Dual Diagnosis

A dual diagnosis is when someone has both an addiction and a mental health condition. It can be complicated, that’s why we’re here to help.

Substance abuse and alcohol abuse disorders are incredibly powerful and dangerous. Unfortunately, many people don't realize that before someone becomes addicted to substances such as drugs and alcohol, there is often times an underlying catalyst for their addiction. This can be previous trauma, childhood abuse, ongoing abuse, or an underlying mental health issue.

For people with an underlying mental health condition, such as a mental illness or PTSD, who also have substance abuse or alcohol-use disorder, they fall under the category of dual-diagnosis patients. People with a dual-diagnosis are at a greater risk of not seeking treatment or getting the help they deserve. It's important to find treatment centers for dual-diagnosis patients so they can recover and improve their chances of obtaining a sober life.

What is Dual Diagnosis?

Dual diagnosis literally means having two diagnoses - alcohol or substance use disorder, and a mental health illness. Dual diagnosis is also known as comorbidity, with "co" meaning occurring with each other.

This is not a concept that is strictly reserved for the mental health or substance abuse field. For instance, in traditional medicine, people with diabetes often have other comorbidities, such as obesity, high blood pressure, or glaucoma. Having a comorbid mental health condition along with a substance use disorder is equally as dangerous for someone with a dual diagnosis.

If someone is considered to have a dual diagnosis, they will need treatment for their substance use issues as well as other mental health treatment including:

  • Depression
  • Anxiety
  • Post-traumatic stress disorder (PTSD)
  • Bipolar Disorder (all different types)
  • Schizophrenia
  • Borderline Personality Disorder
  • Obsessive Compulsive Disorder
  • Attention-deficit Hyperactivity Disorder (ADHD)

History of Dual Diagnosis

As mentioned before, dual diagnosis and co-occuring disorders aren't a brand new way of thinking. In fact, during the 1980s many psychiatrists and those treating people coming out of incarceration referred to people with dual diagnosis disorders as the "Young adult chronic patient."

It wasn't until 1989 in an issue of Hospital and Community Psychiatry that the term "dual diagnosis" was finally used. This was a turning point in the world of substance abuse and alcohol abuse treatment. Though treatment centers for dual diagnosis are now readily available and are the standard in providing treatment for both a person's substance use disorder and mental illness, this was not always the case.

Many psychiatrists believed that the two should work separately, i.e., I need to treat the trauma first before treating the substance abuse, or you are not getting better from PTSD because you need to treat the substance abuse first. Fortunately, these treatment models are now archaic ways of thinking, as more and more evidence shows that integrating care for mental health illnesses and substance abuse disorder can lead to:

  • Better treatment outcomes
  • Reduced substance abuse
  • Complete abstinence from substance abuse
  • Improved quality of life
  • Decreased arrests
  • Increased housing stability

Signs and Symptoms for Dual Diagnosis

Not everyone will need to undertake a dual diagnosis treatment program. There are certain signs and symptoms that will alert a person to whether or not they have a co-occuring mental illness along with substance use disorder. However, it can be fairly complicated and difficult to diagnose without the help of a professional.

Induced psychosis from substances, for instance, can easily mimic the signs and symptoms of a legitimate mental illness such as schizophrenia and bipolar disorder. Similarly, withdrawal symptoms can lead to anxiety and depression, such as during alcohol withdrawal.

Nevertheless, it's important to seek help from dual diagnosis rehabs for the following:

  • Dependence on substances, meaning you cannot function in your daily life without alcohol or drugs
  • Using substances as a coping mechanism for stress, bad news, or to get through the tough parts of your day
  • Self-medicating with substances to ease your depression or anxiety
  • Needing a substance to sleep, visit friends and family, or other seemingly simple tasks
  • Continued mental health issues when sober, such as depression, feeling anxious or panicky, insomnia, intrusive thoughts, or other distressing symptoms
  • Hallucinations even without psychoactive substances, such as paranoid thoughts, hearing or seeing things that are not there, or feeling as if you are being spoken to from the radio or television
  • Delusions of grandeur
  • Going days without sleep or the need for sleep, and then experiencing lows during periods of sobriety
  • Thoughts of hurting yourself or hurting others

All of these symptoms can indicate the need to attend a dual diagnosis treatment program. These symptoms are incredibly varied and can signal a potential underlying mental illness such as schizophrenia, bipolar disorder, depression and anxiety, or a combination of these disorders.

Just like mental health disorders are complex and need treatment that is tailored to a person, so too does a substance or alcohol rehab dual diagnosis treatment center need to have tailored programs.

