‘Dual diagnosis’ is a term used by addiction recovery professionals in the community to describe when an individual suffers from both an addiction and another diagnosed mental health illness. The more accurate term used by private services, addiction treatment specialists, and Public England Health is “co-occurring illnesses” as the term “dual” indicates only two diagnosed illnesses present, one of which is addiction or substance misuse. In reality, there can be a combination of different addictions and mental health illnesses at play, which can make a correct diagnosis challenging. Mental health issues that co-occur alongside an addiction, can be difficult to correctly diagnose for a variety of reasons. Addiction Helper aim to educate you on the most common mental health conditions that co-occur alongside addiction, how to get an accurate diagnosis, the long term implications of not treating a co-occurring illness correctly, how to spot the signs in yourself or a loved one, and more importantly how to access the correct help and treatment for all conditions presenting.
Addiction Helper are here to help and support you or your loved one is accessing the best treatment possible. We are a company who have true compassion and drive to help the still suffering and untreated alcoholic or addict. Most of us that work for Addiction Helper, and in the carefully selected private rehabs we collaborate with, are in recovery; having overcome our own personal issues and addictions. We believe that no one is beyond help; we are living testimony to that, as are the many other individuals that we have helped over the years. In fact, Addiction Helper have assisted well over 10,000 individuals suffering from addiction and co-occurring conditions to access the correct treatment and support for them, and also for their families. We are passionate about saving lives, and believe that it begins with educating others on the nature of addiction and the seriousness of this chronic and progressive disease.
If you or have any questions relating to how we can help you or a loved one find recovery from Addiction or a Dual Diagnosis, please do call us, or use our online LIVE CHAT now!
What Is Dual Diagnosis?
Dual Diagnosis is a terminology applied to an individual who suffers from both an addiction and a confirmed, professionally diagnosed mental health illness. It is very common due to the nature of addiction. Those that develop addiction are more predisposed to developing a mental health condition, and those with a mental health condition are more predisposed to developing an addiction problem as a result of self-medicating their symptoms. A true Dual Diagnosis, or Co-occurring condition, is a mental health illness that remains after the addiction has been dealt with; in other words it is not a side effect of their addiction.
In the field of addiction treatment, it is very common to come across addicted individuals who have developed a co-occurring illness as a direct result of their alcohol or drug or abuse. Remove the alcohol and drugs and the symptoms usually diminish considerably or vanish altogether. With a true mental health illness, the symptoms will remain and sometimes even worsen. Certain Co-occurring illness are very hard to correctly diagnose and therefore treat, until the substances have been safely removed from the alcoholic’s or addict’s body. Until this point, it can be difficult to get a clear picture of what is going on for the individual concerned. This is why the NHS don’t tend to treat a co-occurring illness fully, until the individual stops the alcohol or drug use. Frustratingly for the sufferer, they can find themselves batted back and forth between local drug & alcohol teams and mental health teams with very little communication between the two. This is consequently very unproductive in terms of treatment and also very dangerous for the individual who needs the help and treatment quickly.
What Causes Dual Diagnosis?
A true Dual Diagnosis or Co-occurring illness, is an underlying mental health illness that the individual self-medicates with drugs, alcohol, or compulsive behaviours. Remove the substances or process addiction and, often times, the underlying mental health illness or illnesses will remain. It is imperative that the individual receives professional, expert treatment for all conditions presenting simultaneously. With or without the aid of medication, they will need to implement healthier coping strategies to deal with their underlying mental health problems on a daily basis. If they fail to use healthier coping strategies, which they will be shown in the treatment process, they are likely to return to their old methods of self-medicating as the internal pain becomes too much to bare. Here are some typical examples of why and individual with a mental health illness will turn to alcohol, substances, or another type of unhealthy compulsive behaviour:
Common Dual Diagnosis Illnesses
As previously discussed, it is very common for an individual who has substantially abused alcohol or drugs to develop mental health problems or symptoms as a direct result. It becomes a vicious circle of self-medicating the symptoms and the symptoms worsening due to additional chemical imbalances in the brain resulting from the abuse of substances. This leads to a rapid downward spiral in the individual’s physical and mental health. If not treated correctly and promptly, it can end with the individual dying as a result of taking their own life or their body giving up as a result of their addiction.
Common co-occurring illnesses that accompany addiction are:
- Anxiety/Panic Disorder
- Borderline Personality Disorder (BPD)
- Eating disorders
- Post-Traumatic Stress Disorder (PTSD)
- Obsessive Compulsive Disorder (OCD)
- Bipolar Disorder
Some disorders will be the underlying cause of an addiction, whilst others will develop as a result of an addiction. Depression, Anxiety and Psychosis are the mental health illnesses most likely to result from addiction, and the most easily treatable. Once the individual has detoxed from the substance they are addicted to, the symptoms usually diminish considerable or vanish altogether. Where they are not resolved by merely stopping drinking and taking drugs, then further additional treatment will be required to ensure that all conditions presenting are treated in full and comprehensively. This is vital to long and ongoing recovery.
