What is Dual Diagnosis?

When you suffer from a mental health problem and a substance abuse problem, it is called a dual diagnosis (or co-occurring disorder). It is hard enough to deal with an addiction to alcohol or other substances. This difficulty is multiplied when coupled with a mental health disorder. Don’t despair, there is hope! There are treatments and various other things you can do to help you overcome this dual diagnosis and get your life back on track!

In a dual diagnosis situation, the mental health problem and substance addiction have different symptoms. These symptoms are closely linked and can get in the way of your ability to function. Additionally, these disorders affect each other – if one goes untreated, the other will also worsen.

It is common for people with mental health issues to suffer from addiction, and these disorders are closely linked. It is important to note that one does not directly cause the other.

• Drugs and alcohol are often used to self-medicate symptoms of anxiety or depression. Sadly, this substance abuse has long term side effects that intensify the very symptoms they temporarily alleviate.
• Drugs and alcohol increase the underlying risk of mental disorders. Mental problems arise from a combination of genes, environment, and various other factors. If a person is already at risk of a mental disorder, a substance addiction may be the final straw.
• Drugs and alcohol can magnify mental health problems. Also, a substance abuse can interfere with medications like antidepressants, anti-anxiety pills, and mood stabilizers; and make them less effective.

“37 percent of alcohol abusers and 53 percent of drug abusers also have at least one serious mental illness” – National Alliance on Mental Illness

If you have a dual diagnosis, it can be difficult to suss out which is the mental issue, and which is the substance issue. Because of these difficulties, you may not realize right away that you are suffering from a co-occurring diagnosis.

Denial is one thing that complicates the issue. In instances of substance abuse, it can be very difficult to admit dependency on the substances. In situations where a mental disorder is present, denial causes the person to ignore the symptoms and hope they go away. It is important to remember that drug addictions and mental issues do not just disappear. If left alone, they are liable to get much worse. Accepting your situation and getting help is the first step is reclaiming your life.

Things to consider:

• Family History: are there others in your family who have struggled with a mental disorder or drug addiction? If so, you are at a higher risk of developing problems like these.
• Sensitivity to Substances: Are you easily affected by drugs or alcohol? Have you noticed any correlation between your mental health and your use of drugs or alcohol? For example, does drinking make you depressed?
• What are you like sober?: It is normal to experience anxiety or depression when you are coming off a substance. However, if these symptoms persist, you may be facing a mental disorder.
• Do you have a history of treatment?: Have you been previously treated for a mental health disorder, or substance abuse issue? Did any of your mental health treatments fail because of and interference with your substance abuse, or vice versa?

Signs of a substance abuse:

• Do you ever feel like you should cut back on drinking or using?
• Have you ever attempted to quit and failed?
• Are you deceitful about how much your drink or use?
• Have people close to you expressed concern over your drinking and using habits?
• Do these habits ever make you feel ashamed or guilty?
• Do you often say and do things you later regret, while under the influence?
• Do you find yourself blacking out from drugs or alcohol?
• Have your using and drinking habits affected your relationships?
• Have your using and drinking habits gotten you in trouble with the law or employers?

The most common co-occurring disorders are depression, bipolar disorder, and anxiety disorders

Signs of depression:

• Feeling helpless.
• Feeling hopeless.
• Disinterested with daily activities, or activities that were once enjoyed.
• Changes in appetite or weight.
• Changes in sleep habits.
• Energy Loss.
• Intense feelings of guilt and worthlessness.
• Problems concentrating.
• Anger, pain, and brash behavior. (most prevalent in men)

Signs of bipolar disorder:

• Alternating feelings of intense happiness and irritability.
• Ambitious and impossible beliefs.
• Less need for sleep.
• Accelerated speech and thoughts.
• Increased impulsivity.
• Sudden outbursts of anger.

Signs of Anxiety:

• Extreme worrying.
• Feeling tense and irritable.
• Shortness of breath.
• Racing heart.
• Shaking, dizziness, or nausea.
• Difficulty concentrating or sleeping.

Getting yourself sober is only the beginning of your journey. Maintaining it, and staying on your path of recovery depends on you continually choosing to make different and better choices.

Identify and manage overwhelming emotions and stress. You need to learn to manage your stress. Stress is inevitable, which makes it even more important that you have appropriate coping mechanisms.

Here are 5 ways to help you cope with a dual diagnosis

1. Know your Triggers. If you are struggling with a mental illness, it is important for you to be able to recognize when your illness is flaring up. When this happens, have a plan in place to help you prevent a relapse into substance abuse.
2. Stay connected. Make sure you make regular face-to-face interaction with people you love a priority. Having positive emotional connections is crucial in helping you feel better. Another good solution is a support group. Having people around you who understand what you are going through – and can help you – increase your chances of maintaining sobriety.
3. Take your doctor’s advice. A dual diagnosis may be something you struggle with your entire life, so it is important that during the good times you continue to follow your doctor’s orders. Always consult your doctor before adjusting your medications or treatment plans.
4. Exercise and eat well. Exercise is a natural way to combat stress. Proper nutrition will help you maintain proper blood sugars, which will keep your mood in check.
5. Practice relaxation, and proper sleep habits. Meditation and deep breathing have been proven to help the body and the mind unwind. It can increase feelings of emotional well-being. As well, getting a proper amount of sleep helps to combat symptoms of depression, anxiety, and stress.

It is important that you treat not just the substance abuse, but also the mental health issue. It doesn’t matter which one appeared first. Your best chance for recovery lies in a combined treatment that treats both problems within the same team. If you relapse, don’t get discouraged. Relapses happen and are a normal part of recovery. It may take some time and it will take a lot of commitment, but there is hope!

When looking for a treatment program, ensue that it is properly licensed and accredited. Make sure their treatment methods are research backed, and they have a program for aftercare (to help prevent relapse). Also, ensure the program is equipped to deal with your particular mental disorder (don’t wind up in a program for depression when you have bipolar disorder).

For effective treatment, make sure both issues are being addressed (both the substance abuse, and the mental illness). Make sure your doctor includes you and shares with you the decision-making process. Make sure your doctor is educating you, so you can help yourself too. An effective doctor will teach you healthy and appropriate coping mechanisms and strategies that will help prevent relapse.