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Medically reviewed by: Amelia Hasenohrl Lpc CHt

Ms. Hasenohrl is a Licensed Professional Counselor with over 27 years of experience, specializing in helping clients overcome anxiety, panic disorder and the fear that prevents them from effectively managing their everyday lives.

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Dual Diagnosis Treatment For Substance Use Disorder

Dual Diagnosis, also frequently referred to as co-occurring disorder, is a term that refers to a patient having a mental illness as well as a substance abuse problem. Examples of co-occurring disorders are the following combinations: depression with cocaine addiction, alcohol with panic attacks, and borderline personality with polydrug abuse. Seen in more than half the patients that struggle with mental illness, dual diagnoses were found in more than 7.9 million people in a 2014 national survey.

How Are Dual Diagnosis And Mental Illness Related?

Either substance abuse or illness can arise first. This results in trying to solve one issue by creating another in the midst of doing so. In most cases, it is difficult to tell which problem came first in these situations. Most patients have a tendency to develop drug or alcohol addiction before the mental illness because the substance can work as a trigger. For example, marijuana easily triggers psychotic episodes. Therefore, it is very common for patients with substance and drug abuse to develop a mental illness at more than half the general rate, compared to the community with only one or the other. If you have noticed you are developing a co-occuring disorder, it is very important that you seek help before it gets any worse.

How Do I Know If I Have a Co-occurring Disorder?

Some ways to detect if you have a co-occurring disorder are the following indications:

Feeling depressed, anxious, hopeless, and sad for extended periods of time. This can include many mood fluctuations
Change in appetite, weight, and sleep patterns
Using drugs and alcohol to try to dissipate bad memories or to deal with hard points in life
Frequent suicidal thoughts
Using drugs and abusing substances to get through the day. This could typically mean not being able to complete daily activities, such as work or school, without them
Compulsive qualities result in an obsessive need and desire for drugs and alcohol
Unemployment
Inadequate living situations, causing one to be in a depressed state of mind as a result

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What Is It Like To Have Co-occurring Disorder?

A patient with a co-occurring disorder may struggle with many difficult circumstances. This can include fluctuating mood swings and thought disorders, coinciding with needing drugs and alcohol to subside the mental and physical pain; problems with letting go of stress in life and using drugs or alcohol to deal with mental illness. These common indications all result in a give-and-take dynamic, all while making their conditions far worse by doing so. They fight fire with fire to solve the problems that need adequate attention.

Mental Health Disorders Associated With Substance Abuse And Drugs

When one faces high anxiety, depression, or high fluctuations in moods, one will often turn to substances or drugs to minimize the pain they are enduring. Although much depends on the age of the person, overall anxiety and depression are by far the most common indications found in many people at first. On the other hand, mental health disorders such as ADHD can be found in children from the age of 6 and up. This results in more than 6.4 million people dealing with hyperactivity disorder. Also, schizophrenia and psychotic disorders can emerge later in life, typically after adulthood.

The point being, mental illness can appear throughout one’s life at any time. This results in co-occurring disorders to be at an all-time high in society. All of these mental fluctuations can result in one trying to patch up the frustration and anger found within the illness. Mental illness can appear suddenly, and be cured quite easily, or it can sporadically taking over one’s life. Most frequently, mental illness is one that cant be cured overnight. This leads to the patient to develop the co-occurring disorder. Abusing other substance and drugs to fill their mind with ease, making this predicament all the worse.

Common Co-occurring Disorder Combinations Found Within Patients

Depression and addiction—Many patients will use their addiction in hopes of making themselves happier, leading them into deeper problems when doing so.
Anxiety and addiction—This is by far one of the most prevalent combinations because of the feelings drugs and substance abuse will leave as a result. For example, it will make one feel much more anxious because not feeling able to exhibit self-control as well as to make conscious decisions.
Panic disorder and addiction—Many of those with anxiety will receive similar feelings with a panic disorder. This is because those facing panic attacks may use substances or drugs to calm their nerves. This just causes them to develop more anxiety while doing so, increasing the panic attacks, and therefore causing the co-occurring disorder.
ADHD and addiction— is very common within those of younger age because those are often the ones that suffer from ADHD. The anxiety and hyperactivity of the mind will not allow them to focus, and this may cause them to seek not-so-effective methods in order to deal with their disorder.
Post-traumatic stress disorder and addiction—This is found in those that have trouble letting go of certain traumatic instances in life, leading them to minimize the pain through substance abuse or drugs.

