Addiction and mental health disorders are both highly treatable.
In fact, according to a 2014 National Survey on Drug Use and Health, 7.9 million people in the U.S. experience both a mental disorder and substance use disorder simultaneously. The comorbidity of these two conditions has become so common that it even has a name: dual diagnosis. According to statistics from (SAMHSA), only 8.5 percent of people with a dual diagnosis got care for both addiction and their mental illness.
So, what does dual diagnosis really mean and how can you get care for it?
What Is The Definition Of Dual Diagnosis?
Dual diagnosis is a term that refers to someone that is suffering from a mental health disorder and a substance use problem at the same time. According to the National Alliance On Mental Illness (NAMI), about half of those who have a substance abuse problem also suffer from some kind of mental illness.
While it is not always known which develops first, there is a clear relationship between mental health disorders and addiction. The National Bureau of Economic Research (NBER) discovered that those diagnosed with a mental health disorder are responsible for the consumption of:
- 69% of alcohol
- 84% of cocaine
- 68% of cigarettes
With this knowledge, the NBER stated that there is a connection between mental illness and substance abuse disorders. A number of different combinations of addiction and mental health disorders can occur when someone has a dual diagnosis. Each combination has a unique set of side effects that make a dual diagnosis difficult to understand and even more difficult to diagnose and treat.
Of course, there are some other terms out there that are used sometimes by professionals and non-professionals alike. Things like comorbidity and co-occurring disorders are special terms that you may hear used interchangeably with dual diagnosis or a dual diagnosis treatment.
Let’s break down these terms and find out if they really do mean the same thing.
What Is The Difference Between Dual Diagnosis vs. Co-Occurring Disorders?
The two terms–dual diagnosis and co-occurring disorder–are very similar and often interchangeable. However, when it comes to co-occurring disorders, this term can include additional conditions that occur with a mental illness and substance use disorder.
Dual diagnosis means that there are two conditions occurring simultaneously: mental illness and a substance use disorder. Some professionals will decide to use co-occuring in instances in which a person has more than one diagnosis such as a combination of anxiety, depression and alcohol dependency. Of course, this shows more than two conditions and most would say that dual diagnosis does not appropriately explain the symptoms or experience of the person.
We will follow the more commonly recognized convention, which says that co-occurring disorders and dual diagnosis are similar enough that they can be used interchangeably.
But, how does someone know if they have a dual diagnosis or co-occurring disorder?
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Symptoms Of The Diagnosis
Dual diagnosis is often unpredictable and hard to spot. However, sometimes knowing a person has a mental illness can help with recognizing the other signs of dual diagnosis. In particular, problems with drugs and alcohol tend to occur with:
- Anxiety disorders
- Schizophrenia or other schizoaffective disorders
- Personality disorders
There are common signs and symptoms that someone may be suffering from a co-occurring disorder that you can be on the lookout for, regardless of a current diagnosis related to mental illness such as:
- Unprompted mood swings
- Inability to control emotions
- Trouble at work or with the law
- Pulling away from loved ones
- Intense delusions or hallucinations
- Experiencing withdrawal symptoms
- Strong feelings of mistrust or paranoia
- Difficulty paying attention or concentrating
If someone is suffering from a dual diagnosis, they will experience any number of the symptoms listed above. The may also display other signs that can be more noticeable due to their mental illness rather than their addiction, such as:
- An overall giving up on all things they once loved and cared about
- Significant weight loss or weight gain
- Sleeplessness or constant all day and night sleeping
- Agitation and defensiveness when confronted
- Lack of self-care. Not practicing hygiene, not wearing clean clothes, taking regular showers, brushing teeth
- Self-medication through drugs or alcohol
- Not managing responsibilities, not showing up for work on time or at all
The longer these symptoms remain untreated the more severe they will become. Over time, severe drug or alcohol abuse can lead to brain damage or death.
Identifying and navigating the symptoms can be tricky. This is because dual diagnoses can be made of many possible combinations of mental health and substance use disorders. If your loved one experiences these symptoms, it’s a sign they need help.
But how common is a dual diagnosis really, and what are the surrounding statistics? We’re so glad you asked.
Dual Diagnosis: Stats, Facts, & Figures
Co-occurring mental health conditions and substance use disorders affect around 8.9 million Americans each year. Of those, only 7.4% receive appropriate treatment, with the vast majority bounced among treatment systems with different and opposing treatment structures.
A substance use disorder in combination with a mental illness is more common than most of us realize. At least 45% of people with addiction have a co-occurring disorder according to a National Survey on Drug Use and Health.
