‘Dual diagnosis’ is a term the addiction recovery community uses to describe what the medical field knows as co-occurring conditions. We have put together this guide to help you understand dual diagnosis in case you are concerned that you or a loved one might be suffering from it. If you have any questions after reading this guide, do not hesitate to contact us for additional help and advice.
Definition of Dual Diagnosis
Dual diagnosis is a condition in which a person is suffering from both addiction and mental illness simultaneously. One of the most common examples involves the co-occurring conditions of alcoholism and depression. Because both problems exist at the same time, treatment providers must accurately identify any possible causation. Treatment must be highly targeted in order to be effective for both conditions.
Some dual diagnosis situations are more serious than others, which is why expert treatment is necessary. For example, schizophrenia and amphetamine addiction is a far more challenging dual diagnosis than alcoholism and depression.
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. The previous example of amphetamine use and schizophrenia offers a glimpse into how challenging dual diagnosis really is.
Even short-term amphetamine use can induce schizophrenic behaviour that lasts as long as a person remains under the influence of the drug. Schizophrenic behaviour that is the result of mental illness will be ongoing, even when the subject is not under the influence. Doctors need to be able to interact with patients who are sober in order to determine if the cause of the psychosis is mental illness or drugs.
Although the symptoms of dual diagnosis vary from one condition to the next, some symptoms are common in many dual diagnosis situations. These are:
- ongoing depression or anxiety
- persistent confusion
- hallucinations and delusions
- persistent fear 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. For example, alcoholics frequently suffer from depression that is induced and exacerbated through alcohol consumption. Even after completing treatment and regaining their sobriety, some former alcoholics continue to battle depression on an ongoing basis.
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 situation. 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 long-term amphetamine or cocaine abuse might also be dealing with severe depression. We would expect feelings of depression to be more severe during the withdrawal process 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 dealing with co-occurring conditions.
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 either one worse. For this reason, not every rehab clinic in the UK is capable of taking dual diagnosis cases. Addiction Helper has access to private clinics offering this highly specialised treatment.
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 the 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 for each patient.
Treatment plans frequently include:
Detox – Although detox is important in almost every case of addiction, 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 need to observe 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 the mental illness. Subsequent medications used to treat mental illness after detox must do so without providing a mechanism for addiction relapse.
Psychotherapeutic Treatments – Treating dual diagnosis patients after detox involves a course of psychotherapeutic treatments that address co-occurring conditions either separately or together. Cognitive behavioural therapy and dialectic behavioural therapy are two examples of commonly used psychotherapeutic treatments.
- Group Support – Participation in a group support setting is critical to dual diagnosis patients. Support groups provide a safe and supportive atmosphere whereby patients can learn to overcome addiction and more effectively deal with mental illness.
Aftercare treatments is another important part of recovering from co-occurring conditions. Where the drug addiction portion is concerned, aftercare services may last up to 12 months and include 12-step work, ongoing counselling, and targeted activities that provide patients with an outlet. Where the mental illness portion is concerned, some patients may have to continue receiving psychiatric care for the foreseeable future.
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 find the treatment you need to overcome the co-occurring conditions that are currently controlling your life.