Dual Diagnosis

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Dual diagnosis happens when someone has an addiction and a coexisting mental health condition, like depression, anxiety, bipolar disorder, or Post Traumatic Stress Disorder (PTSD). It’s important to address both the addiction and the mental health condition – but often, only the addiction is treated. Accurately diagnosing dual diagnosis can be the key to lasting recovery – that’s why it should be treated from the start. In this article we’ll talk about dual diagnosis, what it is, how it’s treated, and how proper diagnosis can help a person recover.

What is Dual Diagnosis?

Dual diagnosis is common for those with a diagnosed Substance Use Disorder (SUD). It happens when someone has SUD and another cooccurring mental health or behavioral condition. If someone with a dual diagnosis is approached properly, they can successfully navigate their recovery and life in general. When the mental health or behavioral diagnosis is left without proper diagnosis and action, often addiction reoccurs. An integrated treatment plan will address both disorders and help the dual diagnosis patient recognize their coexisting disorder and how they can go on in life. Almost half of all people with SUD also have a dual diagnosis.

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Common Co Occurring Mental Health Disorders

Some disorders are seen often in people with addiction issues. Many times, the underlying cause of addiction is an undiagnosed mental health condition. It’s estimated that nearly half of all people with SUD also have a cooccuring mental health diagnosis. 

  • Borderline Personality Disorder (BPD) is a common disorder for those with dual diagnosis. In fact, it is estimated that two-thirds of those with BPD have or will abuse substances during their lifetime. 
  • Bipolar Disorder is another common disorder with dual diagnosis. It’s estimated that half of all people with bipolar have an issue with substances. 
  • Attention Deficit Disorder (ADD) and Attention Deficit Hyperactivity Disorder (ADHD) are often seen in people with a dual diagnosis. The disorder is often made worse when stimulants are prescribed due to the fact that they are extremely habit forming. This starts a cycle of drug abuse in the user and ends only when the person is properly diagnosed. 
  • Anxiety disorders often lead to substance use disorders. That’s because people look to self medicate when their symptoms get out of hand. A person with anxiety may become addicted to Benzodiazepines that they’ve been prescribed from a doctor or they may become addicted to opiates – either is common. 
  • Depression is commonly seen in those with dual diagnosis. Drugs come in as a way for a person suffering from depression to self medicate. For a time, the person with depression may feel happy – even euphoric – but those feelings are only pumped up by the drug they’re taking. 
  • Schizophrenia is marked by intense hallucinations and delusional thinking, which can make diagnosis difficult, depending on the drugs the person has been taking. If they’re taking Methamphetamine for example, hallucinations are associated with taking the drug. This can lead to issues with proper diagnosis because the symptoms of the drug and the symptoms of the disorder mimic one another. As with any dual diagnosis, the person is looking to medicate their condition.
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What are the Dangers of Self-Medication?

When discussing dual diagnosis, one of the biggest issues is self-medicating. Self-medication is when a person takes drugs or alcohol to manage the symptoms of their mental illness. At first, self-medicating may help. The person may feel their symptoms less. They may even think they’ve been cured. Addiction always spirals out of control in the end. Substance abuse will turn into tolerance, dependence, and finally addiction. Using substances as a coping mechanism can even make the mental illness worse. This happens when symptoms get exacerbated by the substances. Here are a few examples of how self-medicating works.

  • A person with Generalized Anxiety Disorder (GAD) drinks alcohol in order to feel comfortable in social situations. The next day they feel even more anxious about how they behaved the night before.  
  • A person with Generalized Anxiety Disorder (GAD) takes Benzodiazepines (like Xanax, Valium, or Klonopin) to feel calm, but winds up self-medicating outside of their prescription. Now they’re taking too much of the drug and they’ve now exposed themselves to the possibility of a panic attack. 
  • A person with PTSD smokes marijuanna in order to heal the emotional pain of the trauma they’ve experienced. In the end, they don’t deal with their pain at all – they’re just masking it with a substance. 
  • A person with ADD or ADHD takes cocaine in order to concentrate on tasks. Soon they feel out of control all of the time. 
  • A person with Bipolar takes opiates in order to manage the symptoms of a manic episode. Soon the symptoms of their disorder become even more apparent.
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In Conclusion

Dual diagnosis occurs when someone has a Substance Use Disorder (SUD) and another mental health condition at the same time. Some common coexisting conditions include depression, anxiety, bipolar disorder, and PTSD. A tailored treatment plan can help those with dual diagnosis. The only way to effectively manage dual diagnosis is to recognize the coexisting conditions.

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