Integrative Treatment for Dual Diagnosis
Addiction Helpers private rehabs take a different approach to the NHS; our main aim is to stabilise the patient immediately. We then treat all conditions presenting simultaneously for maximum effect. It has been proven consistently, that this is the best approach in order to achieve a full and lasting recovery from all conditions the individual suffers from. Neglecting to treat one, can be very detrimental to the individual’s recovery and will usually result in relapse. We are passionate about treating each individual as a whole person, this means comprehensively treating the mind, body, and spirit through a combination of medication (where absolutely necessary, or where there is an alcohol or drug dependency requiring a medical detox) psychotherapies, and holistic therapies. All of our therapies are designed to bring about a huge shift in the individual’s thinking and perception. We also unearth and comprehensively treat the root issues of the illnesses, as failing to do this can prove to be a great stumbling block in their future recovery. We only work with CQC-regulated treatment centres of the highest calibre, who specialise in treating dual addiction. If you would like to find out more about how we can help you or a family member, please call us now or use our online live chat for web assistance.
Signs, Symptoms and Diagnosis
Experienced doctors and therapists will tell you that diagnosing co-occurring conditions is extremely difficult. The primary challenge is recognising the difference between substance-induced behaviours and behaviours that are the result of mental illness. There are many examples of mental illnesses symptoms and behaviours that can manifest in an individual who is abusing alcohol or drugs or who have an addiction.
Here are just a few examples to prove how challenging it can be to correctly diagnose:
Alcohol addiction : can often result in severe Depression, Anxiety, Panic disorder, and Suicidal ideation and Self-harm
Heroin addiction : can often result in acute Depression, Paranoia, Suicidal ideation
Cocaine or Crack-cocaine addiction : Can result in severe Paranoia, Psychosis, Schizophrenia, Depression, Anxiety, and Suicidal ideation
Cannabis or Skunk addiction: can result in severe Depression, Paranoia, Psychosis, Schizophrenia, and Suicidal ideation
Amphetamine addiction : can result in Psychosis, Schizophrenia, OCD, and Severe weight loss, leading to an Eating disorder
Even process addictions (addiction to an activity or person) such as Gambling , Sex and Love, Co-dependency, and Eating Disorders can significantly alter the brain’s chemistry; leading to Depression, Paranoia, Psychosis, Anxiety and Suicidal ideation. Prescription pill addiction and abuse can also result in an individual developing mental health conditions
Any true mental health illness will continue once the drink, drugs or addictive behaviours have been stopped. As time goes on it will become more apparent if there is an underlying mental health condition that has resulted in the individual self-medicating. Mental health illnesses that have also been diagnosed prior to an addiction or abuse problem commencing, will require specific and ongoing treatment from medical professionals
Although the symptoms of dual diagnosis/co-occurring illnesses vary from one condition to the next, some symptoms are common in many situations. These are:
- ongoing depression or anxiety
- persistent confusion
- hallucinations and delusions
- persistent fear, panic, or paranoia.
It should be noted that some substances have very damaging effects on the brain, to the point of being able to create a mental illness where none previously existed. Even once the substance has been removed, the damage cannot be fully repaired without medical intervention and ongoing treatment and support.
How We Tell the Difference
As previously stated, experienced dual diagnosis professionals need to examine patients carefully in order to figure out what is going on. Those of us in the addiction recovery community utilise a number of different strategies to tell the difference between substance-induced psychosis and genuine mental illness.
Our most important strategy involves strictly defined observation procedures during and after the withdrawal process. In our observations, we are looking for specific symptoms and reactions that would help identify a legitimate dual diagnosis/co-occurring illness. In other words, do psychiatric symptoms continue unabated even after withdrawal is complete? If so, how severe are the symptoms and do they show any signs of fading?
A person coming down from a long-term alcohol, amphetamine, or cocaine addiction might also be dealing with severe depression. We would expect feelings of depression to be more severe during the withdrawal process from substances and even continue for a few days or weeks following detox. But if depression persists at the same level beyond this time frame, there is a good chance the person is suffering from a co-occurring mental health condition.
Treatment for Dual Diagnosis
We cannot stress enough that the treatment for dual diagnosis is highly specialised due to the need for treating co-occurring conditions without making any of the conditions presenting worse. For this reason, not every rehab clinic in the UK is capable of taking dual diagnosis patients. Addiction Helper has access to over 100 exemplary CQC-regulated private rehab clinics in the UK, and a select number overseas, offering this highly specialised treatment. Our detox and rehabilitation centres have the necessary professional experience and qualifications to start treating co-occurring conditions comprehensively whilst in our care. We also ensure that the patient’s doctor is fully informed and the relevant referrals are made, so that ongoing support can be given when they leave the treatment environment and return to the community.
