Many of the people in America suffering from substance abuse also have mental health disorders. Different mental health issues interact with various drugs and other substances differently, and when these two issues become a dangerous symbiosis of drug use and mental health disorder symptoms, they create an intense dependency that is very difficult to break. Substance abuse professionals refer to these cases as “co-occurring disorders” or “dual diagnoses,” and treating them requires a comprehensive approach on an individual basis.
Harmony Place is a dual diagnosis rehab center, meaning we have the training, staff, and resources to handle dual diagnosis cases. Not every treatment center provides dual diagnosis care, and among those that do, people struggling with addiction need reassurance their mental health issues will receive the attention they need during treatment.
What Does Dual Diagnosis Mean? Understanding Dual Diagnosis
What does a dual diagnosis mean? Some people may assume that treating one issue, either the substance abuse or the mental health issue, will help abate the symptoms of the other, but this is not entirely true. Substance abuse professionals know that co-occurring mental health disorders require attention simultaneously with substance abuse treatment. It is not possible to cure one without addressing the other.
Dual Diagnosis For Different Drugs
Different mental health issues and different substances produce varying interactions. For example, a person with an anxiety disorder who abuses opioids to cope will have a vastly different recovery experience than a person who abuses methamphetamine while suffering from depression. The physicians and substance abuse professionals who treat dual diagnosis cases must analyze each case on an individual basis. There are no blanket treatments for dual diagnosis.
Treating dual diagnosis for opioid addiction will take a vastly different path than a treatment plan for dual diagnosis for alcohol. The patient’s mental health condition, age, overall medical condition, preexisting conditions, and social factors all play important roles in any type of dual diagnosis treatment. Treatment center staff members will carefully review these details to look for the patterns of abuse and mental health disorder symptoms and which factors contribute to each or both.
Common Co-Occurring Disorders
Any patient who meets the diagnostic criteria for a substance abuse disorder and a mental health disorder at the same time is a dual diagnosis case. While this definition applies to any mental health disorder co-occurring with substance abuse, some types of mental illness more commonly link to substance abuse than others.
It’s also possible for a person to start displaying symptoms of a mental health disorder once substance abuse has progressed. A person with no history of mental health issues may suddenly meet the diagnostic criteria for one of these conditions after abusing illicit drugs for an extended period. On the other hand, a person who suffers from a mental health disorder but doesn’t receive effective treatment may eventually turn to illicit drugs for relief.
Depression is one of the most commonly diagnosed mental health conditions in dual diagnosis treatment. This condition often entails intense feelings of sadness, hopelessness, and guilt. It can also manifest as low energy, eating disorders, lack of motivation, disinterest in previously enjoyable activities, and reclusiveness. People with depression often struggle with social situations and may have consistent suicidal thoughts. Depression can also make it difficult to perform well academically or at work.
Over time, a person with depression may use drugs to cope with these negative symptoms. Unfortunately, this relief is not only temporary; it builds a dangerous symbiotic relationship between drug abuse and depression. Eventually, the individual will start feeling the symptoms of depression more acutely between doses. In turn, the symptoms of withdrawal can make depression even more difficult to manage.
Generalized Anxiety Disorders
Anxiety disorders produce feelings of worry, anxiety, and irrational fear. People who struggle with anxiety disorders may avoid social situations or high-pressure lines of work due to these intense fears. Drugs like alcohol, marijuana, benzodiazepines, and opioids depress the nervous system and produce euphoric feelings of relaxation, which can appear as a tempting escape from the symptoms of living with anxiety on a daily basis.
Post-Traumatic Stress Disorder
People who experience or witness traumatic events sometimes develop post-traumatic stress disorder (PTSD) in response. PTSD entails varying symptoms that are different for each person, but some of the most commonly reported symptoms include nightmares, vivid flashbacks of the traumatic event (these episodes make it seem like the person is “reliving” their past trauma), insomnia, eating disorders, restlessness, irritability, and feelings of anxiety or paranoia. This condition is very common among veterans who have experienced battlefield injuries in combat, survivors of assaults and sexual assaults, and children who witness extreme domestic violence.
PTSD requires very intimate counseling on a one-on-one basis, and the symptoms are often manageable with medications. However, if it takes time for a person suffering from PTSD to seek professional treatment, they may experiment with alcohol or other drugs in the interim to stave off the negative symptoms of PTSD. A person who has intense nightmares may have difficulty sleeping and turn to alcohol to help them rest. This type of self-medication is destructive and builds a strong dependency very quickly.
A panic disorder can produce panic attacks, feelings of intense anxiety, and stress during relatively calm situations. During a panic attack, a person may feel an overwhelming sense of impending doom or death, chest pain, tremors, sweating, and difficulty breathing. These disorders make social situations and high-stress work more demanding, and certain triggers may cause intense panic attacks.
Benzodiazepines are one of the most common medications prescribed to people struggling with panic disorders. These medications help suppress the panic response and provide relief from normally stressful situations, but they are not without risks. When a patient feels ready to stop taking a prescribed benzodiazepine medication, his or her doctor will typically suggest slowly tapering off the medication instead of stopping all at once. Sudden cessation of these medications can cause an intense resurgence of the symptoms the medication originally intended to treat. People who develop addictions to benzodiazepines will feel these sensations even more acutely if they stop taking the drugs, and this strengthens the grip of addiction.
