When someone has a dual diagnosis, it means the person suffers from a substance use disorder and a mental health disorder at the same time. Individuals who have a dual diagnosis must attend dual diagnosis rehab.
Examples of dual diagnoses include:
Some individuals who suffer from dual diagnoses first acquire substance use problems that then trigger mental health issues. Others first acquire mental health disorders that later trigger the desire to abuse substances.
In either case, when entering treatment, both disorders within a dual diagnosis must be treated at the same time for a successful recovery. Otherwise, the untreated disorder will trigger the reappearance of the treated disorder.
A substance use disorder (SUD), also known as an alcohol use disorder (AUD) or a drug use disorder (DUD), occurs when:
Continuing to use drugs or alcohol after experiencing these signs of a substance use disorder can lead to negative consequences.
SUDs range in severity from mild to severe. People with SUDs can also simultaneously suffer from a wide range of mental health issues.
The National Survey on Drug Use and Health reported that in 2018, more than 9 million Americans struggled with both a substance use disorder and mental illness.
The same study also looked at Americans with AMI (any mental illness), SMI (serious mental illness), and no mental illness and compared each group’s illicit drug use. The dual diagnosis study found that:
The dual diagnosis study also looked at alcohol use and mental illness and reported that:
These statistics from the dual diagnosis study show whether people with AMI or SMI are more likely to abuse drugs or alcohol. Of all the people diagnosed as mentally ill, 29% abused either drugs or alcohol. The type of mental health issues in a dual diagnosis can vary from person to person.
Anger is a primal emotion for humans. When someone is offended or experiences injustice or feels a need to protect something, anger can be quite useful. When anger is appropriately expressed, it can help reveal bothersome issues. After the issue is revealed, anger opens the door to solutions. Once those solutions are introduced, anger should fade.
The problem for some, is that anger is often not expressed appropriately, and thus never fades away. As a result, long after an offense or injustice has occurred, anger lingers.
Sometimes the incident that triggered the emotion of anger happened months or years ago, but the anger remains fresh. As a result, any new issues can cause a quick, intense, and overwhelming response. This shows that the anger never goes away. Instead, it operates at low-levels, causing bitterness in daily life.
Individuals with a dual diagnosis that involves anger are often put in hazardous situations. This is especially true when people’s inhibitions are lowered due to substance use. Coupling people’s lack of control due to substance use with anger issues can lead to serious situations and consequences. Dual diagnosis rehab with an anger management program incorporated within it can help those with anger problems manage their behaviors while simultaneously undergoing drug or alcohol treatment.
Anxiety is a bodily reaction that’s characterized by feeling nervous, tense, apprehensive, and/or fearful. This bodily reaction is caused by a threat or danger that can be coming from the outside or within.
It’s natural to experience anxiety at times. But for some people, anxiety leads to the development of a full-fledged anxiety disorder. An anxiety disorder is a mental health disorder that causes people to frequently experience various symptoms of anxiety and panic attacks.
A commonly seen anxiety disorder is called Generalized Anxiety Disorder (GAD). People with GAD have high levels of anxiety, fear, or worry and might try to self-medicate. To be diagnosed with a general anxiety disorder, individuals must feel worried or anxious most days of the week for a minimum of six months. The focus of the worries may involve:
Fearfulness and anxiousness can lead to major problems socially at work and in school.
A panic attack is when a high level of discomfort or fear causes a sudden, serious physical reaction. Heart palpitations, trembling, sweating, hyperventilating, and tingling or numbness are all typical symptoms of panic attacks.
Mental reactions can also occur due to panic attacks. Some examples of such mental reactions include a fear or fainting, feeling out of the body, or a fear of or feeling nauseous. Some people feel like fainting, dying, or losing control.
Obsessive-compulsive disorder (OCD) and post-traumatic stress disorder (PTSD) are two specific types of anxiety disorders.
People with SUDs were found to be 1.8 times more likely to have a borderline personality disorder. Borderline personality disorder is a mental illness characterized by a repeated pattern of shifting moods, behaviors, and self-image. These patterns result in impulsive actions and relationship problems and an increase in the risk of a dual diagnosis. Signs of borderline personality disorder include:
People with borderline personality disorders can also experience the following:
People dealing with codependency suffer from feelings of emptiness. They may also experience isolation, self-alienation, and shame. For many who suffer from a dual diagnosis made of codependency and addiction, these issues come from growing up in a dysfunctional family. Some individuals who suffer from codependency turn to drugs or alcohol for temporary relief from feelings, but this only serves to distance long-term solutions further.
