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Understanding Addiction: Dual Diagnosis

June 4, 2021
All Points North Lodge

We've come a long way in understanding the causes and underlying factors that cause one to suffer from addiction. What was once verboten, is now accepted, not as an embarrassment, but as a genuine illness that can be managed. But we're still learning, and with new knowledge there is a better path forward for those suffering from this mental illness. 

The pain of dealing with substance abuse can render one to feel helpless. But what some addicts don't realize, is that feeling of helplessness may also be a symptom of the disease. A Dual Diagnosis was not on a physicians' radars until 40 years ago and without professional help, these dual diagnosis’ can often be difficult to detect. Once identified, individuals can now formulate a path forward and start their recovery process. 

What is a Dual Diagnosis?

Around the 1980’s, psychologists started to understand mental health disorders, in particular, how they relate to addiction. Often, these disorders are, in fact, the underlying cause of the addiction. According to American Addiction Centers, up to 60% of those with a substance abuse addiction, also suffer from another mental health or behavioral disorder1. This is known as a dual diagnosis or co-occurring disorder.

Certain disorders that are commonly linked to substance abuse include:

Attention-Deficit Hyperactive Disorder (ADHD)

People with ADHD are more likely to abuse substances to cope with their condition. Those living with ADHD are prescribed stimulants to treat symptoms, which can be habit-forming.

Bipolar Disorder

Roughly half of people with bipolar disorder are also battling substance abuse2. Alcohol and other drugs can temporarily relieve some of the emotional pain associated with this condition and help soothe manic episodes, which is why people will turn to substances to cope.

Borderline Personality Disorder (BPD)

People with BPD have symptoms of impulsivity and intense emotion. Roughly two-thirds of people diagnosed with BPD have turned to substance abuse at some point in their lives3.

Depression

One in 10 Americans suffer from depression4, and many with that diagnosis have said they've used drugs or alcohol to cope with their mental anguish. Self-medicating often worsens the problem, as the withdrawal from the substance only compounds their depression.

Generalized Anxiety Disorder (GAD)

GAD is the most common disorder in America, affecting around 18 percent of adults5. Symptoms can include insomnia, muscle pain, difficulty concentrating, and an overall sense of uneasiness. Physicians commonly treat this with benzodiazepines, which can be extremely habit-forming. People with GAD are also more likely to use other substances to cope with their symptoms.

Obsessive-Compulsive Disorder (OCD)

People suffering from OCD will have some unwanted obsessions and compulsions, that can often be debilitating. They may have an irrational fear of something like germs, and feel the need to clean frequently. There are many variations of the illness, where individuals will also experience depression or anxiety. Given the clear link to substance abuse and depression, OCD is not far removed.

Post-traumatic Stress Disorder (PTSD)

Those who suffer with PTSD, will produce fewer endorphins than a normal, healthy brain. This makes people with PTSD, more likely to turn to substances to feel happy. The U.S. Department of Veteran's Affairs said that nearly 75 percent6 of all soldiers who experienced traumatic violence during combat turned to substance abuse more than once.

Schizophrenia

Schizophrenia causes delusional thinking and sometimes visual and auditory hallucinations. It's difficult to diagnose substance abuse alongside schizophrenia, as both conditions can share the same effects.

The "Other" Dual Diagnosis 

Often, patients with underlying health problems and physical disabilities can become reliant on substances. Whether they're trying to ease physical pain or suffering from depression due to their limitations, it can easily trigger an addiction to painkillers, alcohol, or other substances.

Signs You May Have A Dual Diagnosis

A dual diagnosis is not always easy to pinpoint. Substance abuse and mental health disorders are often symbiotic; they feed off and complement one another. As a result, if not correctly diagnosed, someone under the assumption they only suffer from addiction could be setting themselves up for a relapse. 

There are a few telltale signs that may indicate a dual diagnosis, including:

  • You use drugs as an escape.
  • Trying to quit makes you violent, to yourself or others.
  • You feel more like yourself on drugs.
  • A history of mental illness is not something to ignore.

Treating a Dual Diagnosis

As a mental illness can give way to substance addiction, substance addiction can induce a mental illness. They're tragically symbiotic, to your detriment. As such, several factors overlap, both aggravating the conditions. Brain responses, genetics, triggers, and exposure at an early age are all things that will spur on an addiction.