People who struggle with bipolar disorder experience shifting episodes of depression and mania. This leads to significant emotional instability, and the people around a bipolar person may witness unpredictable behavior, intense overreactions to events, and exaggerated emotional responses to stimuli.
Episodes of depression and mania can last a few hours to a few weeks, depending on the individual. During a period of depression, the individual will experience intense feelings of guilt, hopelessness, and despair, while periods of mania make the individual more prone to risky behaviors due to higher energy levels and more positive emotional interpretations of situations. Drug abuse can lead to exaggerated periods of either depression or mania. Depressants like marijuana, alcohol, and benzodiazepines can make depression episodes worse or “level out” manic periods. Conversely, stimulants like cocaine and amphetamines may make periods of depression more manageable while escalating manic periods to dangerous levels.
Schizophrenia is a severe mental health condition that interferes with an individual’s interpretations of reality. A person with schizophrenia may hear voices, experience vivid hallucinations and delusions, have disorganized thoughts, and may even have psychotic episodes. Untreated schizophrenia can easily lead to legal trouble, incarceration, and financial ruin. When a schizophrenic person abuses alcohol or other drugs, he or she risks making symptoms worse. Additionally, psychotic episodes are far more likely to lead to catastrophic results when drugs are involved.
Three of the most common eating disorders are anorexia, bulimia, and binge eating. A person with anorexia suffers from a distorted perception of the self, often assuming he or she is overweight when this is not true. Anorexia also revolves around controlling behavior, as a person who feels out of control in his or her life may take control over his or her own eating habits as a way of making sense of the world. This can lead to malnutrition, muscle loss, bone deterioration, and makes the person more susceptible to other diseases and infections due to a weakened immune system.
Bulimia describes “binging and purging,” or the act of voiding or vomiting immediately after consuming food to prevent weight gain. This disorder is also heavily rooted in compulsive behavior and the idea of control. Binge eating is a disorder that involves eating an unhealthy amount of food on a regular basis, often in response to stress and negative environmental triggers.
Some people may attempt to self-medicate to manage the negative symptoms of these disorders, such as stomach pains, muscle weakness, and sickness caused by malnutrition. For example, most people are aware that many types of marijuana cause “the munchies,” or an increased appetite. This may be a beneficial use for some people struggling with eating disorders, and a few states have legalized medical marijuana to treat eating disorders. However, self-medicating without a medical doctor’s prescription is dangerous and can lead to dependency.
Other drugs such as cocaine, methamphetamines, and opioids may help a person struggling with an eating disorder manage the stress, anxiety, and feelings of hopelessness that often accompany these disorders. Over time, the individual will feel unable to manage these symptoms without drugs, creating an intense cycle of dependency.
Treating Dual Diagnosis
Outdated methods of treating patients with co-occurring mental health disorders and substance abuse disorders addressed each issue separately, so many people struggling with dual diagnoses did not receive the treatment they needed. Either they went to rehab without receiving psychological counseling, or they underwent mental health treatment without addressing their substance abuse problems. In either case, treating one before the other rarely works well for the patient. To effectively rehabilitate a person suffering from a dual diagnosis, it’s imperative to treat the substance abuse and mental health disorder simultaneously.
Today, treatment of co-occurring disorders is a field of its own, and anyone looking for dual diagnosis treatment needs to confirm that potential facilities have the training and resources to provide it. Harmony Place staff members have completed extensive co-occurring disorder treatment training, and the wide variety of physical therapies and counseling options helps us address many patients’ co-occurring disorders. The U.S. Department of Health and Human Services estimates that about seven million people with diagnosed mental health disorders also suffer from substance abuse.
Effective treatment of co-occurring disorders hinges on several factors, but the main goal is to address the mental health issue and the substance abuse at the same time. The caregivers providing dual diagnosis care must develop a treatment plan specific to each patient that integrates mental health disorder symptom management, counseling, nutritional support, physical therapy, and substance abuse recovery for the best results.
Therapies can work together in several ways to help patients with dual diagnoses get the most out of their rehab experiences. Many of the physical therapies available at Harmony Place such as massage, acupuncture, and physical therapy address the physical symptoms of many mental health issues and substance withdrawal. Counseling takes many forms, including one-on-one sessions with a therapist and participation in dual diagnosis groups to share stories, experiences, and coping strategies.
Long-Term Addiction Treatment and Care
Ultimately, a dual diagnosis case requires equal attention to the mental health issue and the substance abuse throughout the course of treatment. Additionally, the coping techniques and therapeutic exercises learned in treatment will be very important after returning to “normal” life. The shock of reentering your everyday life again can seem overwhelming, especially with a mental health disorder.
Support groups, residential recovery programs, and ongoing care options are invaluable to people struggling with co-occurring disorders. Recovery does not end at rehab, and this is especially true when it comes to mental health disorders. Effective dual diagnostic care hinges on thorough treatment plan development during rehab and consistent maintenance after rehab. Once a dual diagnosis patient reaches this point, he or she will likely connect with a mental health professional for regular counseling and therapy, and the lessons learned in rehab will help maintain sobriety.