In order to successfully treat dual diagnosis patients, every case must start with a comprehensive assessment, provided by a doctor or therapist with experience in this particular field. Assessments focus on determining how severe the conditions are, when they began, and how they play off one another. From there, bespoke treatment plans can be developed to ensure that all conditions presenting are included in the patient’s individual treatment programme.
Our Rehab Treatment Plans Frequently Include:
Comprehensive assessment – Our doctors are experienced and proficient in diagnosing and in treating dual diagnosis patients. On admission each patient undergoes a comprehensive assessment of their mental and physical health treatment needs. These needs are then met within their individualised treatment programme during their stay.
Medical Detox – This is vital to achieving abstinence through a safe and controlled medical detox, where there is an alcohol or drug dependency present. It is of particular importance in dual diagnosis scenarios, because it is very difficult to determine how severe co-occurring conditions are while the chemicals associated with substance abuse are still in the patient’s body. Doctors and therapists will need to carefully observe and monitor withdrawal and its after-effects in order to fully understand what is going on.
Medication – In a dual diagnosis situation, medication is one of the hardest things to master. Medications may be used to help ease withdrawal symptoms during detox, but those same medications could negatively impact on the mental illness if continued. Subsequent medications used to treat mental illness after detox must do so without providing a mechanism for addiction relapse. In other words, the individual’s body has to be completely chemical free before a correct diagnosis and appropriate and approved medications can be prescribed. In an instance where an individual is already on medication for a dual diagnosis, we do not stop this during the detoxification period, (unless there is significant cause for concern, such as abuse of prescription medications) as this could prove to be extremely detrimental to their completion of the detox. Our rehabs stabilize the individual first, in order to gain a better understanding of what is going on for each individual patient.
Psychotherapeutic Treatments – Treating dual diagnosis patients after detox involves a course of evidence based psychotherapeutic treatments that address addictions and co-occurring conditions, either separately or together. Cognitive Behavioural Therapy and Dialectic Behavioural therapy are two examples of commonly used psychotherapeutic treatments that have been proven to be extremely successful in the treatment of addiction and mental health illnesses.
Individual Therapy – This is particularly helpful for a therapist to come to understand a patient better on a one to one basis. Through the use of Individual therapy sessions, patients benefit from a number of proven psychotherapeutic techniques dedicated solely to their individual treatment needs. They also form a closer therapeutic working relationship with their counsellor or therapist, enabling them to feel more trusting in discussing their issues, thoughts, feelings, and fears without judgement. These sessions are very carefully planned and controlled by the counsellor or therapist, to ensure the patient’s safety is paramount in exploring sometimes very difficult and delicate subjects.
Holistic therapies – Our rehabs use a number of evidence based, powerful, healing holistic therapies to help heal the mind, body, and spirit. We use proven therapies such as Mindful Fitness, Meditation, Art, Music, Yoga, Tai Chi, and much, much more. These therapies not only help to heal the addiction but also many co-occurring illnesses; once learned, they can be implemented back in the community as a continuation of the individual patient’s ongoing recovery.
Group Therapy – This is both very healing to any individual who suffers from addiction or a co-occurring illness. Illnesses such as Addiction, PTSD, Depression, Anxiety, Bipolar, Schizophrenia, and Borderline Personality Disorder lend to isolation tendencies and have a heavy social interaction impact on the individual. Group therapy shows the patient the value of support and contribution. The rehabs we use always ensure that group therapy sessions are headed by a qualified therapist who keeps the group safe, directed and focused at all times. Group therapy is extremely flexible and allows for a number of proven addiction and co-occurring illness psychotherapeutic and holistic treatments to be delivered within a compassionate and caring environment.
Aftercare treatment – This is another vital component to ongoing recovery from addiction and co-occurring illnesses. Aftercare services usually last for up to 12 months; the rehabs Addiction Helper work with mostly provide free aftercare on the completion the patient’s treatment programme. Aftercare is instrumental in keeping the patient focused and engaged in the recovery process.
Secondary care and Tertiary care – For an individual who is suffering from a dual diagnosis mental health illness, the longer they stay in the safety of the treatment environment, the better. Secondary and Tertiary care provide a bridge to community living, where they will be supported each and every step of the way by the rehab and also by their peers. Therapies will still be ongoing but the patient will slowly be allowed more freedom, so that they can integrate into society supported and at a pace they can adjust to.
Referrals to outside agencies: For an individual suffering from an ongoing severe mental health illness, we will ensure that they access the correct treatment and care by involving psychiatrists, specialists and the local mental health team. This will be put in place so that on leaving the treatment environment the help and support is already there for them. Where necessary, we can also bring outside services into the rehab to start the process of treatment. A seamless and continuous flow of treatment is vital to an individual suffering from a severe mental health illness. Failing to put these services in place can result in relapse of all conditions and the undoing of all the hard work the individual achieved whilst in rehab treatment.
Please do not hesitate to get in contact with us if you believe you or a loved one is suffering from a dual diagnosis condition. We can help you with any questions that you may have relating to this subject and find the right treatment package needed for a full recovery from all conditions presenting.