Each day, millions of people struggle with the disease of their addictions. As the opioid epidemic in the United States continues to grow, more attention (than ever before) has turned to the stark reality of addiction. Approximately 115 people die as a result of an opioid overdose each day, and this number continues to grow.
In years past, those who battled addiction were shunned in society and labeled as “low in moral fiber.” Addiction, also known as a substance use disorder/alcohol use disorder, was not thought of as a disease or disorder, but rather as a choice. People who acted out in their addictions were considered bad people and were refused any sort of sympathy or help.
This was the unfortunate reality for those suffering from addiction for thousands of years. Since the beginning of time, man has fought against addiction. From the earliest days in recorded history, there were tales of those who drank too much wine or indulged in other substances. These people were left to toil away in the misery of addiction until they suffered early deaths as a result of their substance use disorders.
Today, we are far more fortunate. We live in a time where addiction is finally recognized as a serious medical condition and people are getting the help they need. Within the last 50 years, major discoveries and progress has been made in understanding addiction and developing evidence-based addiction treatment practices.
However, many people who struggle with addiction also struggle with a dual diagnosis. A dual diagnosis is a condition of suffering from a mental illness and a comorbid (co-occurring) substance abuse problem. This means that while struggling with an addiction to drugs and/or alcohol, the individual also possesses another mental health disorder.
There are many types of mental health disorders. For as many different mental disorders that exist, there is an equal number of different combinations that may make up your dual diagnosis. Some of the more common types of mental health disorders seen co-occurring with a substance use disorder are:
- Bipolar disorder
- Borderline personality disorder
- Generalized anxiety disorder
- Depression
- Obsessive-compulsive disorder (OCD)
- Panic disorder
- Eating disorders (bulimia, binge eating, anorexia)
- Personality disorders
- Schizophrenia
- Post-traumatic stress disorder (PTSD)
Receiving a dual diagnosis is not uncommon. In fact, according to the 2015 National Survey on Drug Use and Health, 8.1 million people (or 41.2 percent) among 12.6 million adults with past-year Substance Use Disorder (SUD) also possessed Any Mental Illness (AMI) in the past year in the year 2015. This means that nearly half of those that struggled with an addiction to drugs and/or alcohol also struggled with a co-occurring mental health disorder, also known as a dual diagnosis.
Only recently has dual diagnosis treatment become available to sufferers searching for relief from their addiction to drugs or alcohol. While having a dual diagnosis is not a bad thing, it is important to realize that this means there must be a different approach to your addiction treatment than someone who doesn’t have a dual diagnosis. There is a unique relationship between substance abuse and mental illness, and in order for dual diagnosis treatment to be successful, these two individual mental health disorders must be addressed in specific manners.
How are Substance Abuse and Mental Illness Linked?
There is an important relationship between substance abuse and mental illness. What many people do not understand is that substance abuse (addiction/substance use disorder) is a form of mental illness.
Finally recognized as a disease by the Diagnostic and Statistical Manual (DSM-V), a substance use disorder or alcohol use disorder is a mental disorder. This means that it falls into the same category as depression or bipolar disorder.
The way in which substance use disorders are classified makes it difficult for people to understand its disease label. Since mental health disorders are still not fully understood by the community, especially those with no personal experience with mental health disorders, it can be a difficult concept for people to grasp.
Diseases such as polio or cancer possess physical manifestations. Mental health disorders or mental illnesses possess “invisible symptoms”. This means while they are entirely real and cause serious implications for those who suffer from them, the only ones who can actually experience the symptoms of these disorders are those who suffer themselves.
Substance abuse causes individuals difficulties is almost every facet of life. This means that substance use disorders impact sufferers in a physical, emotional, and financial sense.
Self Medicating
Many people with a dual diagnosis use substances like drugs and alcohol as a form of self-medication. Because they are not receiving or are unable to receive proper care for their mental health disorder, they turn to drugs and alcohol as a form of relief from the symptoms of their mental disorder.
For example, people with depression may turn to alcohol to “numb the pain” associated with disorders like depression. Or perhaps the individual with social anxiety uses alcohol as a means to feel more comfortable and confident among other people. There are several combinations that may occur.
The Cycle Of Substance Abuse and Mental Health Disorders
Regardless of the circumstances surrounding your dual diagnosis, it’s important to seek proper care for your comorbid disorders. Finding the correct dual diagnosis treatment program is crucial to your success in sobriety and life as a whole. Dual diagnosis treatment is different than traditional addiction treatment, so for dual diagnosis patients, locating and enrolling in a good dual diagnosis program is key.
