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A drug or alcohol addiction is often accompanied by other
conditions. As such, most addicts hardly ever choose to continue using alcohol
and other substances without reason. In many cases, pre-existing mental health
conditions cause, contribute to or exacerbate the addiction.
Conversely, the consumption of alcohol and drugs can also
contribute to, worsen, or cause new psychological conditions. When mental
illness and substance addiction exist at the same time, medics refer to it as a
co-occurring disorder or a dual diagnosis.
If you struggle with this type of disorder, you might
require specialized care as administered by trained, qualified, and experienced
professionals before you can be considered to be fully healed.
As such, it is quite common for people seeking addiction
treatment to discover that they also suffer from a co-occurring
psychological/psychiatric disorder. In fact, poor mental health might coexist
with substance abuse and addiction for several years before you discover that
there is more to your addiction that the simple physical dependence on drugs
Unless doctors treat the underlying mental health issue
alongside your addiction disorder, it is highly likely that your chances for
long term recovery remain poor at best. In fact, the NIH (National Institutes
of Health) estimates that people with depression or anxiety disorder are 50%
more likely than those without similar conditions to abuse alcohol and drugs.
Additionally, individuals suffering severe mental illnesses such as schizoaffective
disorder (with psychotic features) and schizophrenia will also experience
higher rates of substance abuse and addiction than those in the general
To this end, as you undergo assessment for addiction, you
might have to meet with a mental health professional. This expert will use
several diagnostic tools to determine whether you also suffer from a
co-occurring psychiatric disorder. If they find that mental illness and alcohol
or drug addiction coexist, the condition will be referred to as a dual
Treatment for dual diagnosis is relatively new in the
field of substance addiction recovery. In fact, until the 90s, people who
suffered the typical symptoms of poor mental health - mood swings, delusional behavior,
depressive episodes, and anxiety attacks, among others - received treatment
separate from those seeking help for alcohol and drug abuse.
Where these conditions were found to be overlapping, the
client would be denied treatment for mental illness until after they had
sobered up and cleaned their bodies of the drugs/alcohol.
Unfortunately, since recent research has discovered that
substance abuse is sometimes driven by underlying psychiatric disorders, it
follows that many people suffering from the dual diagnosis of poor mental
health and addiction never received the help that would have saved them.
That said, the relationship between mental illness and
substance abuse is now understood to be more complex than previously assumed.
In fact, these two conditions might be related in any or all of the ways listed
For treatment, skilled therapists are highly likely to
assess you on multiple levels to uncover the relationship between your
substance abuse and mental health. However, even highly experienced experts
have a challenging time making a dual diagnosis.
Although the symptoms of one disorder might predate those
from the other, both disorders are highly likely to exacerbate each other. This
usually makes it close to impossible for medics to extricate and differentiate
the symptoms of one condition from the other.
For instance, if you try to escape the symptoms of your
depression as caused by personality or mood disorder by shooting heroin or
taking prescription pills, you might eventually discover that although this
self-medication is effective a couple of times, you might eventually start
struggling with (on top of your depression symptoms) the following:
Otherwise referred to as dual diagnosis, concurrent
disorders (or double trouble in layman's terms) are used to define the
combination of substance abuse and mental health issues).
Instances of concurrent disorders include clinical
depression or PTSD and alcohol addiction, cocaine addiction and ADHD,
Benzodiazepine dependency and Generalized Anxiety Disorder.
In many cases, it is often close to impossible for the
medics to separate addiction and poor mental health because most doctors tend
to misdiagnose addiction and/or confuse the accompanying symptoms.
It is due to this that many clients are only able to
enjoy normality and mental stability after their addiction has been addressed.
As a direct result, substance abuse is now thought of as a self-medication
condition, which often carries the following mental and emotional disorders:
Also, it is common for individuals suffering from poor
mental health to start using illicit and addictive substances to improve their
ability to cope, feel better, or numb and decrease their feelings.
Of course, self-medication might work in the first few
days or weeks, and provide you with relief from your excited brain. However,
the problems and pain might start getting out of control, and the drugs/alcohol
will only make your issues worse than they were before.
