Dual Diagnosis: The Connection Between Addiction and Mental Illness
Dual diagnosis also referred to as co-occurring disorders, is the condition of suffering from a mental illness and a substance abuse problem.
The concept of dual diagnosis first emerged two decades ago, and today it is part of virtually every addiction treatment program in the United States.
Dual diagnosis most often occurs because a person is self-medicating a mental illness with drugs or alcohol, then subsequently develops an addiction that needs treatment.
Some of the most common mental illnesses involved with dual diagnosis include:
- anxiety disorder
- bipolar disorder
- personality disorders like:
- borderline personality disorder
- paranoid personality disorder
- antisocial personality disorder
- narcissistic personality disorder
Many mental illnesses are not diagnosed early in life, especially if they are not particularly debilitating in younger years. However, as people get older and experience problems in life that they cannot explain nor control, the risk of self-medicating with drugs or alcohol increases.
Identifying Mental Illness
Ideally, we would be able to identify and treat all mental illnesses before any substance abuse can occur. Unfortunately, mental illnesses develop at different rates and in different ways, but there are some warning signs that there may be a problem.
Although each has a unique set of symptoms, some of the most common signs of mental illness include the following:
- unrealistic and intense concern with weight and appearance
- sudden changes in sex drive
- social avoidance or fear
- difficulty thinking or concentrating
- excessive sadness
- increased hunger or lack of appetite
- extreme mood changes
- intense anger
- difficulty relating to others
- frequent and multiple physical pains
- suicidal thoughts
- visual, sensory, or auditory hallucinations
It is always important to seek help, even if you’re not sure if you have a mental illness.
One of the most common obstacles to people getting dual diagnosis help is denial. Often, mental illness can cause thoughts and beliefs that are contrary to reality, increasing the risk of denial and taking appropriate steps to care for oneself.
As someone suffers from a mental illness and uses drugs or alcohol to self-medicate, the substance abuse often exacerbates the mental illness and worsens the symptoms, which the individual takes more drugs or alcohol to medicate, thereby worsening addiction.
The cycle of mental illness and substance abuse never ends, and will continues to get worse without dual diagnosis treatment.
Does Addiction Cause Mental Illness?
There is extensive evidence that supports the comorbidity of substance abuse and mental illness, as about half of people who have a mental illness will also experience substance abuse.
Although substance abuse and mental illness often co-occur, addiction has not been found to directly cause mental illness. However, addiction and substance abuse can cause changes in the brain that may trigger the development of mental illness or exacerbate an existing mental illness.
People with mental illnesses are at an increased risk of developing a substance use disorder for a few reasons:
- Many people attempt to self-medicate their mental illness with drugs or alcohol
- Effective treatment of some mental illnesses varies between individuals, and in some circumstances, certain medications may worsen mental illness, placing the individual at higher risk for substance abuse
- Some mental illnesses change the brain in a way that makes someone more sensitive to the rewarding effects of substances
Treating Dual Diagnosis
Mental health and addiction used to be treated separately, and that created two problems:
- Individuals who received addiction treatment first often experienced an immediate relapse, triggered by the untreated mental illness
- Mental health professionals and addiction professionals did not have access to each other’s medical treatment of a patient, increasing the risk of treatments that may exacerbate either addiction or mental illness
Today, virtually every addiction rehab program incorporates dual diagnosis treatment. Since about half of addicts seeking treatment also have a mental illness, addiction professionals have adapted to address both conditions concurrently.
Dual diagnosis treatment means that both the mental illness and the addiction disorder are being treated at the same time.
Conditions that may co-occur with mental illness can include addictions to:
- prescription opioids
Now that mental illness and addiction can be treated at the same time, addiction treatment professionals are also able to get certifications to treat mental illness and prescribe medications to address the symptoms. Some of the most common medications prescribed for mental illness in dual diagnosis patients include the following:
- sleep aids
- beta blockers
Some of these medications are also commonly abused, and the reason for many people seeking addiction treatment. However, when a dual diagnosis client can receive these medications to treat mental illness while participating in addiction treatment, the risk of substance abuse is significantly reduced. The reasons this is effective are:
- the medication that treats the symptoms of mental illness eliminates the discomfort and pain that prompts many to self medicate with drugs or alcohol
- in addiction rehab, patients learn the appropriate medication management, along with healthy lifestyle choices, and tools to avoid relapse in the future
Although nearly 8 million Americans struggle with dual diagnosis, the addiction treatment industry can offer comprehensive behavioral therapies for treating both conditions during rehab.
While everyone will have a unique treatment plan based on their individual needs, the components of effective dual diagnosis treatment include the following:
- Detoxification allows the body to expel drugs and their toxins while under medical supervision if detox is completed in an inpatient environment
- Inpatient rehab offers the most intensive form of drug treatment and is recommended for individuals who have presented dangerous and destructive patterns resulting from mental illness and substance abuse
- Psychotherapy is a crucial part of dual diagnosis treatment. Cognitive behavioral therapy (CBT) is the most commonly used form of psychotherapy in the treatment
- Medication management can help people with mental illness ease their symptoms, reducing the risk for self-medicating and certain medications are used to ease withdrawal symptoms during detox
- Support groups are important parts of recovery for dual diagnosis patients who can participate in groups that support addiction recovery, mental illness support, and groups like Double Trouble in Recovery specifically for dual diagnosis.
Struggling with mental illness and addiction is difficult as each condition can are effective treatments, intensive therapy approaches, and numerous support groups and organizations specifically devoted to helping dual diagnosis persons find and thrive in recovery.