses impact various regions of the brain.
Multiple neurotransmitter systems play a role in both substance use disorders and other mental disorders.
These include:
- Dopamine
- Serotonin
- Glutamate
- GABA
- Norepinephrine (5)
Certain mental disorders are established risk factors for developing a substance use disorder. Those with severe, mild, or even subclinical mental disorders may use drugs as a form of self-medication.
Although some drugs may temporarily reduce symptoms of a mental illness, they can also worsen symptoms. Evidence suggests that periods of cocaine use may worsen the symptoms of bipolar disorder and contribute to the progression of the illness. (5)
The Dangers of Self-Medication
Some believe that using illegal drugs will relieve their emotional pain. However, research shows that this isn’t true.
Potential risks of self-medication practices include:
- Incorrect self-diagnosis
- Delays in seeking medical advice
- Infrequent but severe adverse reactions
- Dangerous drug interactions
- Incorrect manner of administration
- Incorrect dosage
- Incorrect choice of therapy
- Masking of a severe disease
- Risk of dependence and abuse (6)
Self-medication often masks the root causes of mental health symptoms, delaying proper diagnosis and treatment. This can result in worsening mental health conditions and increased complications, including overdose and other serious health consequences.
Without medical care, you will not receive the diagnosis and guidance you need to move forward.
What are the Treatments for Dual Diagnosis?
Healthcare professionals may misdiagnose or improperly treat patients with dual diagnosis disorders. (7) This creates a cycle of relapse and failure that often starts when someone tries to handle one issue without dealing with the other.
Dual diagnosis therapy at mental health treatment facilities addresses each condition individually in a customized treatment plan.
A dual diagnosis can require the help of both mental and physical health specialists. Addiction therapists provide patients with support during detoxification.
Mental health experts can additionally explain what causes the patient’s behavior and offer advice.
There are several ways to help people with dual diagnoses, including medication, therapy, and support groups.
Dual Diagnosis Rehab Treatment Programs
Dual diagnosis rehab is a facility that offers specialized care for people with dual diagnosis disorder. It has programs that usually start with a detox phase to safely manage withdrawal symptoms from drugs or alcohol.
Recent findings from a study conducted by the Substance Abuse and Mental Health Services Administration (SAMHSA) suggests individuals with co-occurring disorders receive disparate care that targets either the psychiatric or substance use disorder. (8) So it is crucial to find treatment programs that address both for successful recovery.
Dual diagnosis treatment programs provide a range of services focusing on integrated treatment.
These can include:
- Assessment and diagnosis
- Crisis intervention
- Counseling targeted at psychiatric and substance use problems
- Medications
- Patient education
- HIV screening and counseling
- Family counseling
- Education (9)
Some programs in dual diagnosis treatment centers offer sober living accommodations to support individuals in transitioning to independent, substance-free lifestyles after completing treatment.
Research has demonstrated that recovery housing is associated with a variety of positive outcomes for residents including:
- Decreased substance use
- Reduced likelihood of return to use
- Lower rates of incarceration
- High income
- Increased employment
- Improved family relationships (10)
Medication Therapy for Dual Diagnosis
The medications available to treat a dual diagnosis depend on a patient’s condition. People with coexisting mental illnesses may need more than one medication to control their symptoms. Medication choices depend on the specific condition being treated.
Some common medications may include:
- Antidepressants: Antidepressant medications work by increasing levels of serotonin and norepinephrine in the brain. Examples include selective serotonin reuptake inhibitors (SSRIs) (11).
- Antipsychotics: People who suffer from schizophrenia, bipolar disorder, or schizoaffective disorder may benefit from taking antipsychotic medications. (12)
- Anxiolytics: Anxiolytic medications are used to treat anxiety disorders. Anxiety disorders and substance use disorders are highly comorbid (between 18% and 37%). (13)
Dual Diagnosis Behavioral Therapy
Psychotherapy can be effective for people with dual diagnoses. It helps them understand their mental illness and learn how to manage symptoms. Therapists also help clients develop coping skills so they don’t fall back into old habits.
