what is a dual diagnosis

What Is a Dual Diagnosis?

If you find yourself struggling with a mental health disorder, such as depression or anxiety, and turn to substances as a means of numbing uncomfortable feelings, you may have a co-occurring disorder.

This is often considered a dual diagnosis by professionals and requires special treatment.

In this article, we’re taking a look at one of the most common questions we hear – what is a dual diagnosis?

What Is a Dual Diagnosis?

People who are being treated for substance addictions often find that they’re also diagnosed with and treated for a mental health condition. When both of these conditions exist at the same time, it’s called a dual diagnosis. Common dual diagnoses include addiction that is present with anxiety disorders, depression, obsessive-compulsive disorder, or ADHD. While the most outward sign might be the substance use or abuse, it is important to treat the mental health condition as well.

So, what is a dual diagnosis and how is it treated?

Why Are Dual Diagnoses So Common?

Why is it that people who have an addiction often have a co-occurring disorder? There are various reasons.

First, many people who are struggling with mental illness use substances as a way to self-medicate. If someone is feeling depressed, for example, they might find that taking a stimulant (such as cocaine or even legal stimulants like medications used for ADHD) makes them feel happier and more energetic. This can quickly turn into an addiction.

Similarly, people with anxiety might be taking opioids (illegal ones or prescription medication) in order to calm their stress levels. Taken regularly, these can turn into substance abuse and addiction. The same thing applies to people with ADHD who are prescribed stimulants; they can become addictive if taken too often or in greater quantities than prescribed. Those with bipolar disorder are often prone to alcoholism because alcohol can help someone feel more in control of both depression and anxiety.

In other cases, substance use can actually cause or exacerbate the mental health issue. For example, people who smoke marijuana regularly might be more prone to schizophrenia. Any type of drug or alcohol use can increase the chances that someone might develop anxiety or depression, particularly if their substance use affects the person’s job, relationships, or other facets of their life.

Why Is It Important to Treat Mental Health Conditions?

When someone is struggling with an addiction, the first step in treatment is often detoxification, commonly called detox. Once that’s done, the rehabilitation process begins. If the addiction is treated without addressing the mental health conditions caused by or causing the addiction, then the chances of relapse are far greater than if the underlying condition is addressed.

For example, if a person has a generalized anxiety disorder and is self-medicating with alcohol, then detoxing from the alcohol and joining a 12-step program that addresses various facets of the disease is important. If the anxiety is not also treated, however, then the person is more likely to begin self-medicating again once the anxiety rears its head. Without knowing other methods to cope with what may be debilitating anxiety, it’s only natural that the individual will want to turn to what they know worked in the past.

Similarly, if someone has been prescribed stimulants for ADHD, coming off of the stimulants will help with the addiction; it won’t, however, solve the problems caused by the ADHD. In this case, the individual will need a different type of medication or to learn other coping mechanisms for handling the difficulties caused by their mental health condition. Otherwise, they may turn back to the same medications that were helping before (and that fueled the addiction).

What Makes Dual Diagnosis More Likely?

There are some factors that can make it more likely that a person with an addiction is also struggling with a mental health issue. 

One is personal medical history. If, for example, you have struggled with a mental health condition in the past, then it is likely that it is contributing to your current addiction. 

Another is family medical history. Anxiety disorders, depression, and other mental health conditions tend to run in families for various reasons. Some of it is genetic, and some of it is the exposure to the coping mechanisms used (or not used) by family members suffering from the same condition. Someone with a family history of mental illness might be dealing with that along with their addiction.

Those who do not have regular access to affordable healthcare might be more likely to develop co-occurring disorders. If they cannot get care for their mental health condition, then they might turn to self-medication to help with symptoms. Similarly, those who cannot get care for their addictions and who struggle with them over a long period of time might be more likely to have various parts of their lives affected, which can lead to depression, anxiety, and other situational mental health issues.

Diagnosing Co-Occurring Mental Health Issues

When someone presents to a rehabilitation program for addiction services, it can be a challenge to determine whether a dual diagnosis exists and, if it does, exactly what the underlying condition is. It can also be hard to determine whether the addiction or the mental illness came first. 

During a rehab program, people struggling with addiction are assigned therapy and counseling sessions. The mental healthcare professionals running these sessions are listening and watching to detect signs of various mental health issues. Once these are diagnosed, treatment can begin. In some cases, this will require medication. In others, cognitive behavioral therapy or other types of counseling will be prescribed in addition to the addiction counseling and family counseling that might already have been part of the treatment plan. 

Avoiding Relapse

A relapse is a common event in addiction recovery, and there is no surefire way to prevent it. However, keeping up with treatment for the co-occurring mental health condition can boost a person’s odds of avoiding relapse throughout recovery and for the rest of their lives. Learning healthy coping mechanisms and, if necessary, taking medications to control mental illness will go a long way toward helping the person avoid self-medication with the substances they are addicted to.

If you are struggling with an addiction, it is important to be evaluated for dual diagnosis. Talk to your addictions specialist about your concerns. You can also talk to a therapist about your addiction if you have not done so already; they will be able to help you find the services you need to get into recovery from your addiction as well as for your mental health condition.