People with SUDs were found to be 1.3 times more likely to suffer a dual diagnosis with clinical depression. A CDC (Centers for Disease Control) survey that looked at the years 2009 to 2012 reported that:
Clinical depression is having moderate or severe depressive symptoms that last two weeks or more. Depression can trigger the desire to use drugs or alcohol to cope. This drug and alcohol use can then turn into a full-fledged substance addiction. Individuals that simultaneously suffer from depression and substance addiction contain a dual diagnosis disorder that requires dual diagnosis rehab for treatment.
When people experience these depression symptoms, they may self-medicate for relief. Seeking relief from depression for extended periods of time through substance use can lead to addiction and a dual diagnosis.
Reversely, when people take certain drugs or drink alcohol for long periods of time, the changes made in the brain and body from these substances can lead to the development of depression.
Unhealthy grief can cause individuals to choose to self-medicate themselves through the use of drugs and alcohol. Such drug and alcohol use can then develop into substance addiction and ultimately a dual diagnosis disorder. Different types of unhealthy grief that can put a person at risk for drug or alcohol misuse include:
People who do not deal with grief in healthy ways can get “stuck.” This can play a big part in how these individuals behave. Common behavioral addictions include process addictions to food, drugs, alcohol, etc.
To heal from unhealthy grief and addiction, dual diagnosis treatment. Dual diagnosis treatment is also needed to properly mourn sorrows and work through unhealthy grief while simultaneously treating substance use disorders.
People with impulse control disorders have a hard time controlling their impulses. It’s also difficult for people that suffer from impulse control disorders to overcome urges to harm themselves or others.
Lacking impulse control often leads to drug use and the eventual development of a dual diagnosis. Once individuals develop a dual diagnosis of impulse control disorder and addiction, they must attend dual diagnosis rehab to receive treatment.
Examples of impulse control disorders include:
It’s estimated that 50% of people with narcissistic personality disorder(NPD) have a dual diagnosis with some type of addiction. Symptoms of NPD include:
These symptoms cause extreme distress in a person’s life, family, job, and more. To get relief from all these forms of distress, people with NPD may drink or take drugs. Such substance use can lead to addiction and the development of a dual diagnosis disorder that requires dual diagnosis rehab to treat.
OCD is a type of anxiety disorder that causes individuals to experience repetitive unwanted and disturbing thoughts or images. These thoughts and images provoke anxious feelings. Some of these thoughts and images may even involve thoughts of causing harm or being overcome by germs.
OCD is characterized by excessive worry, along with performing repeated rituals and acts (compulsions) to relieve distress or stress. The compulsive acts brought on by OCD happen so frequently that they are inconvenient and often harmful.
Repetitive hand washing, as well as checking and rechecking things, are physical signs of OCD. Mental signs of OCD include silent counting and word repetition. When put together, OCD signs take up a lot of time and impair day-to-day functioning.
Like with other anxiety disorders, individuals who suffer from OCD may be compelled to self-medicate themselves with drugs and alcohol to control their symptoms. Abusing substances while suffering from a mental health disorder such as OCD though, can lead to the development of a dual diagnosis. The only way to effectively treat such a dual diagnosis is to attend dual diagnosis rehab.
People with SUD were found to be 1.6 times more likely to have PTSD. Post-traumatic stress disorder (PTSD) is a disorder that develops out of experiencing psychological trauma. Some examples of a trauma event can be the threat of death, an injury, or a sexual assault. The person that experiences a traumatic event often feels helpless, extreme fear, or deep shock when the event happens.
Afterward, if PTSD develops, the experience of living the traumatic event happens again and again. Thoughts and images related to the event pop up frequently. Nightmares, reliving the event in dreams, and sometimes hallucinations, occur.
People living with PTSD often deal with irritability, insomnia, a high level of vigilance, and an overdeveloped response when startled. People with PTSD will always try to avoid anything related to the event such as feelings, thoughts, or acts associated with the trauma event. As a result, the possibility of developing a dual diagnosis disorder made of PTSD and addiction to drugs or alcohol is increased by attempts to “medicate away” thoughts or feelings that are associated with past trauma.
Dual diagnosis treatment programs can either be outpatient or inpatient.
Outpatient treatment is any treatment program that allows patients to live in the comfort of their own homes in-between treatment sessions. Counseling sessions during outpatient treatment occur a few times (or more) a week. Counseling sessions during outpatient treatment can include individual counseling, group therapy meetings, and family therapy sessions.
Outpatient treatment suits people who have a mild to low-moderate dual diagnosis. Outpatient dual diagnosis rehab is a good choice for anyone who has less severe symptoms and needs time to meet work, school, or family obligations.
Inpatient treatment programs are treatment programs that require patients to live in a rehab facility during the period of time that they’re receiving care. Another term for inpatient treatment is residential treatment.