They may also deal with obstacles such as:

A difficult diagnosis, because it is very strenuous to pinpoint which came first, the addiction or the mental illness.
Finding the rehabilitation center that best fits their needs. Sometimes, their drug/substance abuse problem can be dismissed because their mental illness is seen as far more important.
During this, it is very important to find the mental institution that best fits your needs. It may not be at your place of choice, but instead, the place that best fits your situation best.
It’s becoming harder and harder to find those that are trained to treat both mental illness and substance abuse or drug abuse all in one. Finding the treatment best for you may be a difficult journey, but it is worth the outcome at the end when you find the place you fit in best.

How Is Dual Diagnosis Treated in Rehab?

Once again, it is tremendously important that both mental illness and drug or alcohol abuse are closely watched. This ensures that both are receiving direct attention. There is a multitude of different rehabilitation centers and behavioral practices that help the patient get the help that is needed. Detoxing all former drugs and substance out of the body allows the patient to move further in the given treatment—allowing them to move forward and to have a clear thought process before treatment of the mental illness. This order will help the coping process immensely.

Extremely effective methods of treatment can include:

Giving an equal amount of attention to both the mental illness and the substance abuse or drug problem the patient is enduring.
Detoxification and sobriety for alcohol addictions, as well as refraining from all forms of drugs. This allows for one disorder to be out of the picture, resulting in full attention to the mental illness.
Rehabilitation needed for the patient to seek the help required. Having a very supportive group of people, and needed treatment, are what adequately ensure the patient will recover from their addictions and mental fluctuations.
Group-treatment methods to help match the patient with those who may be going through the same problems in their life. This helps them open up to others and find friends and mentors in this tough process.
Some independent providers may even be willing to come to your home. This sometimes helps those who don’t feel comfortable leaving their house during this strenuous time, ensuring they still receive the help needed.
Hospitals, offering the treatment that is needed for the co-occurring disorder.
On the other hand, allowing the patient to receive help for one, before trying to pursue the other. This allows the patient to have a clear and concise thinking process. When people feel they have a lot of weight on their shoulders, it is hard to deal with a multitude of issues. This is why it’s best to knock one problem out of the way (typically the one of a greater multitude) in order to then move on to the next indicated one present.

Finding A Dual-diagnosis Rehab Center That Fits The Patient

The following rehabilitation facilities are very helpful to patients, including:

Group therapy—This allows for the patient to develop relationships with others with the same issues, as well as providing mentors to guide them. They willingly want to relate and help the patient through this tough time.
Hospitals — This is the standard local hospital that will generally refer you out for mental health treatment.
Individual psychotherapy—This is an individual help mechanism that is between the patient and the mental health profession (psychologist, psychiatrist, social worker) which helps the patient directly. They focus on the problem as one affecting an individual and give it proper awareness.
Community-based organizations
Cognitive behavioral therapy—This is a psycho-social intervention which focuses deeply on their negative emotions and mood fluctuations, believed to be contributors to the outcome of negative behaviors. This allows for the patient to think more happily and clearly in order to move forward.
Dual-diagnosis Rehabilitation—There are vast options when it comes to dual-diagnosis rehabilitation centers. The patient has many options when deciding which one best suits their needs. Rehabilitation will ensure the patient is away from drugs, substances, and negative behavior. This is extremely important when dealing with a dual-diagnosis treatment.

All in all, those with co-occurring disorders may have a tough journey to overcome these circumstances—but they are far from being alone. There are many indicators to diagnose if you have one, as well as a multitude of ways to seek help. Even though the process is tough, the outcome at the end is what is the most rewarding to all involved.

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