Substance abuse has a profound effect on the body, mind, and spirit. As a result, it often appears in conjunction with other medical or psychological problems. In the United States, an estimated 8.9 million adults suffer from substance abuse and a co-occurring mental health problem, according to the Substance Abuse and Mental Health Services Administration. Treatment of co-occurring disorders is often more complex than treating substance abuse in isolation, meaning that it requires an integrated approach.
What Does “Dual Diagnosis” Mean?
Simply put, “dual diagnosis” refers to a situation in which a person is simultaneously struggling with problematic drinking or drug use as well as another psychological problem. This might include mood disorders like depression, anxiety, or post-traumatic stress disorder.
Dual diagnosis may also encompass more serious mental illnesses. A significantly higher proportion of people with bipolar disorder and schizophrenia struggle with drug use than their peers who do not have these disorders.
Why is Dual Diagnosis so Common?
There are several potential explanations as to why a huge margin of people with mental health problems also struggle with substance abuse:
- Drug use increases likelihood of developing mental health problems. There may be something about using drugs that made your loved one more likely to begin to have psychological issues. For example, research suggests that some marijuana users may be at increased risk of developing psychosis. Other drugs may also contribute to depression, anxiety, or other mental health symptoms.
- Mental illness causes individuals to use drugs. Experiencing a mental illness can be extraordinarily difficult. In particular, serious mental illness such as schizophrenia or bipolar disorder can cause difficulties in friendships, disorganization of thoughts, or difficulty holding down a job. These stressors cause some people to turn to drugs or alcohol for relief. Using these substances may help your loved one temporarily cope with distressing thoughts or emotions. Over time, this coping strategy may lead to problematic drug use.
- There is a shared vulnerability for both disorders. Drug abuse and mental health problems share several features. They involve some areas of the brain, particularly a region called the limbic system. The limbic system is responsible for processing emotions and motivating us to act. Structural or functional abnormalities in this system may contribute to vulnerability to both substance abuse and certain mental disorders.
Both diseases have similar underlying environmental triggers, including chronic stress and traumatic events. They both often begin during the adolescent years. There may be something about this developmental time point that predisposes certain people to both disorders.
The Challenge with Dual Diagnosis
Unfortunately, just 7.4% of dually diagnosed patients receive professional treatment for both of their conditions. Over half receive no treatment at all. One reason for this is that the mental health problems may be a barrier to seeking treatment.
For example, someone struggling with depression may simply lack the motivation to seek help. If your loved one is facing this situation, it can be helpful to provide some gentle motivation and incentive to get professional help.
Conventional approaches to treatment often fail to help dually diagnosed patients. That is, focusing solely on the substance abuse issues or receiving only therapy to help with mental health problems is unlikely to be effective.
Tackling psychological issues may alleviate mood or anxiety, but the struggles with addiction may suck a person back into dark moods. Similarly, focusing solely on overcoming drug problems is often ineffective for dually diagnosed patients, as many of them use drugs or alcohol to cope with mental health issues.
How Is Dual Diagnosis Treated?
Effective treatment for individuals with a dual diagnosis require specialized, professional treatment. Scientific research suggests that outcomes are best when addiction and psychological problems are addressed simultaneously.
Thus, the objective of treatment is to take an integrated approach to understand the complicated relationships between mental health problems and substance use.
One of the primary focuses of this type of treatment is disentangling the associations between thoughts, moods, and behaviors. For example, perhaps drinking a bottle of whiskey is a way to temporarily numb the pain associated with a traumatic event in your loved one’s life. Or maybe taking prescription painkillers helps a person feel like he has more control over his anxiety.
Learning To Cope
In treatment, your loved one will learn how certain thoughts and feelings can be triggers to use drugs or alcohol. By learning alternative coping strategies, such as engaging with supportive friends, practicing breathing exercises, spending time outdoors, or removing himself from the situation, and learning important life skills, your loved one will begin to foster the stability needed to change.
Above all, the objective of dual diagnosis treatment is to create a supportive environment in which a person can address both mental health issues and addiction. By receiving integrated treatment and coordinated care from a range of health care professionals, your loved one can learn to restore balance and meaning to his life.
- Substance Abuse and Mental Health Services Administration, About co-occurring, Co-Occurring Disorders, http://media.samhsa.gov/co-occurring/