Understanding and Overcoming Dual Diagnosis

Posted on January 8th, 2015

When you have a problem with drugs or alcohol and you also have a problem with mental illness such as depression, bipolar disorder or anxiety, you have a dual diagnosis. Recovering from substance abuse can be challenging, and it is even more challenging for people that have a dual diagnosis. The fact that treatment may be difficult doesn’t mean that it is impossible. People with dual diagnosis do successfully recover from substance abuse and, with proper treatment, they can also bring their mental health problems under control.

Turning to substance abuse when you have mental health problems is pretty common. If you experience depression or anxiety, or if you’ve been diagnosed with schizophrenia, bipolar disorder, post-traumatic stress disorder or other mental health problems, you may turn to alcohol or other drugs when you are feeling mentally uncomfortable.

Drugs and alcohol are a way for a person with untreated or incorrectly treated mental illness to self-medicate. The problem is that mind-altering chemicals can worsen the symptoms of mental health problems. For example, a depressed person who turns to alcohol will probably feel even more hopeless and unhappy. A person with bipolar disorder who turns to cocaine will exaggerate manic episodes.

Some people who have never suffered from mental illness develop symptoms of mental health problems after they begin to abuse drugs. Some substances may trigger problems with paranoia or hearing voices, while others can cause depression, agitation or anxiety.

If you are under any kind of treatment for mental illness, abusing drugs or alcohol is most likely going to do more harm than good. Mixing alcohol or street drugs with prescriptions will render the prescription medications ineffective, and will make it extremely difficult for your doctor to be able to properly treat your depression or anxiety. If you are abusing substances while you are being treated for mental health conditions, you are at increased risk of impulsive behavior, violence or suicide attempts.

Treating Dual Diagnosis

Recovering from dual diagnosis can be challenging, because both addiction and the mental health issue have their own symptoms that cause problems with your ability to relate to others and to function in day-to-day living. Each disorder interacts with and affects the other. Untreated mental health disorders typically cause an increase in substance abuse, but untreated substance abuse usually causes symptoms of mental illness to get worse.

One of the biggest problems a person with dual diagnosis has is denial. You may try to pretend that you really don’t have a problem with alcohol or drugs. You may also try to pretend that your problems with depression or anxiety will go away if you ignore them. These types of problems won’t go away. They will probably get worse.

Should Substance Abuse or Mental Health Problems Be Treated First?

The best treatment approach for dual diagnosis is to treat both problems simultaneously. Full recovery depends on receiving adequate care for both problems. Inpatient detoxification is often the first step because withdrawal from many substances can be traumatic and even life threatening. But this is only the beginning. You may want to stay in residential treatment facility for a period of time, or move from there to a sober house.

The recovery process will involve many different ongoing approaches to treatment. Your recovery plan will probably include several of the following:

  • Support groups, such as Alcoholics Anonymous or Narcotics Anonymous
  • Specialized support if needed, such as grief support or veterans groups
  • Counseling, both individual and family
  • Behavior therapy
  • Medication management

When you have been told you have a dual diagnosis, it’s important for you to learn to manage stress. Lifestyle changes such as eating healthy foods and becoming physically active may help improve both mental health problems and addiction problems. Learning coping skills such as meditation and relaxation techniques can replace the urge to self-medicate.

Recovering from dual diagnosis will require you to remain committed to getting well. You will need to be completely honest with your doctor and with yourself. Let your doctor know what’s working and what’s not, and follow your doctor’s treatment plan. Although overcoming dual diagnosis is more challenging than recovering from a single problem, it is possible to recover.

By:  Valerie Dansereau

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