With our complex minds and rich tapestry of emotions, our behaviours can rarely be traced back to a single cause. A feeling of stress or anxiety, for example, may make a glass of whisky seem that much more attractive – but that anxiety has its own set of causes, as does the urge to seek relief through chemicals. When a patient is suffering from more than one issue requiring professional attention, such as the combination of addiction and mental issues, dual diagnosis rehab becomes essential.
Given the right conditions, any one of us can become vulnerable to chemical or behavioural addiction. Once started, the cycle of addiction can be difficult to break without a commitment to rehabilitation. Likewise, mental health issues can create a range of persistent symptoms requiring a careful programme of treatment and support.
When these two problems coexist, they reinforce each other and make the patient’s struggle even more difficult. For such patients, dual diagnosis rehab is the most promising avenue of recovery available.
What is dual diagnosis?
Dual diagnosis, also known as co-occurring disorders, refers to a situation where a patient simultaneously suffers from both an addiction and a mental illness. Each issue can dramatically increase the likelihood (and severity) of the other. Even when a patient is the victim of only one of these two underlying issues, the longer that condition goes untreated, the more likely it will be that the patient begins to suffer from the other one as well.
The Journal of the American Medical Association has reported that:
- Among people with mental disorders, 29% abuse either alcohol or drugs,
- Among people with severe mental disorders, about 50% abuse either alcohol or drugs, and
- 37% of alcohol abusers and 53% of drug abusers also suffer from at least one serious mental illness.
In 2014, there were an estimated 7.9 million people in the United States alone who suffered from co-occurring disorders. This number has almost certainly risen between then and now, indicating a significant public health issue that affects many more millions worldwide.
Moreover, the National Bureau of Economic Research (NBER) stresses the existence of a “definite connection between mental illness and the use of addictive substances,” adding that mental health disorder patients are responsible for a large proportion of total drug and alcohol consumption in the United States.
Their calculations suggest that 38% of alcohol, 44% of cocaine, and 40% of cigarettes are consumed by people with mental illnesses. Furthermore, 69% of alcohol, 84% of cocaine, and 68% of cigarettes are consumed by people who have had a mental health disorder at some point in their lives.
These numbers show a clear link between mental illness and substance use, which is consistent with decades of observation among doctors and therapists. The chances of a complete dual diagnosis recovery are radically improved by high quality comprehensive treatment.
Symptoms of a dual diagnosis
Depression, anxiety disorders, and bipolar disorder are the most common mental health problems that co-occur with substance abuse. Each of these brings its own distinct set of symptoms, often to be found in combination with the traditional signs of addiction.
The range of possible dual diagnosis symptoms is therefore wide, and each patient must be evaluated individually by a specialist to determine whether a dual diagnosis programme for treatment is warranted.
With this understanding in mind, it is worth highlighting the fact that patterns do exist, and behavioural features in both section 1 and section 2 below could signify a person in need of dual diagnosis rehab. Section 1 features common symptoms of substance abuse, while section 2 lists common symptoms of depression, anxiety disorders, and bipolar disorder, respectively.
- Withdrawal from friends and family
- The sense that you need a drug or alcohol to be able to function
- Sudden changes in behaviour
- Loss of control over substance use
- Developing high tolerances and withdrawal symptoms
- Engaging in risky behaviours
- Loss of interest in daily activities
- Inability to experience pleasure
- Significant changes in appetite or weight
- Sleep changes
- Anger, physical pain and reckless behaviour (especially in men)
- Feelings of helplessness and hopelessness
- Lack of energy
- Strong feelings of worthlessness or guilt
- Difficulty concentrating
- High levels of tension and worry
- Racing heart or shortness of breath
- Nausea, trembling or dizziness
- Feeling irritable or on edge
- Muscle tension or headaches
- Difficulty concentrating
- Feelings of euphoria or extreme irritability
- Unrealistic, grandiose beliefs
- Anger or rage
- Decreased need for sleep
- Increased energy
- Rapid speech and racing thoughts
- Impaired judgment and impulsive behaviour
Note that the above symptom lists are incomplete and that mental illness in particular can take many possible forms that are not detailed here. Schizophrenia, borderline personality disorder and post-traumatic stress disorder are among the other mental illnesses often associated with substance abuse. Each comes with its own specific group of symptoms.
