What Does It Mean to Have a Dual Diagnosis?

Someone with a Dual Diagnosis has a co-occurring addiction and mental health disorder. Several decades ago, co-occurring disorders typically meant parallel treatment in separate programs, but this treatment protocol changed in the mid-1980s when several facilities integrated addiction and mental health services into a single program. Although the name implies two conditions, a Dual Diagnosis can involve any number of mental health issues, but the treatment is always integrated. The underlying concept of this term is that the disorders may be related on biological and environmental levels, which means that leaving either condition untreated makes relapse more likely for either problem.

How Common Is a Dual Diagnosis?

The need for integrated treatment stems from the high rate of co-occurring disorders. The 2006 National Survey on Drug Use and Health highlights the prevalence of such issues with the following statistics:

  • In 2013, 22.3% of adults with serious psychological distress also engaged in substance abuse. By comparison, only 7.7% of adults without serious psychological distress engaged in substance abuse in the same period
  • 9.4% of adults experiencing a major depressive episode abused illicit drugs, compared to 2.1% of adults without depression
  • 19.3% of adults with depressive episodes abused alcohol compared, to 7% without depression

In a study of co-occurring disorders for 2008 and 2009, the Substance Abuse and Mental Health Services Administration finds that nearly 9 million adults had a Dual Diagnosis.

How Are Addiction and Mental Health Related?

In a 2005 edition of the American Journal of Psychiatry, it suggests that addiction and mental health disorders are possibly variant expressions of similar neurobiological abnormalities. Likewise, a 1998 Addictive Behaviors journal suggests that people with mental health disorders have a higher sensitivity to the psychoactive effects of drugs and alcohol. In 2002, the Archives of General Psychiatry reaffirmed the super-sensitivity model with a study finds that amphetamines produce 3.4-fold greater brain rewards in people who are depressed. The following other connections may also exist between these problems:

  • Shared risk factors, such as social isolation, traumatic life experiences and poverty
  • Untreated mental health disorders that motivate self-medicating substance abuse
  • The ability of addictive behavior to unmask or accelerate mental health disorders
  • Both conditions may damage the same neurobiological pathways

Substance abuse can also impact certain disorders in particularly strong ways. For example, cocaine highs can aggravate anxiety or mania, while the crash that occurs after the high might intensify depression. Such scenarios might motivate further cocaine use to reverse the crash, or people may abuse other drugs to reduce the anxiety. Either way, such drug use will likely make both the addiction and disorder worse.

Dual Diagnosis Treatment

If a Dual Diagnosis is identified, then rehab centers may use Cognitive Behavioral Therapy or Dialectical Behavioral Therapy to address both substance abuse and mental health. Therapists may also help patients identify cues that trigger disorder symptoms or drug cravings; such medical professionals can even teach people to avoid or mitigate such cues. Other integrated treatment methods may address shared risk factors, or it may address problems like anger and stress management. Personalized plans are designed for each patient, so the therapies may vary, but integrated care is the most effective way to treat Dual Diagnoses.

If you need help, speak with one of our admissions coordinators to discuss the many available treatment options. They can answer any of your questions and even check your health insurance policy for treatment benefits. They are available 24 hours a day at a toll-free helpline, so call now to begin recovery as soon as possible.

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