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It’s not uncommon for people who abuse drugs or alcohol to suffer from depression, anxiety, panic attacks or severe mood swings. Sometimes these symptoms are side effects of drug abuse, but they may also be red flags for a dual diagnosis. In fact, a report from the Journal of the American Medical Association reveals that over 50 percent of drug abusers have a co-occurring mental health condition. A dual diagnosis means that you meet the criteria for substance abuse and a second psychiatric or emotional disorder. Mental disorders are defined by the criteria set out in the Diagnostic and Statistical Manual of Mental Disorders – IV (DSM-IV), a reference used by clinical professionals to identify and define psychiatric illnesses.
If you have a dual diagnosis, you need specialized treatment to address both your addiction and your mental health. When you enter treatment, you may also hear these terms:
- Co-occurring disorders
- Co-existing disorders
- Dually diagnosed
- Substance abuse and mental illness (SAMI)
- Chemical abuse and mental illness (CAMI)
Mental illness and addiction are often so closely interconnected that it’s hard to tell where one ends and the other begins. Drugs and alcohol can worsen some of the symptoms of mental illness by causing depression, agitation, restlessness, hallucinations and delusional thinking. On the other hand, many people who have depressive symptoms or who suffer from panic attacks or post-traumatic stress disorder use alcohol and drugs to soothe their symptoms. That’s why it’s so important to be evaluated and treated by addiction specialists who can help you get to the root of a dual diagnosis.
Common Co-Occurring Conditions
A glance at the DSM-IV will tell you that many psychiatric disorders have already been identified, and the discovery of new mental health conditions continues to evolve. But there are certain mental illnesses that are frequently associated with substance abuse. The Substance Abuse and Mental Health Association (SAMHSA) has identified a number of disorders that often occur with substance abuse:
- Generalized anxiety disorder (GAD)
- Bipolar disorder
- Obsessive-compulsive disorder (OCD)
- Attention deficit hyperactivity disorder (ADHD)
- Post-traumatic stress disorder (PTSD)
- Mood disorders
- Borderline personality disorder
Some people who enter treatment have already been diagnosed with a mental health condition, but for many addicts and alcoholics, a co-occurring disorder is discovered during the course of treatment.
Warning Signs of a Dual Diagnosis
How do you know if you or someone close to you has an undiagnosed mental illness? When drugs and alcohol are involved, it can be difficult to tell. According to Dual Recovery Anonymous, a 12-step program for the dually diagnosed, these warning signs may indicate that you have a psychiatric disorder in addition to a substance abuse problem:
- Conflicts in personal relationships
- Isolation from others
- Frequent visits to the emergency room for substance abuse or drug-related injuries
- Frequent arrests for violent behavior or high-risk activities
- Repeated admissions to psychiatric facilities
- Chronic unemployment
- Episodes of homelessness
Finding out that you have a psychiatric disorder can disturbing, but it can also come as a great relief and give you even more motivation to get the maximum benefit out of rehab.
Challenges of Recovery
A dual diagnosis can present certain obstacles during rehab. Mental illness can affect your mood, your level of concentration, your memory and your motivation. Depression can zap your energy, while ADHD may affect your ability to focus. The intrusive thoughts of obsessive-compulsive disorder may interfere with therapy or educational sessions. If you’re taking psychoactive medications for a co-occurring disorder, the side effects of your medications may also interfere with your treatment.
Support groups, a key component of most rehab programs, can be especially challenging for the dually diagnosed. Personality disorders, mood disorders and anxiety disorders can make it difficult to interact with others in a group setting. Sitting in an enclosed room with other people can trigger panic attacks in people with PTSD or a panic disorder. A dual diagnosis group can accommodate the challenges of mental illness while providing support and encouragement during rehab.
Getting through these obstacles requires a personalized treatment plan that takes your dual diagnosis into account. A specialized treatment facility can give you access to addiction professionals who will help you find the right combination of recovery resources for your condition.
Stages of Treatment
Treating a substance use disorder without addressing a co-existing mental illness — or vice versa — won’t give you the foundation you need for a full recovery. The National Alliance on Mental Illness (NAMI) emphasizes that treatment for a dual diagnosis should be completed in stages:
- Establishing trust. Many psychiatric disorders create barriers to trust. When you enter therapy, you may feel demoralized by past experiences and wary of trusting anyone on your treatment team. The therapist must be able to establish an empathetic relationship with you before change can take place.
- Promoting motivation and self-empowerment. Motivational therapy encourages you to discover your own reasons for pursuing rehab. By establishing a collaborative relationship with your treatment team, you can set and reach realistic recovery goals.
- Learning how to actively manage your illness. In rehab, you’ll be empowered with strategies that will help you control the symptoms of your illness. You’ll also learn new coping methods that can help you deal with the stress factors that trigger substance abuse.
- Learning how to prevent a relapse. Relapse prevention is vital to any dual diagnosis program. Your treatment plan must address not only the day-to-day stressors that can lead to a lapse, but the symptoms of your depression, anxiety or personality disorder that make you more vulnerable to drinking and using.
Finding a Dual Diagnosis Rehab Program
Not every rehab facility offers dual diagnosis recovery services. In fact, many rehab programs aren’t tailored to the needs of the dually diagnosed, and many mental health centers don’t provide care for chemical dependence. As a result, people with co-occurring disorders often go in and out of psychiatric facilities or detox programs without reaching a state of long-term sobriety. An effective dual diagnosis program acknowledges the need to integrate addiction treatment with psychiatric therapy. Consider these factors when you’re searching for a dual diagnosis rehab center:
- Staffing. The facility you choose should be staffed by social workers, therapists and counselors who have been trained to identify and treat substance abuse and psychiatric illness.
- Counseling. Individual therapy must consider the complex relationship between alcohol or drug abuse and mental illness.
- Socialization. Support groups and recreational activities are critical for clients who have been isolated from others or who have difficulty relating to their peers. The motivation and encouragement of group therapy is important for all dually diagnosed patients.
- Timing. The symptoms of a psychiatric disorder may affect the pace of recovery. A dually diagnosed client may not proceed as quickly through rehab due to low energy, motivational issues, strong denial or deep emotional conflicts.
- Holistic services. In addition to traditional approaches to treating a dual diagnosis, such as counseling and pharmacotherapy, the center you choose should offer a range of alternative therapies. Yoga, equine-assisted therapy, art therapy, meditation and martial arts are only a few of the holistic modalities that can promote recovery in the dually diagnosed. A holistic treatment program encompasses the entire individual, not just his or her diagnoses.
The dual diagnosis program here at Axis is uniquely qualified to provide integrated care for substance abuse and mental illness. When you entrust your recovery to our addiction specialists, you can benefit from a treatment plan that reflects your personal requirements. Call our treatment team for information on our comprehensive dual diagnosis recovery resources.