In those surveyed with bipolar disorder alone, 48.5% experience an alcohol problem at some point in their lives. In those with bipolar disorder, 61% had a history of any substance use disorder.
According to the same study, 24.2% percent of those surveyed with bipolar disorder have experienced a problem with cocaine in their lives, 4.6% have had opioid issues, and 36% have had cannabis problems.
Any combination of a dual diagnosis is common so these statistics aren’t only for those with bipolar. Remember that about 50% of people who have a mental illness of any kind also have a substance use disorder.
In 2018, 9.2 million people had both a mental health condition and a substance use disorder. This means that they need integrated care for dual diagnosis or co-occurring disorders.
Remember, dual diagnosis is a condition in which someone suffers from a substance use problem like alcohol addiction, illegal drug addiction, or a prescription drug addiction along with a co-occurring mental illness. Let’s look at what the link between these occurrences is.
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The Link Between Addiction And Mental Illness
When someone is suffering from a mental health disorder and substance addiction, the two problems will often interact with each other and create a vicious cycle of dependency.
In most cases, a co-occurring disorder will begin as a means of self-medication for a mental illness.
Self Medicating for Recovery: The Good, The Bad, & The Addictive
Often, people use drugs and alcohol to self-medicate. Self-medication is most commonly done to alleviate symptoms of mental illness or physical injury. When someone is self-medicating, they are usually looking for shortcuts to dealing with whatever is troubling them.
For example, the teacher that takes one too many pain relievers to deal with the pain they feel in their knee after surgery during the school day.
Or perhaps it’s the college student who drinks to help handle the anxiety that they feel while trying to fit in with their roommate’s new friends.
Or maybe it’s the mom and dad who feel they need an escape from the stress of their day-to-day routine.
The biggest thing that most of us don’t consider when we are self-medicating with substances is that it will only make us feel better temporarily. Because the effects wear off, it can lead to repeated use to alleviate the symptoms of the mental illness, physical pain, or stressors.
Self-medication is dangerous because it can often lead to an addiction or even an overdose. It can make treatment harder than well because they may not realize that they need help for both addiction and the mental illness.
When someone has a problem with substance use and mental illness, they need to seek out the best dual diagnosis treatment program near them. If both problems are not treated–ideally at a dual diagnosis treatment center–they are more likely to have a relapse and be farther away from lifelong recovery.
If the cycle of self-medication perpetuates over a long period of time, the body and brain will eventually become addicted to drugs or alcohol to feel normal. Eventually, those self-medicating their mental illness with substances will begin to rely on drugs or alcohol to manage their day-to day-life.
Mental health problems do not always come first. While mental illnesses are caused by a complex combination of a person’s genetics, environment, and other outside factors, extreme drug or alcohol use can increase the underlying risk for a mental health disorder. If someone is already at risk to develop a mental illness, drug or alcohol use could be the thing that sets them over the edge.
Regardless of which developed first, using drugs or alcohol can make the symptoms of a mental illness worse or cause new symptoms to appear–and vice versa. As the symptoms get more out of control, the cycle of use will continue to grow stronger and make diagnosing and treating the co-occurring disorder vastly more complicated.
Survey Says: Research Tells Us Who’s At Risk
While anyone can be diagnosed with a dual diagnosis, researchers have discovered a number of overlapping factors that make someone susceptible to developing a mental health disorder and an addiction including:
- Genetics: A person’s genetic predisposition can make them more likely to develop a mental illness or addiction. For example, if both parents have a mental illness or addiction, their child is more likely to develop one or both conditions rather than a child whose parents do not have an addiction or mental illness.
- Environmental Triggers: Things like chronic stress or traumatic events can often trigger a substance use or mental health disorder.
- Early Exposure To Drugs Or Alcohol: Adolescents and young adults are more likely to get brain damage from substance use while their brains are still developing. Due to the potential effects of brain damage, they are more at risk to develop a dual diagnosis later on in life.
More specifically, a study in the American Journal of Drug and Alcohol Abuse found of those who had a dual diagnosis, most had:
- Poor familial and social relationships
- Undesirable living arrangements
- A history of arrest
- A history of previous psychiatric hospitalizations
- A history of use of multiple drugs
If someone is exposed to a number of these factors, it does not guarantee that they will develop a dual diagnosis. However, it may put them at a higher risk of developing one.
When it comes to providing care for those experiencing these combinations of conditions, a specialized integrated type of care is needed.The foundation of an integrated treatment model which focuses on the psychiatric and psychological history as well as the addiction. Often, this begins with a thorough evaluation and assessment.