As you might already imagine or even have experienced,
the links between substance abuse and poor mental health are manifold. Consider
A family history of either substance abuse or mental
illness might translate into genetic susceptibility and vulnerability to drug
and alcohol use and/or poor mental health.
In the same way, recent research shows that adverse
childhood events - including childhood emotional, physical, and sexual abuse -
might predispose you to substance use problems and/or mental health issues in
Similarly, extensive or prolonged substance use and abuse
might mask, mimic, exacerbate, or cause mental health signs and symptoms. The
poor mental health caused by heavy substance use will typically go away once
you achieve sobriety. However, your vulnerability for poor mental health might
As a direct result, mental health issues arising from
persistent substance abuse are typically referred to as substance-induced
mental health disorders. For instance, if you binge on cocaine, it is highly likely
that you will start suffering depression-like symptoms. In this case, you will
have a difficult time getting out of bed for around 5 days after you abuse the
In the same way, medics have discovered that substances
often exacerbate or compound mental health symptoms. For instance, alcohol acts
to depress the central nervous system, thereby sedating or slowing down nervous
system functioning. In this way, it will often worsen already existing
depressive-symptoms, such as lack of motivation or hypersomnia.
Not surprisingly, substance abuse often tends to cause
instability with regards to sleep, motivation, mental functioning, physical
energy, and mood - areas that are all impacted by poor mental health.
As a direct result, it is common for substance abusers to
experience inaccurate mental health diagnosis - with some being diagnosed with
bipolar disorder. Similarly, some symptoms apply to both substance abuse and
poor mental health - such as problems concentrating or focusing, and insomnia.
Consequently, it might be difficult to ascertain if the
symptoms reported stem from the addiction or they are a reflection of the
mental health difficulties the substance abuser is suffering.
Still, mental health issues tend to increase the
vulnerability of the brain to the harmful effects of regular and heavy alcohol
and drug abuse. According to the Super Sensitivity Model, the brain of
individuals suffering from poor mental health are more negatively and more
strongly impacted by even the most minor amounts of drugs and alcohol as
compared to people without existing mental health issues.
Drug and alcohol dependency might also make it even
harder for you to recover fully from such mental illnesses as anxiety and
depression which interfere with your adherence and commitment to treatment
(including the attendance of counseling and medical appointments or the taking
of the medications prescribed). Further, it might impact your ability to learn
the coping skills required to counter any mental health symptoms you are
Overall, mental health issues are likely to interfere
with your day to day functioning with regards to relationships, leisure,
general productivity, and work. As a direct result, these issues might cause
significant problems in these basic areas of ordinary functioning.
When such difficulties persist for long, you are more
likely to seek some relief or escape by consuming addictive substances and
alcohol. Consequently, the route to addiction might innocently start with your
night caps to help with insomnia as caused by depression and anxiety.
Eventually, relapses in the poor mental health symptoms
might prove concurrent relapses into regular substance alcohol abuse - and vice
versa. Therefore, it is important to understand the complex interaction between
substance and mental health problems. These interactions are likely to change
the outcome and the course of the problems you end up experiencing.
For an official dual diagnosis, it is imperative that you
get evaluated by an addiction specialist or a mental health professional.
However, you most certainly do not have to be a qualified primary care doctor
or a psychologist to be able to tell that something is off with you or with someone
you love/care about.
Although there was no named condition or official term,
substance abuse and mental illness have been closely linked for several years.
As such, dual diagnosis ranges from those who abuse drugs and alcohol to cope
with pre-existing mental health problems to those who develop poor mental
health after using specific drugs and alcohol over a long period.
Irrespective of the reasons given for substance use, it
is now conclusively proven that alcohol and drugs only make the symptoms of psychiatric
and psychological illnesses worse. They might even lead to the development of
new mental health issues.
Since both addiction and mental illness affect the brain,
it is not surprising that these conditions feed off each other. When one
exists, it is highly likely that the other will occur.
