Do you sometimes feel like you've unknowingly turned to alcohol or other drugs to relieve your stress and anxiety? Or do you feel like some of your habits are affecting your mental health? These situations are actually common among us. Today, we're going to talk about how to recognize these two interconnected problems and what you can do about them.
What is Dual Diagnosis? Let's understand it simply!
Simply put, a dual diagnosis means that you have both a mental health condition (such as depression or anxiety) and a substance use disorder at the same time. This is sometimes called a co-occurring disorder . The important thing is that a dual diagnosis is not a new condition, it is a combination of two existing conditions.
Imagine, someone has severe anxiety. Unable to cope with it, they start using alcohol to get some relief. Over time, they become addicted to alcohol. Then they have both anxiety and alcohol use disorders. That's what we call a dual diagnosis.
What happens here is that one condition influences another. It's like a vicious cycle. Untreated mental health problems can worsen substance abuse, and as drug use increases, mental health problems can also increase.
How common is this condition (Dual Diagnosis)?
This condition is more common in society than you might think. Research has found that about 50% of people with a substance use disorder also have a mental health condition at some point in their lives. Similarly, 50% of people with a mental health condition also have a substance use disorder. Just think, in 2020 alone, 17 million adults in the United States had both a mental health condition and a substance use disorder. This situation can be seen to a greater or lesser extent in Sri Lanka.
What are the symptoms of a (Dual Diagnosis)?
This is a bit complicated, because your symptoms related to your substance use problem are different from your symptoms related to your mental health problem. So, the symptoms you show in a dual diagnosis depend on the type of substance you are using and the mental health condition you have. There can be different combinations, so the symptoms can be very diverse.
Some common symptoms of a substance use disorder:
- Trying to stay away from family and friends.
- Difficulty concentrating on something.
- Showing sudden big changes in behavior .
- Frequent engagement in risky activities (e.g., drunk driving).
- Developing a high tolerance to the drug (meaning that the amount you took before no longer feels like enough) and/or experiencing withdrawal symptoms when you don't take the drug.
- Feeling like drugs are essential to living and functioning.
Some common symptoms of a mental health disorder:
- Extreme mood changes.
- Feeling very confused .
- Difficulty concentrating .
- Inability to perform tasks properly at work or school.
- Avoiding social interaction with others .
- Thoughts of suicide .
Important: If you or someone you know has one or more of these symptoms, it is very important to seek medical advice.
Which of these two conditions comes first?
This is like the question of "Which came first, the chicken or the egg?" It's actually difficult to say exactly which of these two conditions came first . (Dual Diagnosis) Even if one is present together, it doesn't mean that one caused the other.
However, while substance use disorders do not directly cause mental health disorders (and vice versa), there is a clear link between the two. Alcohol and drugs can worsen mental health symptoms. And, continued use of these substances can increase the risk of developing a mental illness.
What are the causes of Dual Diagnosis?
Researchers offer different theories about why drug use and mental health problems occur together.
Shared common risk factors
There are some risk factors that can contribute to both mental illness and substance use.
- Genetics: Like mental illness, substance abuse can run in families. This means that if someone in your family has had the condition, you are at a slightly higher risk. Research shows that there are several genes that contribute to both conditions.
- Environmental factors: Some things in our environment, such as stress and trauma (such as childhood trauma or abuse), can cause both conditions. Sometimes, these traumatic experiences can have an impact across generations.
Drug abuse due to mental illness
If you have a mental illness, you may be tempted to "self-medicate." This means that you use alcohol or drugs to temporarily relieve your feelings of pain, anxiety, or depression. While these may temporarily relieve your symptoms, they can actually make them worse in the long run . Also, some mental illnesses can alter the function of your brain's "reward centers." This can increase your risk of developing drug addiction.
Mental illness caused by drug use
When you use alcohol, drugs, and other addictive substances, they can affect the structure and function of your brain . These changes can increase your risk of developing a mental illness. For example, some drugs can cause paranoia or delusions, or hallucinations or delusions.
How to recognize (Dual Diagnosis)?
As we mentioned earlier, a dual diagnosis is not a new diagnosis, it is a combination of two diagnoses. The symptoms of both conditions can be similar and overlap, making an accurate diagnosis can sometimes be a challenge, even for a doctor.
However, your doctor will use special screening tools to test you for both of these conditions. It's important to be as honest as possible when you talk to your doctor at this time. Based on your answers, they will be able to determine what medical conditions you may have and what treatments are best for you.
