For a long time, people experiencing the symptoms of mental health disorders where treated separately from those needing help with drug or alcohol abuse. Mental illnesses were sometimes ignored or those with overlapping conditions were frequently denied treatment for their psychiatric disorders until the substance abuse was under control.
This began to change in the 1990s with the advent of dual diagnosis treatment. This relatively new concept in addiction recovery involves recognizing that someone can experience mental illness and substance abuse simultaneously.
Determining the Dual Diagnosis
Although dual diagnosis is a broad category, there are two key factors involved in determining whether the diagnosis is warranted.
An individual must meet the criteria for mental illness as defined by the Diagnostic and Statistical Manual of Mental Disorders (DSM). The DSM is an official guideline for mental health professionals and is used for diagnosing and treating patients. A dual diagnosis also requires symptoms of drug or alcohol addiction or abuse.
In other words, someone experiencing a mental health condition could be using drugs to self-medicate, in an effort to improve their troubling mental health symptoms. On the other hand, if someone is abusing drugs, they could trigger or intensify an underlying mental health condition.
The diagnosis does not require identifying which of these issues developed first; it only requires that both be present.
Co-Occurring Symptoms and Dual Diagnosis
When both a mental health illness and a substance use disorder coexist, they are referred to as co-occurring disorders. People with mental health disorders are more likely to experience an alcohol or substance use disorder than are those without mental health disorders.
According to information from the Substance Abuse and Mental Health Services Administration and the National Alliance of Mental Illness, the frequency of co-occurring disorders is significant:
- Approximately 7.9 million adults had co-occurring disorders in 2014.
- About one third of people experiencing mental illnesses also experience substance abuse.
- About fifty percent of those living with severe mental illnesses also experience substance abuse.
- Men are more likely to develop co-occurring disorders than women.
- Military veterans, individuals with lower socioeconomic status and people with general medical illnesses have particularly high risk for co-occurring disorders.
Dual diagnosis is a relatively new approach for identifying and treating people with these co-occurring disorders. Unlike times in the past, where one set of symptoms may have been ignored or left untreated, individuals with co-occurring disorders can now receive integrated treatment.
With a dual diagnosis, practitioners can address mental and substance use disorders at the same time, creating better outcomes for their patients.
Benefits of Dual Diagnosis
Although there are numerous variables for treating someone with a dual diagnosis, it commonly involves an integrated intervention. In this treatment, the patient receives care for both the substance abuse and any identified mental illness.
Addiction often has to do with trauma, anxiety, depression and chemical imbalances in the brain. Those struggling with addiction frequently try to relieve their own pain through drugs or alcohol.
But if they have struggled with an undiagnosed mental illness, getting a dual diagnosis can bring great relief. Identifying a specific mental condition that may be contributing to the substance abuse can give a tremendous sense of hope and open new doors for effective treatment.
Mental disorders and addiction have multiple underlying causes, but dual diagnosis treatment deals with these simultaneously, enabling a full and lasting recovery.