That said, dual diagnosis symptoms vary widely because
there is a virtually endless list of possible combinations. According to NAMI
(National Alliance on Mental Illness), some symptoms typically characterize
You can only know for certain whether you suffer from
dual diagnosis by consulting addiction treatment specialists with a background
in serious psychiatric care. At the dual diagnosis rehabilitation facility
where you are likely to be referred, evaluation specialists and intake
counselors will also review your substance use patterns and check your
psychiatric history before coming up with an individualized treatment plan for
The hardest part about getting support is reaching out
for help. However, once you do, the right medics will come to your aid, and you
will soon be on your way to full sobriety and recovery.
For a dual diagnosis to be made, it is imperative that
you meet the criteria set for mental health disorders as stipulated by the DSM
(Diagnostic and Statistical Manual of Mental Disorders). The DSM is published
by the APA (American Psychiatric Association) as a guideline that mental health
professionals can use while diagnosing and treating patients in various
A therapist, counselor, psychologist, physician, or
psychiatrist is qualified to provide a dual diagnosis to patients suffering
from an addiction to alcohol, drugs, or certain behaviors (gambling, sex, and
the like) accompanied by a mental health disorder.
If you get a dual diagnosis, it might come as a relief
especially if you have been living with undiagnosed mental health issues over
an extended period. If you have had to put up with flashbacks to traumatic life
events, hallucinations, suicidal thoughts, episodes of sadness and
hopelessness, and severe mood swings, putting a name to the condition is likely
to provide you with a sense of hope. Once that is done, you would be in a
better position to receive treatment and recover.
However, recovery from poor mental health tends to be
more challenging for people who are also battling addiction. However, with a
compassionate and properly trained team, you should be able to make it through
detoxification and rehabilitation and get started on your journey to full
Through dual diagnosis assessment, the medics will focus
on psychological assessment and cognitive evaluation. The screening tools used
might take the form of computer games, structured questionnaires, and
standardized multiple choice tests. Some of the tests may provide question sets
that the therapist will ask during the face to face interview while others will
be provided as written exams.
To improve the accuracy of the results, the therapists
are likely to administer the tests in a setting that is private, comfortable
and quest. Addiction Science and Clinical Practice asserts that such
standardized diagnostic instruments are effective because they allow
practitioners to develop actionable treatment plans based on research that is
based on empirical evidence.
Consider the following:
The diagnostic criteria for most of the screening tools
might be based on standards established by the DSM-V (Diagnostic and
Statistical Manual of Mental Disorders), a reference book by the APA (American
Today, the DSM-V is widely recognized as the foundational
source of classification of poor mental health within the psychiatric
The therapists might also use cognitive function tests,
which are widely accepted as the norm in evaluating the cognitive function for
dual diagnosis. These tests include:
Cognitive testing is useful in the identification of
those conditions that are known to affect intellectual function - such as ADHD
(attention deficit hyperactivity disorder), brain injury, dementia, and
learning disorders. These conditions can negatively affect judgment and impulse
control, thereby predisposing you to addictive behavior and tendencies.
Similarly, therapists and medics rely on psychological
tests to distinguish between the symptoms of psychiatric disorders and the side
effects of drug and alcohol addiction. These tests are also useful at providing
medics with the information required to develop the client's personality
profile. Some of the tools popularly used for assessing personality and
psychiatric disorders include but are not limited to:
Apart from psychological and cognitive testing, the
therapist is likely to assess you to check the severity of your substance abuse
and addiction. Some of the tools commonly used to screen for addictive behavior
The Psychiatric Research Interview for Substance and
Mental Disorders (commonly abbreviated as PRISM-IV) targets specific
co-occurring disorder. This structured interview is designed to help the
therapist identify certain psychiatric disorders among those who abuse alcohol
The interview was developed so that practitioners would
be able to distinguish between the side effects of substance addiction and the
symptoms of poor mental health. The AJP (American Journal of Psychiatry),
PRISM-IV is reliable in the identification of certain disorders in addicts and
There are many other diagnostic tools that addiction
treatment specialists and mental health practitioners can use for dual
diagnosis. Most of these tools are designed to identify specific disorders and
target certain populations. They include, but are not limited to:
Last but not least, therapists who specialize in dual
diagnosis might apply a wide variety of tests based on your emotional effect,
self-reported symptoms, substance abuse history, age, and other factors.