What are the treatments for Dual Diagnosis?
When treating a dual diagnosis, the most effective approach is to treat both your mental health condition and your substance use disorder at the same time . You and your doctor need to understand how these two conditions affect each other. Only then can you choose the most effective treatment plan.
To fully recover from a dual diagnosis, you need to completely stop using the drug you are addicted to . For many people, this starts with a process called detoxification . In residential detoxification, healthcare providers monitor you 24 hours a day for about a week. They help you gradually wean yourself off the drug and provide you with strategies to reduce the side effects of not taking the drug.
Depending on your situation, treatment for dual diagnosis may include behavioral therapy , medication , support groups , or in-patient care .
Behavioral Therapy
There are several behavioral modification therapies that have shown success in treating these co-occurring conditions:
- Cognitive Behavioral Therapy (CBT): (CBT) is a type of therapy that teaches you to identify, deal with, and change dysfunctional patterns in your thinking. This can help you learn new ways to cope with problems.
- Dialectical Behavioral Therapy (DBT): DBT is a treatment method that helps you reduce self-harming behaviors, especially substance abuse, cutting, and suicidal thoughts or actions. It can help you learn to manage your emotions and have better relationships with others.
Medication
Your doctor may prescribe medication for one or both of your conditions. Some medications can help treat symptoms of both conditions in a dual diagnosis. For example, the drug bupropion is approved by the FDA to treat depression (as Wellbutrin®) and nicotine dependence (as Zyban®).
Support Groups
Support groups are a great place to get the emotional and social support you need to stay sober. The people in these groups are people who have been in the same situation as you. Peers can share their experiences with you and answer your questions. They can also give you advice on how to deal with the challenges of everyday life. Alcoholics Anonymous (AA) and Narcotics Anonymous (NA) are well-known support groups.
In-patient care
If you have a serious addiction to substance use and a mental illness, you may benefit greatly from receiving residential treatment at a dual diagnosis treatment center . There, you can get the medical and mental health services, medications, therapy, and support you need all in one place.
How to reduce the risk of (Dual Diagnosis)?
Like mental illnesses, substance abuse disorders are also brain diseases . While they cannot be completely prevented, you can do the following to reduce your risk:
- Be aware of your biological family history . That is, find out if anyone in your family has had these types of mental illnesses or substance abuse problems.
- If you drink alcohol, limit the amount .
- If you have any mental health concerns or problems, talk to your doctor about them . The earlier you identify them, the easier it is to treat.
What can you expect if you have a dual diagnosis?
With proper treatment, you have a much better chance of recovering from a dual diagnosis . You can improve your quality of life and expect good outcomes. However, to maintain this recovery, you need to continue working with your doctors and/or support groups . Never be afraid to ask for help.
How to help a loved one with a dual diagnosis?
Helping someone with a co-occurring disorder can be really difficult . Your loved one may deny that they have a problem and may not want to seek treatment. Even if they do start treatment, the journey to recovery can be long.
Understand what you can and cannot do. You cannot force your loved one to get off drugs, take medication, or go to counseling.
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But, you can make good decisions for yourself . You can encourage your loved one to get help, you can give them your unconditional love and support. Listen to them, try to understand them.
If you are suffering from a dual diagnosis, you may feel like you are “on the wrong side of the road.” You may also feel like you are doing it yourself. However, it is important to remember that mental illness and substance abuse are medically recognized conditions . Just because they are “invisible” does not mean they are not real. Don’t be afraid to see your doctor and ask for help. Be honest and open with them, and they will be able to help you find the treatment you need. Asking for help is the first step on the journey to recovery.
Summary (Take-Home Message)
- Dual diagnosis is the condition of having both a mental health problem and a substance use disorder at the same time . This is more common than you might think.
- These two conditions can affect each other and operate like a vicious cycle .
- This may be caused by genetic causes, environmental factors, the use of drugs to relieve stress, and the effects of drugs on the brain.
- It is very important to understand the symptoms and seek medical advice .
- Treatment options include behavioral modification therapy, medication, support groups, and residential treatment . A combination of both is most effective.
- With proper treatment and support, a dual diagnosis can lead to a full recovery. Don't be afraid to ask for help, that's the most important step.
` Dual Diagnosis, mental health, substance abuse, addiction, mental illness, treatment, co-occurring disorder
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