Dual Diagnosis - Addiction Recovery

Dual Diagnosis: Your Ultimate Guide to Co-Occurring Disorders

A dual diagnosis is the combination of substance abuse with a mental disorder. Learn everything about co-occurring disorders in our ultimate guide!

Dual Diagnosis: Your Ultimate Guide to Co-Occurring Disorders

Table of Contents

Written by

Brian MooreBrian Moore

Content Writer

Reviewed by

Jeremy ArztJeremy Arzt

Chief Clinical Officer

November 23, 2022

The Edge Treatment Center

According to the National Survey of Drug Use and Health, over 20.4 million Americans suffered from a substance use disorder in 2019. Furthermore, around 9.5 million adults in the United States have coexisting mental health issues.

What this means is this: over half of the people with a substance use disorder also had a mental health condition!

When someone suffers from a mental health disorder and cannot receive sufficient treatment, they are at a greater risk of turning to drugs or alcohol to relieve their symptoms. In clinical terminology, this is referred to as a co-occurring disorder.

In layman’s terms, it’s known as a dual diagnosis.

A dual diagnosis requires more intensive care and one-on-one treatment than a person merely suffering from one condition. Substance abuse and mental health issues can severely deteriorate a person’s health in specific ways. Drug or alcohol misuse can affect a person's physical health, which leads to various effects that make therapy more difficult for this subset of patients.

Dual Diagnosis: Co-Occurring Disorders Are Significant Mental and Physical Health Issues

Today, over eight million people in the United States suffer from co-occurring disorders. According to the Substance Abuse and Mental Health Administration (SAMHSA), they can affect persons of all ages and from all walks of life. For example, those with a mental disorder are twice as likely to acquire a drug addiction problem; the same can be said the other way around.

While some co-occurring disorders are more common than others, any combination of addiction and mental illness is referred to as a "co-occurring condition." 

The following are some common dual diagnoses:

• Bipolar disorder and alcoholism

• Anorexia nervosa and cocaine abuse

• Post-traumatic stress disorder (PTSD), as well as heroin addiction

• Anxiety problems and the misuse of prescription medications

Marijuana addiction and attention deficit hyperactivity disorder

Over half of all Americans with a co-occurring mental illness and substance use disorder are men. According to the research, men account for 56% of those seeking dual diagnosis treatment for co-occurring disorders, making them slightly more common in men than women. Individuals suffering from anxiety and depression are more likely to develop co-occurring substance use disorders as well.

According to one study, people with drug addiction are 1.3 times more likely to suffer from depression in a given year. In addition, people who have struggled with addiction at some point in their lives are 1.3 times more likely to suffer from a generalized anxiety condition.

Dual Diagnosis: Co-Occurring Disorders and Where They May Come From

When it comes to co-occurring disorders, either the Co-occurring disorders substance abuse problem or the mental health issue may develop first. People with mental illnesses frequently use drugs or alcohol to help them cope with their symptoms (this is called self-medication).

In certain cases, people have used drugs or alcohol for a long time, worsening psychological disorders. Research shows that certain substances, or long-term substance usage, aggravates mental disease symptoms.

Even during therapy, mental health problems often get worse, and those diagnosed with mental diseases frequently use medicines to ease their symptoms. For example, people with anxiety may seek out something to help them feel at ease, those with depression may seek out something to help them feel more energized, those with social anxiety may seek out something to help them feel safer and more at ease, and those with psychological pain may seek out something to dull the pain. But using alcohol or other substances not only alleviates a mental health problem but also prevents a person from learning practical coping skills, developing satisfying relationships, and feeling comfortable in their skin.

Alcohol also reduces the effectiveness of antidepressant medications, and substance abuse aggravates mental diseases. People who have co-occurring disorders may be able to stop using alcohol or other drugs, but they will suffer if the symptoms of their mental illnesses persist.

Addiction treatment centers, physicians, and addiction specialists may not be qualified to handle both situations. Furthermore, some traditional peer recovery groups may insist on total abstinence from all drugs, including those prescribed for mental health disorders.

As a result, addressing substance misuse while treating mental health difficulties is particularly difficult for persons with co-occurring illnesses.