Nevertheless, if any set of conditions above seems to accurately describe changes that you or someone you know is experiencing, it is important to consult a specialist for evaluation and possible treatment.
What comes first: substance abuse or a mental health disorder?
There is a strong correlation between substance abuse and mental illness among patients. Studies have shown that people with mental health problems may be tempted to use alcohol and/or drugs in order to treat, relieve, or live with their existing symptoms. This attempt at self-medication, however, can worsen the symptoms of the very mental health problems they were originally meant to address – and possibly open the door to new types of mental illnesses.
As for people with no current mental health issues, they are still susceptible to addiction. The chemicals they abuse can then alter the structure of their brain cells, weakening their resistance to certain forms of mental illness.
Certain drugs are linked to particular mental illnesses. People who take large amounts of stimulants, for example, sometimes experience long-term depression as a result of the changes in their brain chemistry caused by the drugs. This imbalance has been known to persist for months or even years after they stop taking the drugs. To take another example, marijuana has been known to trigger the onset of schizophrenia or increase its severity for patients who already suffer from the disorder.
In these ways, substance abuse and mental health disorders constitute a circular phenomenon in which one element makes the other more likely to occur – which in turn increases the severity of the first.
For people at risk of finding themselves caught in such a dangerous loop, it is important to pay attention to key behavioural traits which can shed light on the current situation. Relying on drugs or alcohol to cope with anxiety, depression or other intense moods can in some cases be a red flag that signifies the need for dual diagnosis rehab.
Another possible sign of these co-occurring disorders can be a strong overlap between the use of drugs or alcohol and the state of your mental health. Additional indicators include unresolved trauma in your life or a lack of personal fulfilment when sober. A family history of similar struggles can also point to a possible dual diagnosis when other factors are taken into account.
Effective dual diagnosis treatment
For patients in a dual diagnosis recovery programme, it is essential to receive treatment for both the addiction and the mental health issue at the same time, by the same team of therapists and experts.
Addiction often requires several different approaches including behavioural therapy, detoxification, management of withdrawal symptoms and participation in support groups to help maintain sobriety.
Mental health treatment typically involves medication, counselling (individually or in groups), changes in lifestyle, and support from peers and loved ones.
Treatment of each type of disorder has two additional requirements as well: time and commitment. Rebuilding a clean, healthy mode of thinking is no small task; and it is also a challenge to detach from behaviours learned through repetition.
The effort begins by learning to manage stress and uncomfortable emotions, as well as preparing a strategy for action to get through difficult or trying moments. Maintaining connections to others, such as doctors, therapists and loved ones, is also essential in providing a positive support network to lean on. Healthier habits in terms of diet, sleep, exercise and daily routines can also make a big difference in training your body to function in a healthier way.
Dual diagnosis treatment at The Dawn
The Dawn provides all of the above treatment methods (where appropriate), along with personalised care from our experienced team, as well as consistent, round-the-clock support. We also provide the following, to facilitate clean, healthy living both mentally and physically:
Comfortable inpatient rehabilitation for focussed and distraction-free dual diagnosis recovery, putting you in a relaxed setting that is conducive to health and healing.
Effective detoxification methods to treat issues related to substance abuse, helping to gently cleanse the body of harmful chemicals while promoting a safer and more sustainable balance.
Appropriate medication to make the process go smoothly and promote dual diagnosis recovery.
Careful application and monitoring of the detoxification process, to keep withdrawal symptoms to a minimum.
Psychotherapy , including cognitive behavioural therapy (CBT), to improve your thought patterns, helping you cope with stresses and urges as they come.
Support groups and individual counselling to reinforce positive behaviour while addressing both addiction and mental health issues as they occur.
The final item on the above list is particularly important to maintain progress through long-term care. Those suffering from co-occurring disorders have the tendency to feel alone in their struggle, which is why we encourage membership in support groups to share feelings, celebrate small victories, and exchange tips and ideas for making the recovery process smoother and more successful.
In the process, patients often make deep friendships that can make recovery more satisfying and enjoyable, while also producing useful advice and moral support throughout the dual diagnosis programme.
Through it all, our individual counselling sessions – available online through our aftercare programme – can help guide you down the road to recovery. We also encourage families and loved ones to help participate in the effort, as support from all sides is essential. To find out more about how we can help you or a loved one through the dual diagnosis recovery process, contact The Dawn today or call +66 63 048 4877 for immediate assistance.