When Mental Health Meets Substance Abuse: The Double Whammy of Dual Diagnosis

dual diagnosisSubstance use and abuse can lead to addiction, which is already hard enough to handle on its own—but what if you are also diagnosed with a mental illness? Coping with both at once can complicate the challenges you may face along the road to rehabilitation and recovery.

A substance abuse problem that is happening at the same time as a mental health issue (such as depression, bipolar disorder, or anxiety) creates a situation called a co-occurring disorder, also known as dual diagnosis.

In such a case, both the mental health problem and the alcohol or drug addiction each have their own particular set of symptoms that interfere with a person’s ability to function normally in the face of life’s challenges. The situation becomes even more complicated by the fact that the co-occurring disorders also interact and affect each other, especially when one or the other remains untreated.

Did the Mental Health Problem or Substance Abuse Come First?

Is it the chicken or the egg conundrum? The particular mental health problems that keep getting mentioned are anxiety disorders, depression and bipolar disorder; this is simply because they are the ones that most commonly co-occur with substance abuse. A tendency toward addiction is not unusual in people with mental health problems, but it’s good to remember that even though they may be linked, one does not directly cause the other.

For instance, someone who is already feeling mildly depressed may turn to alcohol for comfort. On the other hand, those with tendencies for depression may already become addicted to alcohol, and thus fuel the symptoms of depression because of this.

Recognizing and Admitting You Have a Dual Diagnosis

Sometimes it’s not easy to recognize a substance abuse problem and a co-occurring mental health disorder. Denial, which is common in cases of substance abuse, can often complicate the issue, and few people want to readily admit their dependence.

Denial also isn’t absent in cases of mental disorders, as symptoms of anxiety or depression can be disconcerting and even frightening; when coupled with feeling of shame, the head-in-the-sand syndrome can set in.

Unfortunately, simply ignoring substance abuse and mental health issues doesn’t make them disappear or even improve; in fact, they may even worsen. Openly admitting that the signs of a dual diagnosis exist and are creating barriers to a healthy and fulfilling life is the vital first step towards overcoming the problem.

What Can You Do about Co-occurring Disorders?

dual diagnosisSome mental issues may carry with them some genetic components, and it is crucial that you are aware of possible risks and triggers that may exist in your family. It helps to be aware of your family history and that includes the genetic mental disorders that may run in the family.

Knowledge of substance use and abuse symptoms would also be very helpful, especially for those who are want to prevent getting the addiction very early. Think of it more as prevention rather than a cure, especially if you can see a trend in the family or if you are in an environment where the triggers and risks are heightened.

Group support can be very helpful, both for maintaining sobriety and providing a safe environment to talk about challenges. Some dual diagnosis treatment programs even provide groups that keep meeting on an aftercare basis.

An integrated approach is the best one, where both problems are treated at the same time. In other words, regardless of whether your mental health or substance abuse problem came first, successful recovery depends on properly diagnosing and treating them both.

Make sure that any program you undertake uses well researched treatment methods and also provides an aftercare program to help with relapse prevention. And very importantly, the program must have experience with your specific mental health issue. With the right skilled treatment and support, coupled with your personal commitment, the hurdles of a dual diagnosis can be overcome.


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