Dual Diagnosis: How Co-Occurring Disorders Are Treated

To provide effective co-occurring disorder treatment for co-occurring mental health disorders, SAMHSA recommends an integrated co-occurring treatment strategy. Rather than treating each condition separately without respect for the other, integrated therapy combines drug addiction and mental health therapies.

In many studies, CBT has been demonstrated to be as effective as, or more effective than, other forms of psychological therapy or psychiatric medications [Apa.org]

Experts urge integrated therapy for people with co-occurring illnesses, which entails treating both the addiction and the mental illness. One type of treatment appears to be particularly useful for those with co-occurring conditions.

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How Talk Therapy Can Treat Dual Diagnosis

Cognitive behavioral therapy (CBT) is essentially a type of psychotherapy, better known as talk therapy. In the mental health domain, it is primarily used for helping people who have dual-diagnosis mental health conditions. This includes people diagnosed with clinical depression and PTSD. It is also used for people with anxiety, suicidal tendencies, and a drug abuse history.

This therapy has been often used along with the more conventional, integrated dual disorder treatments for helping an individual in identifying and controlling substance addiction habits.

CBT's purpose is to assist clients in identifying, accepting, and changing dysfunctional behaviors connected to their concerns with a drug addiction disorder. This treatment is extremely effective for people with co-occurring conditions because it helps them recognize addiction triggers, reduce cravings, and become aware of high-risk circumstances. Cognitive-behavioral therapy assists individuals in focusing on current issues rather than past difficulties.

This sort of dual diagnosis therapy assists people in replacing unhelpful beliefs and behaviors with healthy ways of thinking and behaving. Because CBT is considered the "gold standard" for treating mental health issues like depression, this may be a highly effective treatment method for persons suffering from addiction and depression.

Individuals who may benefit from CBT have issues or medical concerns such as:

  • Conflicts in Relationships

  • Addictions to Substances

  • Anxiety Stress Management

  • Phobias

  • PTSD

  • Bipolar Illness

  • Sexual Dependence

  • Uncontrollable Emotions

  • Grief from Chronic Pain

  • Disorders of Eating

How Does CBT Work in The Treatment of Dual Diagnosis?

The relationship between a client and the therapist is vital during the course of CBT treatment. Both parties must build positive communication and trust to assist the individual battling substance misuse and in replacing dysfunctional beliefs with more constructive perceptions. When implemented properly, this helps to form a blueprint that provides the individual with the tools to overcome destructive behaviors. Cognitive-behavioral therapy consists of several processes designed to assist clients in identifying patterns of negative ideas, behaviors, and emotions.

CBT typically consists of the following steps:

  • Recognizing tough situations

  • Identifying thoughts, feelings, and beliefs connected with adversity

  • Resolve negative thought patterns

  • Negative thinking transformation

CBT aims to change the ideas, feelings, and behaviors related to drug misuse. It focuses on the individual's habits rather than mainly targeting substance use disorders. CBT finally tailors to the client's requirements. Many people use drugs and alcohol to self-medicate because they are unable to deal with intrapersonal or interpersonal concerns such as:

  • Lack of coping skills:

    Many people never learn good coping abilities for dealing with problems or stress in adulthood. As a result, many of these people turn to drugs and alcohol to cope. In addition, those who began taking other substances at a young age frequently lack good notions for dealing with stress.

  • Chronic drug use:

    People used to have good coping strategies for stress. However, once an individual starts abusing substances and later seeks rehabilitation, a vicious cycle replaces those beneficial coping strategies.

  • Exposure to trauma:

    Most people who have been exposed to trauma lack the skills necessary to deal with it. As a result, the individual begins to self-medicate to cope with the traumatic incident and any associated feelings.

Dialectical behavior therapy (DBT) is a well-known treatment for those suffering from various and severe psychosocial illnesses, including those who are suicidal regularly. Because many of these patients suffer from substance use disorders (SUDs), thus DBT was used for substance abusers, which integrates concepts and modalities aimed at promoting abstinence and reducing the length and negative impact of relapses. Dialectical sobriety, "clear mind," and attachment techniques that include off-site counseling and aggressive efforts to find patients who miss appointments are among them.

