Dual Diagnosis: Addiction and Mental Illness


Did you know that dual diagnosis – the co-occurrence of a Substance Use Disorder with a mental condition – complicates successful recovery?

When most people think of recovery from addiction, they focus on the abuse of the offending substance – alcohol, illicit drugs, or prescription medications. They think that if the person can just stop drinking and using, everything will be okay.

A Dual Diagnosis Happens More Than You Think

But believe it or not, problematic substance use is usually only one aspect of the person’s mental health struggles. Very often, the addict or alcoholic also struggles with another simultaneously-occurring disorder. Look at these comorbidity rates

  • Attention Deficit Hyperactivity Disorder (ADHD)—25%
  • Anxiety—45%
  • Bipolar Disorder—56%
  • Depression—67%
  • Disordered Eating—50%
  • Narcissistic Personality Disorder—64%
  • Obsessive-Compulsive Disorder—25%
  • Post-Traumatic Stress Disorder (PTSD)—66%
  • Schizophrenia65%

Dual Diagnosis—Intertwined Illnesses

The relationship between substance abuse and mental disorders is symbiotic, because each can cause—and be caused by—the other. In other words, they feed each other. And it often doesn’t matter which came first.

For example, a person who has experienced severe unresolved trauma as a child (abuse, neglect, etc.) may turn to alcohol as a teenager or adult as a coping mechanism to ease painful emotions or memories. But excessive drinking can result in NEW trauma (violence, accidents, etc.) that only creates additional pain. Which, invariably, leads to even more drinking.

Thus, the cycle continues.

Treatment for a Dual Diagnosis

When struggling with both mental illness and SUD, not just any treatment program will suffice. Most family counselors lack the expertise and resources to effectively deal with alcohol and drug issues, and many rehab programs provide little to no treatment for emotional or behavioral conditions.

In fact, only about 5% of people with co-occurring illnesses receive treatment for BOTH disorders.

This is why it is important to look for the right program—one that offers specialized care that addresses each disorder, both on their own and in relation to how they co-manifest.

There are a few important considerations:

  • Dual diagnosis care must be comprehensive and integrated. This means that the program should offer all of the services you need, and all of the providers should work together as a cooperative team with a shared treatment philosophy.

Integrated treatment requires communication and cooperation between everyone involved – the patient, providers, legal entities, and even friends and family members. The entire treatment team might include:

  • Psychologist/Psychiatrist/Therapist
  • Substance Abuse Specialist
  • Physician/Physician’s Assistant/Nurse Practitioner
  • Couples/Family Counselor
  • Nutritionist
  • Vocational/Educational Advisor
  • Spouse/Partner/Family Members
  • Close Friends
  • dual diagnoSocial Services/Welfare Caseworker
  • Judge
  • Drug Court or Probation Officer
  • Sponsor from Alcoholics Anonymous or Narcotics Anonymous
  • Dual diagnosis care must be medically-supervised. The use of FDA-approved medications is part of the “gold standard” approach to addiction treatment, and it is also often the ONLY way to treat certain mental conditions. Because of the need for individualized prescribing and follow-up, a medical doctor should be part of the treatment team.
  • Dual diagnosis care must be concurrent. Treating both disorders at the same time is critical for successful recovery from either. Addressing one condition without the other only delays progress and increases the risk of relapse.

The Bottom Line about a Dual Diagnosis

Living with co-occurring addiction and mental illness can disrupt normal everyday functioning. But hope and health can be restored with timely intervention and effective, evidenced-based treatment.

Since 1978, Chapman House has provided premier treatment services for individuals and families struggling with addictive or behavioral disorders. As one of the most-trusted alcohol and drug rehab programs in Southern California, Chapman House can help restore sobriety, stability, and sanity to your life.

If you or someone you care about needs help, contact Chapman House TODAY.

by Albert Fontenot


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