Dual diagnosis means someone is suffering from a simultaneous mental health disorder and substance use disorder. There are a range of possible connections between conditions, with causality between disorders often obscure and difficult to treat.
Co-occurring disorders is a major issue across the world, with millions of people suffering from the co-existence of mental illness and substance use problems. Treatment for co-occurring disorders often involves detox and medication, with ongoing therapy and aftercare programs also in place to reduce the chance of relapse once patients have left residential treatment.
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Also known as co-occurring disorders, this term is used broadly to describe a wide range of interacting conditions. People with co-occurring disorders face a number of challenges with regard to diagnosis and treatment, with the complex interaction between conditions often hard to define. For example, some people have pre-existing mental health problems that lead to substance abuse, while others have addiction problems that lead to mental illness.
While differentiating between these two possibilities might seem simple, in most cases, the connection between conditions is unclear. Co-occurring disorders often describes relationships between mental illness and substance abuse that are chaotic, with each disorder influencing the other in ways that are complex and not linear.
Even though the term “dual diagnosis” is used to define a complex group of individuals, there are some common characteristics used in diagnosis. A typical person with a co-occurring disorders is likely to relate to some or all of the following experiences:
While it is possible to have a co-occurring disorders without experiencing any of these issues, most patients will have trouble fitting in with society in some way.
The connection between depression disorders and addiction are numerous, with depressed people more likely to experience both alcoholism and drug dependence. According to the Epidemiologic Catchment Area study conducted by the National Institute on Health, almost one-third of individuals with depression have also had a co-existing substance use disorder at some point in their lives.
There is a particularly strong link between depression and alcoholism, with long-term alcohol use leading to depression and people self-medicating pre-existing depression disorders with alcohol. According to the National Comorbidity Study, men with alcohol dependence have rates of depression three times higher than the general population, with women four times higher.
Links also exist between anxiety disorders and substance abuse, with people who suffer panic disorders at a high-risk of addiction. Alcohol and drugs may temporarily alleviate the symptoms of a panic attack, with people using drugs and alcohol to cope with high pressure situations.
More often than not, however, these substances will only intensify the symptoms of anxiety, with people then caught in a spiral of anxiety and addiction that quickly gets out of control. According to a study published in Behavior Research and Therapy, alcoholism occurs in 10 to 40 percent of people with a panic disorder, with 10 to 20 percent of people suffering from substance abuse.
A range of treatment options are available for people with co-occurring disorders, with programs available at both drug treatment and mental health clinics. Primary treatment involves treating the primary disorder, with sequential treatment also treating the secondary condition once the primary condition has been stabilized. Parallel treatment treats both conditions at the same time, with a second facility and doctor sometimes used to manage the secondary disorder. Integrated treatment involves treating both conditions at the same time, with no distinction made between primary and secondary disorders.