Dual Diagnosis & Co-Occurring Disorders
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On their own, mental health disorders can be challenging to treat. Symptoms often overlap between conditions, and people respond to different treatment modalities in completely different ways. Things can become much more complicated when a patient develops or experiences a co-occurring disorder, or a combination of a mental health problem with drug addiction. This is also sometimes referred to as a dual diagnosis.
What Is a Dual Diagnosis or a Co-Occurring Disorder?
Substance use and mental health problems often coincide. Statistically, people with a history of mental health issues are far more likely to use drugs, and excessive drug use often correlates with higher rates of anxiety, depression, and other mental health issues.
There are several reasons for this: first, substance use disorders and mental health conditions share many risk factors, meaning life circumstances and genetic predisposition often contribute to the development of both an addiction and a mood disorder, anxiety disorder, or other condition. Second, drug use can exacerbate feelings of low self-worth, anxiety, or even symptoms of psychosis, and behavioral problems. Third, mental health conditions are stressful to deal with and difficult to treat. Some people resort to drug use as an effective short-term distraction from their mental health problems, as a form of self-medication.
Both dual diagnosis and co-occurring disorder are terms usually used interchangeably when discussing the combination of one or more mental health issues with substance use disorders. However, a co-occurring disorder can also be used to refer to multiple mental health conditions with no drug use. In both cases, treatment is complicated by the presence of multiple conditions. Focusing on treating one without addressing the other is not reasonable, because mental health conditions (including addiction) can potentiate each other.
Thankfully, most mental health conditions are addressed nowadays through a holistic, multimodal approach. Mental health professionals take as many facets of a person’s life into account as possible when devising a treatment plan. When someone is struggling with multiple mental health problems, their treatment must be more encompassing, and address each issue concurrently.
Common Signs and Symptoms of a Co-Occurring Disorder
The challenge of a dual diagnosis begins with identifying it. Drug use problems and certain mental health problems can have overlapping symptoms, which is why a thorough examination of a person’s behavioral and physical signs is important when determining a dual diagnosis.
Doctors who screen for a dual diagnosis will look out for signs of continuous and long-term drug use, coupled with signs for various mental health issues, such as week-to-week complaints of low mood, suicidal ideation, irrational responses, hallucinations, feelings of dread, and more. Signs and symptoms of a dual diagnosis may include:
Withdrawal symptoms indicating long-term drug use.
Physical signs of long-term drug use, from track marks to organ damage.
Behavioral and psychiatric symptoms that indicate self-medication.
Social withdrawal and low mood.
Intense mood swings.
Persistent episodes of depression and anxiety, on and off drugs.
Challenges With Addressing Dual Diagnoses
People who experience dual diagnoses often struggle in multiple aspects of life, and face difficulties at home, at work, at school, or within the community in general. They are more likely to struggle with difficult socioeconomic circumstances, traumatic experiences, lack of education, lack of employment, and physical health problems.
Furthermore, many people with a dual diagnosis may struggle to see the point in treatment, either because they aren’t ready to stop using as a means to cope with other problems, or because they are facing critical issues that they see as more pressing than their psychological health (such as imminent homelessness or financial despair).
People who experience dual diagnoses often struggle in multiple aspects of life, and face difficulties at home, at work, at school, or within the Lastly, traditional treatment methods often fail to address dual diagnoses because they do not integrate different treatment approaches to provide an effective and holistic treatment plan for an individual’s circumstances and unique needs.
A dual diagnosis cannot be treated effectively via sequential (first psychiatric treatment, then addiction treatment) or parallel treatment (both treatment methods concurrently, but on separate tracks) – instead, the ideal treatment plan for a dual diagnosis requires the integration of addiction and psychiatric treatment methods through individualized therapy, outpatient and inpatient support, relapse prevention, skill building, and much more.
Treatment Methods for Dual Diagnoses
Treatment methods for co-occurring disorders or a dual diagnosis include:
1. Medication Management
2. Integrative Therapeutic Modalities (e.g., Cognitive Behavioral Therapy, Dialectical Behavior Therapy)
3. Trauma Therapy
4. Supplementary Treatment Options (mindfulness training, meditation, yoga, sound healing)
5. Long-term Peer Support
6. Psychoeducation
7. And more.
Frequently Asked Questions About Dual Diagnosis & Co-Occurring Disorders
What Causes Dual Diagnosis & Co-Occurring Disorders?
There is no single cause for a dual diagnosis, or a co-occurring disorder. The phenomenon of dual diagnoses is recent in psychiatric history, partially because substance use disorders have only been separately diagnosed as a primary disorder since the 1980s, rather than a symptom of a different mental health problem.
Furthermore, access to drugs has greatly expanded in the last decades, especially in the Western world. Coupled with global financial insecurity, record wealth inequality, rising rates of depression and anxiety, and social changes that further marginalize people from poorer socioeconomic backgrounds as well as racial and sexual minorities, many people who struggle with mental health problems are turning to drug use as a form of self-medication.
What Are the Risk Factors for Dual Diagnosis & Co-Occurring Disorders?
The risk factors for a dual diagnosis include genetic predisposition, early drug use, trauma, chronic health problems, pre-existing mental health issues, abuse in the family, victimization (bullying), experiences with violence, poverty, lack of education/employment, homelessness, and greater access to drugs in the area.
How Can I Help a Loved One with Dual Diagnosis & Co-Occurring Disorders?
Referral to a mental health professional is an important first step towards getting your loved one the help they need. The treatment of a dual diagnosis requires a comprehensive and holistic approach. Find a treatment provider who focuses on co-occurring disorders, and utilizes an integrative and multimodal treatment approach.
Here at Coastwise, we help our clients cope with the long-term challenges posed by their mental health history through healthier, and more effective coping strategies, medication management, and a transition into support groups. Meanwhile, our outpatient programs also help address substance use disorders by identifying and avoiding craving triggers, establishing an individualized path towards long-term recovery based on intrinsic reward and motivation, and navigating stressful situations without drugs.
Come work with us at Coastwise to combat your dual diagnosis, and forge a happier, healthier life for yourself and your loved ones. Give us a call or get in touch with us via our contact form to learn more.