A dual diagnosis, the co-occurrence of a mental illness and substance use disorder, requires an equally dual approach for successful treatment and recovery. Most dual diagnoses start out as one disorder: mental illness or addiction. When substances are taken with the intended purpose of coping with a mental illness, an addiction can quickly develop. Conversely, substance use disorder can trigger symptoms of mental illness. The intricate relationship between diagnoses requires an individualized course of action that aims to treat both conditions.
A dual diagnosis is not exclusive to any specific group, but some encounter more risk factors than others, such as people suffering from chronic illnesses or those with a lower socioeconomic status. Oftentimes, substance abuse is a means of coping with chronic pain or feelings of depression or anxiety. Self-medicating can provide temporary relief from certain symptoms of certain physical or mental conditions, but the risk of developing a dependency on the drug or alcohol is high. In fact, the National Alliance on Mental Illness (NAMI) reports that one-half of people suffering from severe mental disorders have issues with substance abuse. On the other hand, a substance use disorder can lead to the development of mental illness. The NAMI further indicates that one-third of alcoholics and one-half of drug addicts experience some form of mental illness.
Special Concerns of Dual Diagnosis Patients
A dual diagnosis presents special concerns. Though self-medicating relieves some symptoms temporarily, substance use can exacerbate symptoms of underlying mental illness. Someone suffering from depression may experience worsened depressive symptoms or have suicidal thoughts. Some substances can trigger the onset of symptoms of mental illness not previously experienced, such as episodes of psychosis.
A dual diagnosis requires a treatment plan that addresses the co-occurring conditions. The treatment of just one of the conditions will ultimately result in unsuccessful recovery. A mental illness cannot be adequately addressed if substance use continues through treatment. Likewise, recovery from an addiction will be extremely difficult to achieve when battling untreated symptoms of mental illness.
Treatment Geared Toward Individual Needs
Any immediate threats to survival, such as an overdose or suicide attempt, should be quickly assessed and treated first, followed by management of withdrawal symptoms. An inpatient treatment center specializing in dual diagnoses have experience with the recovery process for someone with co-occurring conditions. Treatment depends on individual circumstances.
Common stages of recovery include:
• Engagement and stabilization: Willing participation is an essential component of recovery. Someone with a dual diagnosis needs to be engaged and motivated to put effort into the recovery process. Acute symptoms need to be stabilized for this to happen. This stage can last several weeks or longer.
• Early recovery: Early recovery involves the introduction of coping techniques for resisting or avoiding triggers for a relapse. Cognitive behavioral therapy may be instrumental in understanding reasons behind the addiction in relation to the mental disorder and ways to manage stress. A strong support system can play a huge role in staying on track in some circumstances. Depending on the person’s willingness to commit to treatment, this stage may last three months.
• Middle recovery: In addition to coping skills, steps will be taken to improve important relationships with others. Techniques for recognizing negative self-talk or for coping with feelings of depression and anxiety may be addressed for when these situations arise. A stronger focus on the symptoms of mental illness may help with the feeling of self-confidence and self-esteem. This stage may monopolize the next six to seven months.
• Maintaining recovery: A more in-depth approach to relationship skills and coping techniques helps to solidify skills and concepts explored previously. If new issues have come up, they can be addressed now in order to maintain a steady recovery. This stage usually occurs following the first year of recovery and aims to increase positivity in the person’s life.
Accurate Diagnosis is the Key to Finding Adequate Treatment
A dual diagnosis is not a life sentence, but it does demand commitment and the motivation to achieve recovery. The key is an accurate diagnosis with a treatment plan conducive to co-occurring conditions. A treatment center specializing in these situations offers the kind of support and experience necessary for successful recovery. In a sense, a dual diagnosis requires twice the effort for successful recovery, but the success will be twice as meaningful.