“Dual diagnosis” is a common term used in addiction research and treatment to refer to the co-existence of an addiction and another mental disorder. This may include depression, anxiety, schizophrenia, and many others. Dual diagnosis Treatment often requires specialized therapies and more involved treatment due to the fact that both the addiction and mental illness must be addressed.
According to dual diagnosis statistics, mental illness and addiction often go hand-in-hand. Patients with depression, for example, have a 40% lifetime co-morbidity for alcoholism and a 17% co-morbidity with other substance addictions. Cocaine abuse is likewise associated with Cluster B and Cluster C personality disorders, and cannabis abuse with the development of psychotic illnesses.
Over half of all individuals seeking addiction treatment can qualify for needing dual diagnosis treatment. Substance abuse disorder seems to be particularly linked to bipolar disorder, occurring in 56% of bipolar patients.
The most common dual diagnosis patient is a single, young adult male with a history of conduct disorder, a family history of addiction, and a lower education. The need for dual diagnosis treatment is further increased if an individual has spent time in jail, is currently homeless, or has ever been homeless.
Most addicts, regardless of whether or not they have received a dual diagnosis, share many similarities. Both often turn to substances out of loneliness and boredom, and both exhibit low levels of inhibition. Having a mental illness, however, appears to lower one’s ability to use substances in moderation. Drugs and alcohol also tend to have a stronger effect and a more adverse impact on mental stability in people with a co-occurring mental disorder.
Traditionally, when seeking treatment for an addiction and a mental illness, an individual had to take part in two separate, sequential treatment programs. Rather than forcing patients to choose which problem to seek help for first, today’s dual diagnosis treatment programs take an integrative approach which addresses both disorders at the same time. Such programs have significantly improved treatment outcomes.
Integrated services often provide patients with an interdisciplinary case management team. This team is crucial for letting patients know that treatment for their addiction and their substance abuse is possible, and for motivating them to work towards recovery.
Once a patient accepts treatment and the need for change through these motivational techniques, a trained therapist will typically transition into using cognitive behavioral therapy (CBT). CBT, which can be used to counsel an individual, a couple, or an entire family, is all about identifying problematic behavior and employing effective coping techniques to manage it. CBT can be used both as a relapse prevention tool and as a mental illness coping tool.
Just like addicts without a co-occurring mental disorder, dual diagnosis patients can also benefit from programs such as Alcoholics Anonymous and Narcotics Anonymous. These 12-Step, peer-support programs can help prevent relapse to those in recovery by offering structure and a chance to partake in purposeful, goal-directed behavior. Building new social ties is important for recovering addicts, as it helps them steer clear of the old ties which may have contributed to their addiction.
Because managing the symptoms of mental illness is so important to successful recovery from addiction, therapists will often prescribe psychotropic medication to their patients. Patients with schizophrenia, for example, may need antipsychotics because they can then better understand the effect that their addiction is on their life and realize the need for change. Mood stabilizers can likewise help with treatment adherence and outcomes in patients with bipolar, depressive, and anxiety disorders.
Dual diagnosis recovery and management is possible, and today there are many more treatment options available than there once were. Patients deserve to have both problems addressed and treated at once, and often benefit greatly from receiving integrated care.
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