Individuals who struggle with substance abuse and chemical dependency often have other underlying psychological disorders that can go unidentified and, therefore, untreated: referred to as dual diagnosis. Quite often, substance abuse is a coping mechanism used by individuals to treat their undiagnosed underlying mental health disorders.
Primary diagnoses for individuals struggling with chemical dependency include:
For example, if an individual suffers from depression, and drinks alcohol in order to self-medicate, the alcohol addiction becomes more prevalent than the depression and is treated as the primary diagnosis, but when the drinking stops, the depression remains and often worsens to a debilitating level. This cycle makes it almost impossible to stop using because the substance abuse exacerbates mental health disorder.
Dual diagnosis cases are quite prominent, and individuals suffering from substance abuse and a co-occurring disorder have a significantly lower recovery prognosis. Nearly 9 million adults in the United States suffer from co-occurring disorders, and less than 8% of those receive treatment for both disorders. More than 50% of individuals suffering from co-occurring disorders receive absolutely no treatment whatsoever (SAMHSA, 2014).
Often known as concurring disorders, dual diagnosis is the condition of suffering from both a mental illness and substance addiction at the same time. It is common for people who have a mental illness to self-medicate using drugs leading to addiction. The opposite is also possible where substance abuse leads to mental health illness.
For the most part, it doesn’t matter which came first, what matters now is finding out treatment options and moving forward with them.
Often a cycle can develop rather quickly of using drugs to treat emotional/mental issues.
This is often the reason why many drug addicts who successfully go sober can relapse because they haven’t dealt with the underlying mental and psychological issues or vice versa.
Often times there is a genetic risk factor for both substance use and certain mental health disorders, but genes alone usually don’t explain all causes of co-occurring disorders. Other factors include family, environment, and life stress, including traumatic life events, poverty, and loss. Stressful experiences can also trigger genetic factors that contribute to co-occurring disorders. It is possible that people with mental health disorders may be more biologically sensitive to the effects of mood-altering substances.
They may use alcohol or other drugs to cope with mental health symptoms or to counter social anxiety. People who have a mental health disorder are at much higher risk of also having a substance use disorder and, conversely, people who have a substance use disorder are at much greater risk of developing a mental health disorder.
It is important to recognize that both the addiction and the mental health disorder need to be treated. Treating only one of the disorders will result in inadequate treatment and a potential worsening of the other condition.
To accurately diagnose and help a dual diagnosis patient, substance abuse must be eliminated for a period of time. This allows true psychological symptoms to surface without being tainted by drugs and alcohol. Detoxification in such situations should be monitored and take place within a licensed dual diagnosis facility, enabling doctors, nurses and therapists carefully to monitor and assist with physical withdrawal and psychiatric symptoms. Continuing with residential treatment after inpatient detox gives the patient time to stabilize mood and learn how to manage symptoms produced by the mental health disorder without using drugs or alcohol.
An integrated treatment approach is key, with a focus on stabilizing symptoms of the co-occurring mental health disorder while providing the patient with a foundation for recovery from addiction.
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