Additionally, they will use their observational skills and clinical training to
develop comprehensive client profiles showing your neuropsychological
Living with addiction alongside poor mental health is one
of the deadliest of combinations. The poor lifestyle choices you are likely to
make on account of these two disorders will often translate into sudden or
early death for you if you don't receive due treatment.
Some of the life-threatening issues commonly co-occurring
with poor mental health include:
To this end, addressing the disorders that are likely to
contribute to poor lifestyle choices that might hasten early death is crucial
for anyone living with a co-occurring disorder.
Through integrative treatment, you will receive the
complete range of treatment services you need, thereby getting everything
needed to help you heal at every level. The specific services vary depending on
your needs, but might also include resources to help you make certain lifestyle
changes. Others will be directed at mental health and addiction treatment.
Additionally, the integrated treatment program is likely
to recommend certain lifestyle changes to promote your wellness and health.
These changes include:
Through these changes, you will receive everything you
need to return to work, build an uniquely strong support network, rebuild your
relationships at home, and start getting back on track with your life.
Integrated treatment outlines the comprehensive
rehabilitation program that will offer you all the holistic, therapeutic, and
medical resources you need to heal spiritually, emotionally, mentally, and
physically. Irrespective of the mental health diagnosis - and especially if the
issue lies with co-occurring disorders - it is highly likely that the doctors
will recommend integrated care.
Due to your unique condition, the medics might also
create a treatment plan that is highly personalized. Since you may be living
with both a mental health disorder and a substance abuse/addiction disorder, the
integrated treatment plan is likely to include the following options:
If you have been struggling with your addiction to drugs,
alcohol, and other substances, the detoxification period might take place over
the first few days or weeks after you cease your substance use. This period is
often defined by mental and physical withdrawal symptoms.
As such, detoxification services are designed to provide
you with medical monitoring and support to help you stabilize during your
The second step in integrated treatment is designed to
ensure that all the mental health symptoms you suffer are diagnosed accurately.
During this evaluation, the therapists will also identify all the other issues
that might act as a hindrance on your path to full recovery.
Based on the experience you reported and the results from
your evaluation, the medics might also make diagnoses to improve your
understanding of past experiences and frame them while planning for the future.
Next up, the medics may create an unique treatment plan.
This plan is highly likely to integrate a wide variety of medical and
therapeutic interventions. The goal of the integrated treatment would be to
empower you to start healing from your addiction. You will also learn how to
address any problematic personal issues and manage your mental health symptoms.
The foundation of full recovery after a dual diagnosis
often like on face to face therapy. By undertaking one-on-one therapy, you will
have a confidential and safe forum in which you can discuss current issues,
past experiences, goals for your future, and the changes happen to you during
As you achieve different treatment goals based on your
initial treatment plan, you might also work together with your therapist to
formulate new goals while adjusting your current treatment plan
You may also join different types of groups as part of
your integrated treatment program after a dual diagnosis. These groups include
During your treatment, you might get the opportunity to
work together with your loved ones to rebuild the relations you damaged when
you were suffering from untreated poor mental health and addiction.
During family therapy, you will improve your chances of
recovery especially if you plan on returning home to continue with your family
after you undergo treatment and come out healed.
By empowering your family members, you might be able to
ensure that they connect with the treatment. As a direct result, they are
highly likely to start healing in their own way while also striving to help
everyone in the group learn more positive communication skills.
Before you leave treatment after the dual diagnosis, you
are highly encouraged to continue working with your therapist to formulate a personalized
after care plan. Similar to the treatment plan, your aftercare plan should
include a wide mix of treatment services designed to serve your treatment needs
and goals albeit on an outpatient basis.
The aftercare treatment will help you both during and
after you start transitioning to independent living after you recover.
Last but not least, seeking integrated treatment for your
co-occurring disorders means that you should create an unique integrated
aftercare plan. This plan should incorporate all the services that will address
your treatment needs until you recover fully.
Similarly, the therapist will recommend continued mental
health care and support building as you recover from addiction and poor mental
health. Finally, you might end up continuing with the personal therapy and
alternative and holistic therapies that worked for you during treatment.
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