What is Dual Diagnosis in Mental Health?

What is Dual Diagnosis

When a person has a substance abuse problem and also has accompanying mental health issues, this is known as a dual diagnosis. Also known as co-existing disorders, a person might find themselves chemically dependent on drugs or alcohol while also experiencing a disorder like depression, anxiety, or bipolar.

Addiction specialists need to discover all co-existing disorders to ensure a comprehensive dual diagnosis is reached. After complete identification, rehab programs need to treat all issues for successful recovery.

The National Alliance on Mental Illness reports:

• A third of people with mental illness and half of people living with severe mental illnesses also have substance abuse problems.
• A third of all alcohol abusers have been diagnosed with a co-existing mental illness.
• More than half of all drug abusers have been diagnosed with a co-existing mental illness.

Dual Diagnosis Signs & Symptoms

Since dual diagnosis is a mental health and substance abuse disorder occurring simultaneously, there are many combinations of disorders that exist. The symptoms of dual diagnosis vary widely. Some of the symptoms include:

• Isolation from friends and family
• Sudden behavioral changes
• Using substances under unsafe conditions
• Acting out risky behaviors while under the influence
• Loss of control over using substances
• Doing things out of character to obtain drugs or alcohol
• Developing tolerance to substances
• Relapsing on substances after treatment
• Legal problems
• Showing withdrawal symptoms from substances
• Feeling like drugs or alcohol are needed to function
• Extreme mood changes
• Confused thinking
• Concentration and memory problems
• Thoughts of suicide

Diagnosis of Co-Occurring Disorders

To properly diagnose dual disorders in a person, a professional performs an assessment that details the signs and symptoms being experienced. Since symptoms of substance abuse can mimic the signs of mental health disorders and vice versa, it might take a few days or weeks of observation before an accurate assessment can be made.

The following methods are used to evaluate and diagnose addiction and mental health disorders:

• Interviewing the client, family and friends about past and current psychiatric symptoms and substance use.
• Conducting lab tests to detect the presence and quantity of drugs or alcohol that are currently in the body.
• Holding a physical exam and/or lab tests to look for any physical problems that could cause psychiatric symptoms.
• Completing a checklist regarding alcohol or drug use, psychiatric history and health.

Treatment for Dual Diagnosis Disorders

Treatment for dual diagnosis is usually a program of medication, therapy and behavioral counseling. All disorders must be treated at the same time to be effective and to prevent relapse.

There are several treatments available for dual diagnosis: psychopharmacology, psychotherapy and behavioral therapy.

Psychopharmacology treats each disorder with prescription medications. Ongoing assessments are made to track the effectiveness of treatment of each disorder.

Psychotherapy uses counselors and therapists to help resolve mental or emotional problems by discussion. Root causes of substance abuse and trauma are uncovered and analyzed.

Behavioral therapy examines behaviors, focusing on the negative consequences and harmful effects. Positive behaviors are developed to avoid these negative consequences using improved judgements. Positive and negative reinforcements are used to foster better decisions.