Dual Diagnosis Treatment: Treating Addiction and Mental Health Together

Studies show that about half of people with mental health disorders also struggle with addiction, clinically referred to as a substance use disorder (SUD). Mental health disorders and SUDs are related, which means that when one is treated, the other needs to be treated as well for the treatment to be successful. While this may seem complex, the treatments are similar in many ways, and it’s become common for addiction treatment facilities to provide dual diagnosis treatment.

What Is a Dual Diagnosis?

A dual diagnosis is the diagnosis of co-occurring disorders, meaning a substance use disorder and a mental health disorder such as anxiety, depression, post-traumatic stress disorder (PTSD), or bipolar disorder. There are two main reasons that dual diagnoses are common.

Many people who have a mental health disorder turn to substance use, whether alcohol or drugs, to self-medicate the symptoms of a mental health disorder. For example, someone who suffers from anxiety may turn to drinking to soothe their persistent anxiety symptoms. The substance use over time becomes an SUD.

In the other scenario, people with SUDs develop mental health disorder symptoms due to the substance use. During addiction, the brain undergoes changes which can cause mental health symptoms. In these cases, once substance use stops, the mental health symptoms often go away over time.

Diagnosing a Substance Use Disorder

An SUD is diagnosed based on 11 criteria from the definition of an SUD, published by the American Psychiatric Association.

1. Using the substance in large quantities or for longer than intended.
2. Having the desire to cut down or quit the use of the substance but not being able to.
3. Spending excessive amounts of time getting, using, or recovering from the substance.
4. Having cravings for the substance.
5. Not living up to responsibilities at home, work, or school because of substance use.
6. Continuing substance use even though it’s causing relationship problems.
7. Giving up normal or enjoyable activities to use the substance.
8. Using the substance in dangerous situations, such as while driving.
9. Continuing substance use in spite of negative consequences.
10. Needing more of the substance to get the desired effects.
11. Having withdrawal symptoms when not using the substance.

Two or three of these symptoms indicate a mild SUD, four or five is considered moderate, while six or more symptoms indicate a severe SUD.

Diagnosing a Mental Health Disorder

Diagnosing a mental health disorder involves an assessment which will include:

• A physical exam
• Family history assessment
• A discussion about your concerns
• Questions about recent events or changes in your life
• An assessment of your symptoms
• Questions about how you react or behave in certain situations
• Questions about your substance use history
• Questions about past trauma or abuse
• Questions about any thoughts of harming yourself or others

Symptoms of a mental health disorder vary by the type of disorder, but general symptoms may include:

• Persistent sadness
• Excessive worry or fear
• Feelings of guilt
• Confusion
• Lack of concentration
• Extreme mood swings
• Significant personality changes
• Fatigue or insomnia
• Withdrawal from friends, family, and activities
• Delusions, paranoia, or hallucinations
• Detachment from reality and irrational beliefs
• An inability to deal with stress
• Sex drive changes
• Extreme changes in eating habits
• Excessive anger or violent behavior

Dual Diagnosis Treatment

Treating a dual diagnosis starts with a period of detox from your substance of choice. Ideally this is done in an inpatient medically supervised setting in which you are kept safe and comfortable while you go through withdrawal.

During this period, you may also be given medications to treat your mental health disorder, such as antidepressants or anti-anxiety medications. Finding the right medications often takes some experimentation, since every person is different, so your medications and doses may be adjusted until an effective treatment is found.

Treating both the SUD and the mental health disorder will involve therapy. Fortunately, the same types of therapy are used for both disorders.

The two most common therapies used are:

• Cognitive behavioral therapy (CBT): In CBT, you learn how to change your thinking patterns from negative and irrational to positive and reasonable. You’ll also learn healthy coping mechanisms to turn to instead of substance use.
• Dialectical behavioral therapy (DBT): DBT is similar to CBT but focuses more on regulating emotions and learning how to change your negative behaviors.

Your treatment, except for the detox period, can be inpatient or outpatient. However, ideally treatment consists of a 30 to 90 day inpatient program, followed by outpatient treatment. Both of your disorders will continue to be addressed throughout your entire course of treatment.

In Closing

Dual diagnosis treatment can help you to deal with your substance abuse and your mental health disorder at the same time, which can drastically change your life. At NEMG, we provide dual diagnosis treatment in a compassionate, comprehensive way. We are dedicated to helping you to build a healthier, more fulfilling future. Give us a call today to take the first step.