Dual Diagnosis Statistics

It can be easy to dismiss dual diagnosis as a one-off occurrence. However, the statistics are staggering, indicating that this is a problem far more serious, and more prevalent, than previously imagined. According to the National Institute on Drug Abuse,

  • An estimated 7.7 million people in the United States alone are diagnosed with both substance use disorder and a co-occurring mental illness
  • From almost 20 million adults that have substance use disorder, 37.9% of them have a mental illness
  • From almost 42 million adults with a mental illness, 18.2% of them have a substance use disorder also
  • Only 9.1% of people with a dual-diagnosis received treatment for both their substance abuse and mental health disorder
  • The biggest barrier for people with a substance use disorder not receiving mental health treatment was the cost of dual diagnosis therapy
  • Among people with a mental health disorder who did not receive help for substance abuse, their biggest drawback was not being able to quit using

These statistics are quite alarming, considering that it is essential to combine both mental health treatment and substance abuse treatment for better outcomes of sobriety. In addition, statistics also showed that many people did not know where to go to receive the help they needed. Many of them also still had stigmas against mental health treatment, not wanting to upset their families or neighbors.

These are barriers that might be easily overcome with the addition of a supportive unit, continuing education, and outreach efforts.

How Dual Diagnosis Is Different in Men vs. Women

Dual diagnosis can occur in both men and women. However, statistics suggest that men are more susceptible than women at being diagnosed with a co-occuring disorder along with substance use disorder. This is because statistics show that the average dual diagnosis patient is usually male, between the ages of 25 to 50.

In addition, males seem to have more severe symptoms of psychosis associated with their dual diagnosis. Men are more likely to present with a dual diagnosis disorder of schizophrenia and substance use disorder. They are also more likely to use other substances besides alcohol, such as stimulants, hallucinogenics, sedatives, opioid, and other substances.

This isn't exactly shocking, considering that schizophrenia does tend to appear more in men than in women. This is a serious mental health condition that can make it incredibly distressing for both men and women to cope, and includes symptoms such as:

  • Auditory hallucinations, meaning hearing things that are not there
  • Visual hallucinations, or seeing things that are not there
  • Believing there are messages being sent to you from the radio, television, or another outside force
  • Illusions of grandeur and thinking you are more important than you really are (you're the president, a king, etc.)
  • Low level symptoms of schizophrenia, including a flat affect, or not reacting to stimuli
  • Inability to feel or speak in a voice other than monotone
  • Catatonia, or being in the same position for hours
  • Voices in your head that command you to do things or tell you lies, almost like intrusive thoughts

Schizophrenia is difficult to treat, but not impossible. There are medications, therapy, and other interventions by a psychiatrist that can help men and women learn to live with the symptoms of schizophrenia, minimize paranoid thinking patterns, and stop their hallucinations as well.

Getting Help From A Dual Diagnosis Treatment Program For Men

For men looking for treatment, it's important to seek help sooner rather than later. Evidence does also show that men are less likely to seek mental health treatment, also due to stigmas and gender stereotypes. For men that are looking to enroll in dual diagnosis rehabs, there are male-only treatment centers available, as well as treatment centers for male-dominated fields such as first-responders and military veterans.

These programs are also available for women with dual diagnosis disorders.

How Dual Diagnosis Is Different in Women vs. Men

Women are also susceptible to substance use and other mental health disorders. Unfortunately, many of the studies conducted on dual diagnosis patients have been done on men, with little of them focusing on the needs of women. However, new studies and surveys are emerging that can help us better understand the differences between women and men with dual diagnosis disorders.

Evidence does show that women are more likely to have been victims of crimes, such as domestic violence, sexual assault, childhood trauma, and childhood sexual abuse as well. This trauma can create a cycle of victimization, leading to substance and alcohol abuse later on in life.

For women seeking treatment, there are also dual diagnosis treatment programs available that can help women treat their underlying trauma, find help to escape domestic violence, and provide resources for single mothers that need to enroll in treatment but have children at home.

Many of these treatment programs can help women get the help they need to achieve sobriety, as well as treat the underlying mental health disorder or trauma that could be contributing to their substance use or alcohol use disorder.

What to Look for in Addiction Treatment Dual Diagnosis Support Groups

Whether you want to attend an inpatient treatment center, outpatient treatment center, or outside support groups for dual diagnosis treatment, all of these should have certain characteristics that will make it easier for you to complete treatment and enjoy better outcomes. Below are some of the things you should look for in dual diagnosis treatment and support groups.

  1. Available gender-based treatment: As mentioned above, there are several differences between men and women when it comes to the treatment of dual diagnosis disorders. If you feel more comfortable engaging in treatment with an all male, female, queer, or trans community, look for a substance or alcohol rehab dual diagnosis program that offers gender-based treatment programs.
  2. Emphasis on both mental health treatment and substance abuse treatment: A successful dual diagnosis treatment program will incorporate both mental health treatment and substance abuse treatment. This can include one on one therapy or group therapy. Whichever therapy is included in your treatment program, it's important to choose a rehab facility that emphasizes both mental health and substance abuse treatment together.
  3. Medical professionals to reduce drug interactions: Certain mental health conditions, such as schizophrenia or anxiety, will need to be treated using medications that could, possibly, interfere with medications used during substance abuse treatment. These include medications such as methadone, naltrexone, and buprenorphine to name a few. A good dual diagnosis support group should offer medical care so you can continue to take medications for your existing mental health condition as well as medications for addiction treatment.

Dual Diagnosis Resources

There is help available to treat your dual diagnosis disorder. You can reach out today to Chapman Behavioral Health, or look below for some helpful resources on dual diagnosis treatment.