During the evaluation stage, professionals and care providers get a clear picture of the severity of the mental health issues as well as the addiction. Often, these inpatient interviews reveal deep problems that must be addressed in treatment.
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Sometimes the mental problem occurs first. This can lead people to use alcohol or drugs that make them feel better temporarily. Sometimes, the substance use occurs first. Over time, that can lead to emotional and mental problems.
Either way, someone experiencing a substance use addiction along with a co-occurring mental disorder must be treated for both conditions.
In order to treat a dual diagnosis patient effectively, both the mental illness and addiction will need to be diagnosed and addressed together. Since the two illnesses are so deeply entwined, treating them separately is incredibly difficult and often unsuccessful.
Due to the severity of many dual diagnoses, those suffering should seek treatment at an inpatient facility that offers specialized care for co-occurring disorders. While in treatment, patients will receive a unique blend of treatment options that will help them address the root cause of their mental illness and their addiction. The use of varying therapies and modalities also helps clients begin to understand the complicated connection between their mental illness and their addiction.
The most important thing to remember when treating a dual diagnosis is that the cycle must be broken, and this starts by identifying the root cause of the addiction or mental illness. Once it has been addressed, clients can work with treatment professionals in order to identify triggers and set boundaries to ensure that the cycle of abuse doesn’t continue.
When mental illness and addiction begin to work simultaneously, they can be incredibly destructive. Thankfully, mental illness and addiction are treatable and with the right methods, those suffering from both can live a fulfilling life in long-term recovery.
For the treatment to be effective, the person needs to stop using alcohol or drugs. Dual diagnosis treatment may include a combination of behavioral therapy, medicines, and support groups to address and correct mental health issues that lead to or continue the cycle of substance use.
Without dual diagnosis treatment and therapy there is a higher chance of relapse because the problems of addiction are not properly addressed. Successful treatment of a dual diagnosis/co-occurring condition involves caring for both the mental illness and the substance use disorder. This is important because both conditions greatly impact one another.
Additionally, treatment should be individualized. This means that programs are unique to the individual. Using evidence-based treatment along with a trauma care approach in a co-occurring and substance use disorder program is essential.
The components of this type of program include a range of services:
- In-depth care as well as psychiatrists and nurse practitioners
- Life skills and healthy living groups
- Stress management like yoga
- Mindfulness and problem-solving
Different types of therapy are a good option for treating a dual diagnosis. These can be focused on an individual or group. There are a variety of types including:
- Group psychotherapy: allows patients to realize they aren’t alone while getting support, a sense of community, and recovery tips
- Cognitive Behavioral Therapy (CBT): addresses the thought patterns and behaviors and how to modify them.
- Recreational Therapy: allows patients to express themselves in creative ways
- Pet Therapy: reduces the symptoms of anxiety and depression
Frequently Asked Questions
What is the difference between comorbidity and dual diagnosis?
Comorbidity is another term that is often used to describe when a person has multiple conditions or diagnoses at the same time. Comorbidity is something that would be most often heard in a doctor’s office or other primary care medical setting. In the world of behavioral health, you may hear it used but more often you will hear co-occurring and dual diagnosis.
What causes dual diagnosis?
It can be hard to say definitively why it causes any type of mental illness. Most often it is the combination of risk factors like genetics, environment and previous experiences.
What are the two most common mental disorders?
Anxiety disorders make up the bulk of mental illnesses experienced in the United States. The next most prevalent type of disorder is depression.
What are the five most common mental disorders?
The top five most common mental disorders in the United States are anxiety disorders, depression, PTSD, dual diagnosis, and bipolar disorder.
A Dual Diagnosis Treatment Center That Puts You First
Through the dual diagnosis treatment centers at Vertava Health, you or your loved one can get treatment for mental health disorders and addictions. During intake, a specialist will do an assessment and then an individualized treatment plan will be planned.
Therapeutic choices are vast, and they could mean real help for people who have a dual diagnosis.
Our staff at Vertava Health know that dual diagnosis treatment is essential in order for people who suffer from mental illness and addiction to fully recover. We also understand that treatment should be individualized.
Vertava Health (formerly Vertava Health) is equipped to manage both dual diagnosis and dual therapy. We have a talented, caring staff poised to assess the client and place him or her on the treatment path that best suits them for success.
You can get help for co-occurring disorders. There is a dual diagnosis treatment that works. Vertava Health has a program for you that will work. Don’t wait. Call now .