Dual Diagnosis: When Addiction and Mental Health Concerns Meet

by Jodee Redmond | Oct 6, 2017 | Addiction

A dual diagnosis (also called co-occurring disorder) occurs when a client is living with a mental health disorder and an addiction simultaneously.

This condition occurs more often than you might think; according to statistics released by the National Survey on Drug Use and Health (NSDUH) in 2014, 7.9 million US adults were in this category.

Mental Health Disorders Increase Likelihood of Addiction

Someone who has a mental health disorder is more likely to have a substance abuse issue than a person who doesn’t have this background. They may start using drugs or alcohol to self-medicate because they:

Don’t realize effective treatment is available
Don’t know how or where to get help
Are afraid of the stigmas about mental health care
Think that getting treatment automatically means being hospitalized

These misunderstandings about mental health care are unfortunate. In reality, effective treatment is available, and each person is evaluated individually to determine the best way to offer care. A diagnosis of a mental illness doesn’t necessarily mean that someone needs inpatient treatment, although a doctor may determine that it’s necessary to stabilize the patient. However, inpatient treatment is required for a number of health concerns, both physical and mental, and it makes no difference if a patient is dealing with anxiety, depression, bipolar disorder, schizophrenia, Post-traumatic Stress Disorder (PTSD) or another condition.

Dual Diagnosis Can be Difficult to Diagnose

One challenging aspect of dual diagnosis is that it can be difficult for health care practitioners to determine. In some cases, substance abuse can lead to a person developing symptoms of mental illness.

Alcohol, Anxiety and Depression. A person who is drinking alcohol in moderate amounts feels relaxed and happy. With long-term or heavy use, increased anxiety is possible. Alcohol use can also increase feelings of depression, according to a study in the American Journal of Psychiatry. It concluded that depressed alcohol abusers were 59 percent more likely to die by suicide than depressed individuals without a history of alcoholism.

Opioids and Depression. Patients prescribed opioid pain medications may be at higher risk for becoming depressed if they use the drugs for longer than 30 days. According to a study conducted at St. Louis University, 10 percent of 100,000 participating patients became depressed after using the medication for more than 30 days. The patients were using the opioids for a number of medical conditions, including back pain, arthritis and headaches. None of the participants had a history of depression before starting to take this type of medication.

One disturbing aspect of the current opioid crisis is that some substance abusers will turn to heroin as a cheaper, more easily available source for getting high. Heroin addicts often experience symptoms of depression (hopelessness or guilt). They are at an increased risk of suicide compared to the general population, with death by suicide rates ranging between 3-35 percent.

Treatment for Dual Diagnosis Clients

The best way to offer treatment to a client with a dual diagnosis is with a concurrent approach. It doesn’t make sense to focus on either the mental health issue or the addiction and leave the other one for later treatment. Each one is equally important and requires the same level of attention.

The first step in the process is for the client complete detoxification (detox). This is a necessary step in treating addiction clients. Once a client is clean and sober, it becomes easier for the treatment team to determine a diagnosis and treatment plan.

Treatment includes individual and group counseling sessions, attending 12-step program meetings, participating in recreational activities and health and wellness groups. For clients with a dual diagnosis, treatment would also include being monitored by a psychiatrist and medications, as appropriate, to treat the mental health condition and focus on helping the client move forward with their sobriety goals.

Great Oaks Recovery Center welcomes clients seeking help for substance abuse, including those with a dual diagnosis.