Dual diagnoses, also known as co-occurring disorders, refers to the presence of 2 or more mental health disorders or substance use disorders. These disorders often intersect and influence each other’s symptoms.
Dual diagnoses can be complex. A person with alcohol addiction may develop depression as the substance affects their brain, while someone with anxiety disorder may use drugs to cope with discomfort.
In order to heal, all disorders should be addressed and treated together. You may risk an ineffective outcome or potential relapse if they are not treated together.
What are the most common dual diagnoses?
- Anxiety Disorders and Substance Use Disorder
- Post-Traumatic Stress Disorder (PTSD) and Substance Use Disorder
- Attention-Deficit/Hyperactivity Disorder (ADHD) and Substance Use Disorder
- Borderline Personality Disorder (BPD) and Substance Use Disorder
- Eating Disorders and Substance Use Disorder
Many mental health conditions can drive a person to self-medicate with a substance. And many substance use disorders can play a part in developing a mental health condition.
Self-medicating with a substance is common, but risky. Self-medicating can temporarily numb emotional pain and even mask your mental health symptoms, delaying your pursuit of treatment. If you are self-medicating while dealing with a co-occurring disorder, it is important to seek professional help.
Causes of Dual Diagnoses
While many things factor into the development of co-occurring disorders, they are thought to have common risk factors like stress and trauma. Mental health conditions and addiction can also be passed down genetically in families.
If you have a mental health disorder like anxiety, depression, or post-traumatic stress disorder (PTSD), addiction can develop from using substances to cope with uncomfortable feelings.
On the other hand, substance use changes the brain, making it more vulnerable to develop mental health disorders. And the longer the substance is being used, the greater the risk of developing a mental health disorder. Fortunately, many rehabs offer specialized dual diagnosis treatment.
How Are Co-occurring Disorders Diagnosed?
Recently, it has become standard practice to screen for dual diagnoses upon entering treatment. The evaluation usually involves a series of questions and standardized assessments.
The Diagnostic and Statistical Manual of Mental Disorders (DSM) diagnoses mental health and substance use disorders. This manual acts as a guide for trained clinicians to diagnose based on symptoms that occur. Throughout your evaluation, the clinician will likely try to piece apart whether or not one disorder is the result of the other.
It’s vital to seek professional help if you feel you may be struggling with more than one diagnosis. A consultation with a mental health professional can provide you with appropriate treatment plans, diagnoses and support. Some questions you can ask your provider include:
- How do you treat dual diagnosis?
- What does the treatment plan look like?
- Are there any medications that can help?
- Are there any lifestyle changes I can make to help manage my symptoms?
How to Navigate Dual Diagnosis
As you go through treatment, you can build a support network. Connecting with friends, family, and support groups can provide understanding and encouragement as you seek help. Many therapists and treatment centres will be able to help you find support groups that are specifically tailored to what you need.
Learning to manage your stress and take care of yourself is an essential part of recovery. Finding healthy coping mechanisms like exercise, meditation, journaling, and fun hobbies, can help you find joy in healing. As you navigate treatment, it’s important to celebrate small victories. When you take the time to acknowledge your progress, it helps to reinforce positive behaviors.
Dual Diagnosis Treatment
Dual diagnosis can be treated in several different settings. Despite the level of care you need, it is important to find integrated treatment, where both conditions are treated simultaneously.
Given the complexity of multiple diagnoses, you will want to find a treatment centre with a multi-disciplinary team of professionals equipped to handle co-occurring disorders. Medication, individual and group therapy, medication-assisted treatment (MAT) and detox may be required to recover, so you may want to find a comprehensive treatment centre.
Treatment for dual diagnosis can be applied in numerous settings:
- Outpatient programs - You meet once or twice a week with others in treatment and your care provider.
- Intensive outpatient programs - You meet 3-5 times a week for several hours for more intensive care.
- Partial hospitalization programs - You meet 5-7 times weekly for a full day, or most of one.
- Residential treatment - You live in a rehab centre for 28+ days and engage in treatment with a community of peers and treatment providers.
- Inpatient Treatment - You live in a treatment centre or hospital and receive 24/7 monitoring.
Evidence based therapies like cognitive behavioral therapy (CBT), dialectical behavioral therapy (DBT), motivational interviewing and contingency management are proven to be effective when treating both substance use and mental health disorders.
CBT helps individuals identify and challenge negative thought patterns that are associated with both disorders. This form of therapy can be tailored to address the specific interactions between substance use and mental health symptoms.
Motivational interviewing helps individuals explore their feelings about changing their behavior. This therapy encourages self-efficacy and can be used with both types of disorders.
Co-occurring disorder programs often have psychoeducational classes that can educate you on the symptoms and relationship between mental health and substance use. Relapse prevention counseling is often helpful as well to help you become aware of cues that precede relapse and to teach you new coping strategies.
With the right personalized treatment, you can develop coping skills to help you manage your conditions. It’s important to be patient with yourself, communicate openly with your providers and lean on trusted loved ones for support along the way.