DBT for substance abusers has been shown in several randomized clinical trials to reduce substance misuse in patients with borderline personality disorder. Patients with additional severe disorders co-occurring with SUDs or who have not responded to existing evidence-based SUD therapies may also benefit from the treatment. 

How Dialectical Behavioral Therapy Helps Patients Cope With Dual Diagnosis

Co-occurring disorder treatment centers focus on therapeutic intervention, and most provide a combination of individual and group treatment and family therapy if the client's immediate family members live nearby. There are numerous treatments, but talk therapy is the most common. This therapy approach is founded on the notion that acceptance and transformation are critical to the healing process. Clients must accept where they are to begin healing - and healing does not occur in the absence of change. 

Dialectical behavioral therapy has traditionally been used to treat men and women suffering from severe substance addiction disorders as well as underlying mental illnesses. For example, according to an American Psychiatric Association publication, DBT helps treat symptoms associated with borderline personality disorder, such as suicidal ideation. Among men and women who frequently use DBT, some additional benefits include:

  • A greater possibility of completing a long-term clinical treatment program and not leaving rehab before the release date

  • Reacting in more healthy and less damaging ways, such as working through anger before reacting aggressively to another person

  • It has been consistently demonstrated that men and women who continue to participate in DBT may create and maintain healthy and effective relationships with others because they have greater social functioning.

  • Shorter psychiatric hospitalizations and a significant decrease in suicidal ideation and depression symptoms

Suggestions for Dealing with a Dual Diagnosis

1. Do not put off seeking and receiving treatment: don't put off getting the therapy you need for a co-occurring disorder; instead, contact a competent medical practitioner right now to get started. Through a personalized treatment program for co-occurring disorders, professional counselors can help you in understanding the diagnosis, identifying the usual triggers, and minimizing symptoms.

2. Maintain a healthy diet and sleep schedule: so much of our lives are influenced by the food we eat and the amount of sleep we get each night. To give your body a fighting chance against co-occurring illnesses, especially if you are using medication to control symptoms, it's critical to avoid potentially harmful substances. For example, even modest amounts of artificial sugars can significantly affect and make it difficult to control your co-occurring conditions. You must also obtain a good night's sleep every night. Because technology is so easily accessible, we frequently surf the internet, turn between television channels, or scroll through items on our phones instead of going to bed. We found that setting limitations for your end-of-day activities, such as turning off all devices in preparation for slowing down for the evening, often helps.

3. Rejoice in your victories: take time during the day to appreciate modest achievements. Small successes can make all the difference, especially when dealing with co-occurring disorders. Perhaps you have avoided substances for a while. Maybe you've discovered a new approach to managing your symptoms, or experimental medicine is starting to work. Take time out of your day to admire your resolve, no matter how big or small achievement, and don't be afraid to enjoy it in your distinctive way.

4. Remember that you are not alone: this phase is vital to your long-term success when dealing with co-occurring disorders. It is easy to become frustrated or lose sight of the light at the end of the tunnel when diseases keep us from feeling the happiness or fulfillment we desire to handle regularly. We recommend that, regardless of how these disorders manifest in your own life, you take the time to connect with other people who are going through many of the same things you are.

Get the Assistance You Need for Dual Diagnosis at The Edge Treatment Center

Learning to manage co-occurring disorders is not a skill that can be acquired quickly. Instead, you will gradually develop productive habits to reduce symptoms and promote healthy, joyful living, frequently with the assistance of competent medical specialists. Connect with an online community if that means it. You must find time to attend an in-person group therapy session to discuss your thoughts, struggles, and celebrations in a judgment-free environment. Finally, everything you can do to encourage the community will make co-occurring diseases more manageable and even inspiring daily.

The Edge Treatment Center is the nation's premier drug addiction treatment provider. Our drug rehab provides greater flexibility in its treatment plans to ensure that everyone receives tailored treatment that can result in better and faster results, paving the path to sobriety and an everyday, healthy life. The therapy options include assistance for those whose depression is intimately linked to substance misuse and alcoholism, with a combination of professional therapies and personal monitoring at every stage of recovery.

Don’t try to live with a dual diagnosis. Contact The Edge Treatment Center today and find relief.

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