Dual Diagnosis

May 10, 2024

By: Emily DeWalt, Prevention Specialist

From the beginning of the COVID-19 pandemic to today, we have seen a significant rise of mental illness in the United States. This is understandable due to the devastating effects of the pandemic, such as job loss, isolation during quarantine, or the death of a loved one. Now that we are a couple of years past the pandemic’s worst moments, we are still seeing the prevalence of mental health disorders stay just as high. Not only have we seen the rise in this public health issue, we’ve seen substance use disorders follow a similar pattern. Mental illness and substance use disorders often influence each other, and many people are diagnosed with both.

This is what’s known as a dual diagnosis, and it can be challenging to recover from for a multitude of reasons. By trying to understand dual diagnoses we can get a better idea of how to treat it in all its complexity. Furthermore, taking the time to learn the ways in which a dual diagnosis can be a vicious cycle will allow us to be more empathetic to those experiencing them.

A dual diagnosis involves someone having both a mental illness and substance use disorder. It falls under a category of conditions called a comorbidity, which is also known as co-occurring disorders. We often see people with a dual diagnosis due to the nature of these disorders, and how they can effect each other. Dual diagnoses are seen most often in those with serious mental illness and teenagers.

Researchers believe there are three possible reasons mental illness and substance use disorders often occur together. First, both disorders have common risk factors such as genetic predisposition, trauma, stress. Another reason may be the fact that many people with mental illness try to cope or self-medicate with drugs or alcohol to manage their symptoms. Research also suggests that mental illness can alter brain chemistry and structure that could make those diagnosed more susceptible to addiction. Conversely, addiction due to substance use can lead into mental illness, also because drugs alter the brain in ways that cause mental health issues. Although these possible reasons for dual diagnosis are notably different, it is possible for all three of these to be true.

Having both a mental illness and substance disorder make it challenging to treat one condition due to the presence of the other. Because the conditions are often so interconnected, it is better to treat both at the same time versus separately.

A dual diagnosis is often treated with behavioral therapy techniques, such as cognitive behavioral therapy (CBT) or assertive community treatment (ACT).

Medication can also help in the recovery process for someone with a dual diagnosis. These may include buprenorphine, which is used for an opioid disorder or  naltrexone for an addiction to alcohol. It is common for treatment for a dual diagnosis to include both behavioral therapy and medication.

It is widely known that recovering from addiction is difficult, and it is even more difficult if you also experience mental illness. It is hard to determine just how many people have co-occurring mental illness and a substance use disorder because so many symptoms overlap. Based on what we know about the rise of mental illness and rise substance use disorders in recent years, we can infer that a significant portion of those affected have a dual diagnosis based on what we know about how the two influence each other. It is important to recognize that although using drugs to cope with a mental illness may not be the healthiest choice, some people do not have the access to recovery services to get better. It’s important to show compassion to those struggling with addiction or mental illness. Circumstances beyond their control may have played a major role in their diagnoses, and it is unfair to assume that their challenges are completely their fault. If more people were to buy into this mentality, perhaps the stigma around mental illness and substance use disorders can be a thing of the past.

Thanks for reading. Please stick around for next week’s blog!

Sources

1.      MedlinePlus (2023). Dual Diagnosis. Last viewed May 10, 2024. Available at: https://medlineplus.gov/dualdiagnosis.html#:~:text=If%20you%20have%20a%20dual,disorders%20at%20the%20same%20time

2.      National Alliance on Mental Illness (2024). Mental Health Awareness Month. Last viewed May 10, 2024. Available at: https://www.nami.org/get-involved/awareness-events/mental-health-awareness-month/#graphics

3.      National Institute of Mental Health (2024). Substance Use and Co-Occurring Mental Disorders. Last viewed May 10, 2024. Available at: https://www.nimh.nih.gov/health/topics/substance-use-and-mental-health

Images

1.      Addiction Rehab Toronto (2019). Man drinking with numerous bottles. Last viewed May 10, 2024. Available at: https://addictionrehabtoronto.ca/depression-related-alcohol-abuse/

2.      Journey Pure (2021). Dual diagnosis Venn diagram. Last viewed May 10, 2024. Available at: https://journeypure.com/ask-our-doctors/addiction-recovery/what-is-dual-diagnosis/