Dual Diagnosis Treatment vs. Traditional Rehab
As mentioned previously, there is a major difference between simply having a substance use disorder and a dual diagnosis. The entire approach to addiction treatment is different in dual diagnosis treatment and traditional rehab. For people dealing only with a substance abuse problem, the only issue that needs to be addressed is their addiction to drugs and alcohol. For dual diagnosis patients, there is another underlying mental health condition that also needs to be treated.
A treatment facility must have a dual diagnosis program that specializes in the treatment of dual diagnosis patients. These types of programs practice a philosophy that believes that recovery “begins in the mind”. For dual diagnosis treatment to truly be effective, the facility must use an integrated approach to substance abuse and mental illness.
There are different addiction therapy techniques and approaches that are used in a dual diagnosis treatment program versus a traditional drug rehab program. There are several different key factors that must be taken into consideration when treating the dual diagnosis patient:
- What kinds of drugs or alcohol are being abused by the patient?
- What is the co-occurring mental health disorder?
- How long has the patient been self-medicating?
There are different therapy techniques used for different mental health disorders. For example, the therapy methods used for patients with an anxiety disorder will be different than for those struggling with a bipolar diagnosis. The dual diagnosis treatment plan will vary on a case-by-case basis to meet the individual needs of each patient.
Different Types of Therapy Used in Dual Diagnosis Treatment
While each dual diagnosis treatment plan will be unique, there are certain types of therapy methods that seem to be effective in treating dual diagnosis patients. It is important to remember that what may work for one patient may not be helpful to another, so much of it may be trial and error. A dual diagnosis treatment program will work with you to find what is effective for you and will implement different kinds of approaches until you find the right fit.
Some of the more common types of therapy you may encounter during dual diagnosis treatment are:
Cognitive Behavioral Therapy
This is a form of therapy that attempts to change patterns of thought and therefore change patterns of behavior. Known as CBT, this is a highly effective form of therapy for substance use disorders and other mental health disorders, making it a great approach to dual diagnosis treatment.
Guided Imagery
Guided imagery is a form of meditation therapy. In this type of therapy, the therapist will help you focus on mental images to evoke feelings of relaxation.
Breathing Exercises
Breathing exercises can help patients relax by lowering blood pressure and breathing rates. Evoking a calming sensation over the patient can help ease the tension patients may feel in therapy sessions and help them open up.
Self-Hypnosis
Another relaxation technique, self-hypnosis can help patients modify their behavior, emotions, and attitude. It is often used to help people overcome certain types of addiction, and can be highly effective in treating other mental health disorders too.
Yoga
Yoga has long been a choice method in substance abuse treatment, as it teaches patience, relaxation, and focus. By engaging both the body and mind, it can help you find balance in your life by helping people accept negative emotions and learn to how to respond more productively to them.
Meditation
Similar to yoga, meditation is an effective way to manage many different mental health disorders, including addiction. Implementing meditation into your dual diagnosis treatment can help treat both co-occurring disorders together.
Progressive Relaxation
Progressive relaxation is a helpful therapy technique, particularly for people with anxiety disorder. The goal is to relax your muscles in your body. By tensing up the muscles and then releasing the tension, it causes the muscles to relax. People struggling with anxiety may unconsciously tense up certain areas of their body in response to the stress, so by releasing the built-up tension, it can also ease their anxiety altogether.
Benefits of Dual Diagnosis Treatment
So, why should you engage in dual diagnosis treatment? For starters, if you have a dual diagnosis, participating in a dual diagnosis program may be the only way that you find relief from your substance abuse disorder.
Without receiving proper treatment for both disorders at the same time, when you address one, the other will still affect you. It will be a cycle of each individual disorder flaring up until you can finally address both at the same time. You may continue to use drugs to deal with your mental health disorder, which flares up because you’re using drugs. In order to effectively break the cycle, you need dual diagnosis treatment.
Dual diagnosis treatment is also effective in educating you in mental health. Throughout your journey in dual diagnosis treatment, you’ll finally receive the proper mental health diagnosis you may have been missing. You will be able to fully understand your underlying mental health disorder and the proper ways to treat it, cope with it, and avoid further self-medicating.
Since dual diagnosis treatment programs focus on integrating both substance abuse treatment and mental health treatment, you’ll have the benefit of being able to recover both physically and mentally. You’ll be given your very own personalized dual diagnosis treatment program plan that will meet your needs rather than just undergoing a one-size-fits-all generalized addiction treatment program.