Whichever came first, it can often be difficult to tell. But whatever the case, it's vital to find a treatment plan tailored to treat both conditions simultaneously. This can often mean the best form of treatment starts at an inpatient rehab center, where a safe, structured environment can be maintained. Part of the reason an inpatient environment is ideal, is the special attention afforded to each patient.

A treatment plan for a dual diagnosis should include, first and foremost, a clear identification of the problems at hand. From there, short and long-term goals should be outlined, then you must establish approaches to meet those goals. This is known as an integrated treatment plan, recognized by the Substance Abuse and Mental Health Service Administration as a best practice for treating co-occurring disorders.

Integrated treatment plans sometimes include additional support, including housing, employment, and socialization programs. Research has shown that people who have participated in integrated treatment programs are more likely to stay sober – which is the program's ultimate goal. An integrated treatment plan is not just one treatment approach, but integrates many, utilizing effective counseling, behavioral therapy, and medication when necessary.

Cognitive Behavioral Therapy is used to explore and challenge a person's thoughts and beliefs to change their behaviors. Dialectical Behavioral Therapy can be employed to treat BPD by reducing negative actions like self-harm, including substance abuse.

A patient may be introduced to contingency management, which provides small incentives (i.e., A trip to the movies, a candy, or even an A.A. chip) for those who succeed in remaining sober. Motivation enhancement may also be used to encourage sobriety. And mutual support groups for others with similar dual diagnoses can provide the emotional support a patient needs to recognize they're not alone.

After leaving the inpatient center, outpatient care should be provided with the opportunity for patients to receive similar services they did at inpatient care facility, emphasizing re-entering society safely without relapse. Gradually, these services will grow less intensive as the patient starts to carve a new path forward.

Get Help Today

There's much more to life, and we can help you discover it. When you’re ready, All Points North Lodge is here with the programs and expertise you need to face your dual diagnosis with confidence. Our team of expert clinicians are ready to help you take the next step towards healing and recovery. We offer programs designed to treat addictions and mental health disorders. Nestled in the beautiful Rocky Mountains, APN Lodge offers a luxury rehab experience that is surrounded by the perfect environment for healing, personal growth, and recovery. Using evidence-based treatment approaches, our team of clinicians has the expertise to guide you through the process from referral through program completion.

To learn about all that the APN Lodge experience offers, reach out to one of our Contact Center team members at 866-525-9107. Let us help you find your way forward.

Reference

  1. American Addiction Centers. (2020). 5 Signs You Need Dual Diagnosis Treatment. Mental Help 5 Signs You Need Dual Diagnosis Treatment Comments. https://www.mentalhelp.net/addiction/dual-diagnosis/5-signs-that-show-you-need-treatment/.
  2. Juergens, Jeffrey. “Dual Diagnosis: Mental Health and Addiction.” Dual Diagnosis: Mental Health and Addiction - Addiction Center, Addiction Center, 6 May 2021, www.addictioncenter.com/addiction/dual-diagnosis/.
  3. Trull, Timothy J, et al. “Borderline Personality Disorder and Substance Use Disorders: an Updated Review.” Borderline Personality Disorder and Emotion Dysregulation, BioMed Central, 19 Sept. 2018, www.ncbi.nlm.nih.gov/pmc/articles/PMC6145127/.
  4. Miller, Michael Craig. “1 In 10 Americans Depressed.” Harvard Health, Harvard Medical School, 2 Oct. 2010, www.health.harvard.edu/blog/1-in-10-americans-depressed-20101002478.
  5. AADA. “Facts & Statistics.” Facts & Statistics | Anxiety and Depression Association of America, ADAA, AADA, 21 Apr. 2021, adaa.org/understanding-anxiety/facts-statistics.
  6. Reisman, Miriam. “PTSD Treatment for Veterans: What's Working, What's New, and What's Next.” P & T : a Peer-Reviewed Journal for Formulary Management, MediMedia USA, Inc., Oct. 2016, www.ncbi.nlm.nih.gov/pmc/articles/PMC5047000/.

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