The most common therapies include:
- Cognitive Behavioral Therapy (CBT): CBT teaches patients new behaviors and thought processes to cope with their problems. This type of therapy works best when combined with other treatments. (14)
- Dialectical Behavioral Therapy (DBT): DBT helps patients to identify negative emotions and unhealthy behaviors before acting on them. By identifying triggers, patients can avoid falling back into negative patterns. Studies indicate that DBT may provide a useful therapeutic approach to managing co-occurring symptoms. (15)
- Interpersonal Psychotherapy (IPT): IPT helps patients improve relationships with family members and friends. It teaches them to recognize and change destructive interactions. (16)
- Mindfulness Based Cognitive Therapy (MBCT): MBCT teaches patients to focus on the present moment and accept things as they are. They learn to notice thoughts without judging themselves or others. (17)
- Motivational Interviewing (MI): MI is an intervention technique that encourages people to make positive changes in their lives. (18)
Support Groups for Dual Diagnosis
Support groups for dual diagnosis are important for those dealing with both substance abuse disorders and mental health challenges. They provide a safe and supportive environment you can discuss your experiences and struggles with others.
Social support can help individuals live a better life. Support groups offer helpful peer support and encouragement for relapse prevention and holistic wellness.
They complement the services of addiction treatment centers and mental health care facilities.
Counseling
Different types of counseling might be involved in your dual diagnosis treatment, including:
- Individual Counseling: If you’re having difficulty managing your symptoms, individual counseling might be helpful. Individual counselors usually specialize in one area of psychology, such as addiction treatment, eating disorders, or depression.
- Group Counseling: Group counseling involves two or more patients struggling with similar disorders. Trained professionals with experience helping people with dual diagnoses lead these groups.
- Family Counseling: Sometimes families struggle with a dual diagnosis. In these cases, family therapy can provide support and guidance.
Helping a Loved One with a Dual Diagnosis
For those struggling with addiction and another mental illness, it can feel like being stuck in a rut. But there are ways to navigate the obstacles and make progress toward lasting sobriety.
Talk to a doctor or therapist about options for managing symptoms if your loved one continues to resist treatment. A psychiatrist might prescribe medications to treat depression or anxiety, or a psychologist could recommend cognitive behavioral therapy.
Once your loved one is ready to seek help, you can have options ready for them. There are different levels of treatment available, including inpatient, outpatient, and partial hospitalization.
Get Help for A Dual Diagnosis
If you’re struggling with addiction, finding the right treatment program can seem like a daunting task. But it doesn’t have to be difficult.
The most reputable facilities have had success helping others successfully address their issues. Determine the following.
- How long the substance abuse treatment facility has been around
- What kinds of clients they treat,hether they work with other organizations.
If you’re struggling with a dual diagnosis, there are several resources available to help you get better. Zinnia Health can help you get the treatment you need. Call our helpline at (855) 430-9439 to learn more about dual-diagnosis treatment options.
Citations
- SAMHSA. Mental Health and Substance Use Disorders.
- National Institute of Mental Health. Substance Use and Co-Occurring Mental Disorders.
- National Library of Medicine. A Call for Standardized Definition of Dual Diagnosis.
- National Institute on Drug Abuse. The Connection Between Substance Use Disorders and Mental Illness.
- National Institute on Drug Abuse. Why is there comorbidity between substance use disorders and mental illnesses?
- National Library of Medicine. Risks of self-medication practices.
- National Library of Medicine. The Challenge of Dual Diagnosis.
- National Library of Medicine. Dual diagnosis capability in mental health and addiction treatment services: An assessment of programs across multiple state systems.
- National Library of Medicine. Treatment for dual diagnosis patients in the psychiatric and substance abuse systems.
- SAMHSA. Best Practices for Recovery Housing.
- National Library of Medicine. Use of Antidepressants in Patients with Co-occurring Depression and Substance Use Disorders.
- National Library of Medicine. Atypical antipsychotics in the treatment of patients with a dual diagnosis of schizophrenia spectrum disorders and substance use disorders: the results of a randomized comparative study.
- National Library of Medicine. Dual diagnosis in anxiety disorders: pharmacologic treatment recommendations.
- CSUSB ScholarWorks. Treatment Access for Dual Diagnosis Substance Use and Mental Health Disorders.
- National Library of Medicine. Does an adapted Dialectical Behaviour Therapy skills training programme result in positive outcomes for participants with a dual diagnosis? A mixed methods study.
- National Library of Medicine. Interpersonal Psychotherapy for Patients with Mental Disorders.
- National Library of Medicine. Mindfulness-Based Treatments for Co-Occurring Depression and Substance Use Disorders: What Can We Learn from the Brain?
- National Library of Medicine. Dual Diagnosis Motivational Interviewing: a modification of Motivational Interviewing for substance-abusing patients with psychotic disorders.