Lifeline Connections

Understanding Dual Diagnosis

What is a Dual Diagnosis?

Someone who suffers from both an alcohol or drug problem and a mental or emotional health issue is said to have a dual diagnosis. It’s important to understand that for the person to recover fully, he or she will need treatment for both problems. Many rehabilitation centers offer both mental health and addiction services, and so can help a patient to overcome both difficulties.


How Common is Dual Diagnosis?

Dual diagnoses are a lot more common than you might expect. According to the American Medical Association, about 37% of alcohol abusers and 53% of drug abusers also have at least one serious mental illness. In addition, 29% of people diagnosed as mentally ill abuse either alcohol or drugs. It’s clear that the two problems can go hand-in-hand.


Which comes First, the Mental Health Problems, or the Substance Abuse?

There are no hard and fast answers to this question. One individual’s situation may be completely different from another’s, which is why it’s so important to work with a rehabilitation center that works directly to your needs.

Often substance abuse develops first and may trigger psychiatric problems. A person whose substance abuse problem has gotten out of hand may feel like he is losing control of his life. Reactions to this feeling can vary. Some people might have episodes of depression, attempt suicide, or outbursts of rage against things and people around them. Substance abusers can even begin to have hallucinations or delusions.

In other cases, the mental or emotional problems are the primary, underlying condition. In attempting to cope with a mental illness or emotional imbalance, a person may drink or use drugs. For example, someone struggling with post-traumatic stress disorder might drink to cope with the emotional pain, or a depressed person might use stimulants to try to feel more energetic. This is a process called self-medication, and can serve to exacerbate already present mental and emotional problems while adding yet another problem to the mix.

A good rehabilitation center will work with a patient with dual diagnosis to understand his particular symptoms and history, helping to make a more effective treatment plan.


How Does Treatment Work?

For best results, both problems need to be treated simultaneously. However, for any substance abuser, the first step in treatment must be detoxification, a period of time during which the body is allowed to cleanse itself of drugs and alcohol. Detox should take place under the supervision of a medical professional in order to manage withdrawal symptoms and prevent relapse.

Once detox is completed, dual treatment can begin: therapy for the mental or emotional issue and rehabilitation for the substance abuse problem.

Rehabilitation is usually similar for all types of substance abuse. Individual and group therapy, education about alcohol and drugs, and participation in a relapse prevention program like Alcoholics Anonymous. In addition, a healthy lifestyle is very important, involving good nutrition and daily exercise in moderate amounts.

Treatment for mental problems varies widely based upon the diagnosis. Group therapy can often be helpful, especially when combined with appropriate medication to minimize symptoms. Education about the particular condition can also be very beneficial and help to remove the feeling of powerlessness people struggling with mental health often have.


What Role Do Family and Friends Have in Treatment and Recovery?

The first thing family and friends need to do is to ensure that they have stopped enabling the patient’s addiction. Enabling refers to kinds of behaviors that encourage the patient to keep up his lifestyle of drinking or using drugs. Giving money to an addict he will use for drugs or alcohol, calling to work for him to say he’s sick when he is too drunk or high to do it himself, or making excuses for his behavior are all forms of enabling.

Secondly, family and friends can be a huge help in supporting the patient’s mental health by providing an atmosphere of kindness, calmness, understanding, and support. They should avoid acting critical or fearful. Additionally, though they may talk about the mental treatment the patient is undergoing, that shouldn’t be the only topic of conversation.

If you know someone with a substance abuse problem or the symptoms of a mental disorder, you can help him. Encourage him to seek professional help from a licensed physician who can help him to understand his problems and set the next steps for treatment. If the person is reluctant to go, do all the work yourself: find the treatment facility, make the appointment, or even offer to go with the person. A little encouragement may be all it takes.


Don’t Give Up!

If you’re struggling with the symptoms of a dual diagnosis and trying to deal with it all on your own, it might be too heavy of a burden for you to carry all alone. You might feel like giving up, but it’s important to remember that there is hope. There are doctors, psychiatrists, rehabilitation centers, and support groups who can provide you with whatever you need to beat your addiction and become emotionally and mentally healthy.

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