Residential treatment can last anywhere from several weeks to a month, to several months, or longer. Residential treatment involves one-on-one therapy sessions and group meetings.
Inpatient dual diagnosis rehab is best suited to people with mild-moderate to severe symptoms. Anyone with a high risk of relapse is also best suited for inpatient dual diagnosis rehab.
Inpatient dual diagnosis rehab occurs in a highly engaging, rigidly structured, and constantly monitored setting. Triggers and stressors are removed during inpatient forms of rehab to help support healing, growth, and recovery in a protected atmosphere.
There are different types of therapies that can help individuals with dual diagnoses recover. Since mental health disorders can both contribute to and result from drug or alcohol addiction, dual diagnosis treatment plans typically use a variety of therapy approaches. The following are some of the most common and effective types of therapies within a dual diagnosis program.
CBT is one of the most commonly found therapies in dual diagnosis rehab programs. Cognitive-behavioral therapy focuses on helping individuals learn how their thoughts can affect their feelings and behaviors. There is usually a limit to the number of CBT sessions needed during dual diagnosis drug rehab. Goals are agreed upon between the therapist and client early on within a dual diagnosis drug rehab program.
Cognitive behavioral therapy uses a hands-on, practical approach to problem-solving. CBT works by changing people’s attitudes and behaviors by focusing on thoughts, images, beliefs, and attitudes (cognitive processes). The focus of CBT is seeing how cognitive processes affect how a person behaves when dealing with emotional issues.
DBT is a specialized form of CBT. Dialectical behavior therapy builds upon the foundation of CBT to help make CBT more effective. DBT focuses on helping people accept their negative thoughts and emotions so that they can effectively change them.
Some people tend to react more intensely and inappropriately in certain emotional situations. Most of these out-of-the-ordinary reactions happen within family, friend, or romantic relationships. DBT works to bring down the intensity of a person’s reactions to situations through acceptance.
Medication-assisted treatment is an evidence-based method that’s a combination of traditional therapies and the use of medication. Medication helps individuals manage cravings and relieves detoxification symptoms. MAT is especially useful for those with opioid or alcohol use disorders as part of their dual diagnosis program.
REBT takes a close look at beliefs and if those beliefs are logical or actual. Beliefs can be either positive or negative. A negative belief may be useful, but if it is false, it’s called an irrational belief.
Irrational beliefs can make the person unhappy and malcontent. Irrational beliefs can block love, approval, comfort, and success. During dual diagnosis treatment, REBT works to question irrational beliefs. REBT uses a process to develop rational ones as replacements.
Motivational interviewing is a team effort between a therapist and patient to bring about change within the patient and to strengthen his or her motivation. A therapist guides conversations with patients to help them realize their own personal and genuine motivations for changing problematic behaviors caused by their dual diagnosis disorders. Motivational interviewing focuses on inspiring patients to create plans for moving forward to reach their goals.
MI is not a standalone therapy, but it is one way of inspiring change for people who have a hard time changing. MI is a 4-step process that works to:
Motivational Enhancement Therapy (MET) is meant to produce quick, internally motivated changes. MET is based on the principles of Motivational Interviewing (MI).
The motivation for how patients are currently living is examined during MET. Then, problem-solving and interpersonal skills are worked on. A MET therapist guides patients to see that they have problems. MET therapists do this by discovering the motivations behind how patients currently live. MET therapists also help patients discover the reasons behind the development of their dual diagnoses.
An integrated dual diagnosis program will treat the whole person. This includes the physical, mental, emotional, and spiritual aspects of a person.
Treatment programs that treat the “whole” person are known as holistic treatment programs. Holistic treatment programs contain a blend of traditional therapies as well as alternative ones. Meditation and yoga are two popular and effective forms of alternative therapies.
Taking good care of one’s self means taking time to heal and grow. Meditation, or quiet time alone, is a healthy and healing form of self-care. Just 10 minutes of meditation each day can help create positive changes.
Meditation is also a good tool for fighting a relapse. It’s estimated that about 60% of people with SUDs relapse. Meditation can help a person form mindful responses to stresses and triggers to help avoid relapse. Yoga is also a great way to incorporate mindfulness while improving physical health when recovering from a dual diagnosis.
Is an inpatient dual diagnosis program right for you or a loved one? First, do some research to see as you make a list of your unique dual diagnosis program requirements.
Important factors you should consider when choosing a dual diagnosis drug rehab are:
Take the first step toward sobriety by contacting us at CNV Detox for dual diagnosis rehab. Talk with your doctor, mental health professional, and/or treatment center to see what dual diagnosis program options are best for you or someone you love. Getting sober is the first step towards gaining the healthy and renewed life you deserve.