Double Jeopardy: Understanding Dual Diagnosis

If you know someone who’s struggling with substance abuse, and you’ve ever thought, Hmmm, I feel like he/she might also have depression/ADHD/generalized anxiety [insert any mental health disorder], you’re observing something known as “dual diagnosis.” Also sometimes referred to as “co-occurring disorders,” the condition describes a situation in which an individual has both a mental illness and a substance use disorder.

Determining which came first can be a discussion akin to the “chicken or egg” question. Sometimes people will self-medicate to find relief from the symptoms of mental illness, and sometimes substance abuse is implicated in causing the symptoms of mental illness. What IS abundantly clear is that dual diagnosis isn’t uncommon. The 2014 National Survey on Drug Use and Health estimated that 7.9 million adults have co-occurring mental illness and substance use disorders, roughly 3.3 percent of all adults living in the U.S. Findings from the National Survey or Substance Abuse Treatment Services indicate that around 45 percent of Americans being treated for substance use also have a diagnosis with a co-occurring mental disorder.

Know the signs and symptoms of dual diagnosis

Identifying the signs and symptoms of dual diagnosis is rarely straightforward, as many disorders can have similar symptoms that overlap and interact with each other. However, some of the more common indicators include:

  • Altered sleep patterns (whether that’s insomnia or sleeping too much)
  • Chronic, severe stress, anxiety, or fear
  • Social isolation (when the individual withdraws from friends and family)
  • Reckless, angry, or violent behavior
  • Difficulty concentrating
  • Unstable work history
  • Extreme mood swings
  • Trouble maintaining relationships
  • Intense or prolonged feelings of despair, hopelessness, and worthlessness

Treatment techniques

The two disorders were treated separately (and sequentially) until the 1990s. Those suffering from mental illness sometimes had treatment withheld until they were sober, an unfortunate situation that often led to ineffective or no treatment for individuals struggling with addiction and a mental disorder. Fortunately, advances in the fields of mental health and addiction led to the development of integrated treatment, which treats both disorders simultaneously.

Today, we appreciate the interactions that take place when someone has both a mental illness and a substance use disorder, and that understanding underscores the need for treatment that integrates a range of disciplines. Integrated treatment planning considers both substance abuse and mental illness, both separately as well as how they coexist.

The best integrated treatment plans are client-centered, personally tailored to what each person needs and what will work for their lifestyle. It’s an approach that appears to be effective. According to Substance Abuse and Mental Health Services Administration, modern integrated treatment for dual diagnosis helps reduce costs and achieve better outcomes including:

  • Reduced substance use
  • Improved psychiatric symptoms and functioning
  • Decreased hospitalization
  • Increased housing stability
  • Fewer arrests
  • Improved quality of life

If you or someone you care about is struggling with mental health challenges, substance abuse, or both, Choice House can help. Please give us a call at 720-577-4422.


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