Norman (name changed) is a 35-year-old widowed man. He works as a business manager in a top financial services firm in the United States. Two years ago, Norman lost his wife and four-year-old child in a car crash. The incident shattered him, leaving him helpless and severely depressed. He took to drinking to find succor from his depression and memories of the horrific day. Once a fun-loving man, Norman had now turned into a severe alcoholic.
Some people can suffer from post-traumatic stress disorder (PTSD), coupled with alcohol addiction; some can be severely depressed and also indulge in drug abuse; while some can be addicted to opioids and suffer from anxiety at the same time. Two co-existing disorders often worsen the condition of the person. Such a condition is known as dual diagnosis or co-occurring disorders. It presents a big challenge to the practitioners as it is difficult to determine what caused what.
The prime determinant of co-occurring disorders is always baffling. Some studies state that certain drugs can cause mental illness in a person with a vulnerable genetic profile. Others say that drugs don’t necessarily cause mental illness, but can worsen the symptoms. In fact, there are some people who started using drugs as a form of self-medication but gradually became addicted to it.
Recognized subgroups of patients with dual diagnosis are defined by certain mechanisms:
- Primary psychiatric disorder with secondary substance misuse,
- Substance misuse with secondary psychiatric disorder,
- Psychiatric symptoms related to substance intoxication or withdrawal.
These categories are consistent with the operationally defined corresponding categories in DSM–IV (American Psychiatric Association, 1994), in which a distinction is made between independent (primary psychiatric comorbidity) and substance-induced (organic) psychiatric comorbidity and the category of expected symptoms of substance use or withdrawal.
The examples cited below can throw more light on the situations a person with co-occurring disorders may face:
- People with depression may turn to substance abuse in search of a calmer self.
- Studies say that 70 percent of schizophrenics smoke because it gives them a sense of well-being and help them in diminishing the uncomfortable side effects of medications.
- A teen who has a family history of mental illness has more chances of being mentally unsound himself. If he uses drugs, symptoms of mental illness surfaces sooner than they would have, and worsen dramatically with prolonged drug use.
- Cocaine can cause anxiety, panic attacks, mania, and sleep disorders.
According to the National Institute of Mental Health (NAMI), about a third of all people experiencing mental illnesses and about half of the people living with severe mental illnesses also experience substance abuse. Moreover, about a third of all alcohol abusers and more than half of all drug abusers report experiencing a mental illness.
Treatments for dual diagnosis
The most common method of treatment for dual diagnosis is an integrated intervention to treat both the disorders simultaneously. Some of the treatment procedures are:
Detoxification: The first major hurdle that people with co-occurring disorders need to go through is detoxification. The medical staff administer the tapering amounts of the consumed substance or its medical alternative to lessen the effects of withdrawal. Inpatient detoxification is much more effective because the treatment monitors a person 24/7 and provides a consistent environment free from addiction exposure.
Psychotherapy: An effective dual diagnosis treatment is psychotherapy because it showcases a patient the real facet of his situation, educates him of the influence of his behaviors and beliefs on his psychological thoughts etc. Such discussions and therapies have improved the symptoms of both mental illness and substance abuse.
Cognitive behavioral therapy (CBT) in particular is effective in helping people with dual diagnosis learn how to cope and to change ineffective patterns of thinking. Holistic therapies, for example, can help individuals manage their stress and cope with the emotional triggers that lead to substance abuse. These alternative modalities include hypnotherapy, biofeedback, massage, yoga, guided meditation, exercise therapy and more.
Medications: Depending on the nature of the co-occurring disorders, medications can play a vital role in treating mental disorders and substance abuse. Coupled with psychotherapies, some medications can help in a patient’s recovery process. In fact, during the detoxification process, medication can help ease withdrawal.
Inpatient rehabilitation: A person suffering from a severe mental disorder coupled with substance abuse can find help in inpatient rehabilitation centers where they are monitored 24/7 by medical experts. The patient can receive holistic treatment like therapies, support, medication and health services with the goal of treating her addiction and its underlying causes.
Living with a dual diagnosis condition makes the person’s life a hell. It needs proper treatment for both the problems simultaneously. If you or your loved one is battling with such a situation, please seek medical help immediately. The California Dual Diagnosis Helpline can help you find a treatment program that specializes in treating patients with dual diagnosis. Chat online or call anytime at 855-980-1736.