Help For Co-Occurring Disorders

Dual diagnosis refers to the simultaneous occurrence of mental illness and one or several substance use disorders (SUDs). Dual diagnosis is, in itself, not a diagnosis but rather a combination of diagnoses.

Dual diagnosis may seem like it would be a rare occurrence—after all, what are the odds that a person would experience both a mental disorder and SUD?

With 21 million people in the U.S. experiencing a substance use disorder and 9.2 million living with a mental illness, dual diagnosis is not unusual. In fact, it’s much more common than most people think.

Sequoia Behavioral Health aims to clarify the uncertainty surrounding dual diagnosis so that those affected can have better treatment outcomes. 

What is Dual Diagnosis?

According to the National Alliance on Mental Health (NAMI), people with dual diagnoses have one or more substance use disorders while simultaneously dealing with one or more mental disorders. Because both diseases occur at the same time, dual diagnosis is also referred to as a co-occurring disorder (COD), dual disorder, or comorbidity.

With 21 million people in the U.S. experiencing a substance use disorder and 9.2 million living with a mental illness, dual diagnosis is not unusual.

Mental illnesses and addiction are both conditions that affect the brain. Because one disorder can influence the symptoms of another, dual diagnosis treatment requires specialized expertise in psychiatry and addiction.

Today we know that people with COD must be treated for their substance and mental health disorders simultaneously for recovery to be successful. Unfortunately, this wasn’t always the case. 

History of Dual Diagnosis and Co-Existing Disorders

Psychologists first identified dual diagnosis in the early 1980s. Before its identification, people who experienced mental health issues were treated independently from those requiring addiction treatment. 

There was a mistaken belief at the time that only a sober person could address their mental illness. Therefore, before the 1980s, addiction treatment occurred first. Once the individual was in recovery, a physician could finally address their mental health needs.

Physicians were not yet aware of the way that substance use and mental health amplify the symptoms of each other. 

For instance, a depressed person may utilize substances to cope with intense feelings of hopelessness. Likewise, a person with substance use disorder may become depressed due to functional changes in the brain related to drugs or alcohol. 

The addiction treatment community now understands that mental health and substance use disorders are interrelated and, therefore, must be addressed at the same time. 

Is There a Specific Combination of Disorders Required for Dual Diagnosis?

While there is no specific combination, some of the most common mental disorders affiliated with SUDs include:

• Anxiety and mood disorders
• Attention deficit hyperactivity disorder (ADHD)
• Bipolar disorder
• Conduct disorders
• Major depressive disorder (MDD)
• Post traumatic stress disorder (PTSD)
• Schizophrenia

People in treatment for mental disorders tend to also have history of misusing the following types of substances:

• Alcohol
• Hallucinogens
• Marijuana
• Prescription drugs (including benzodiazepines, opioids, and stimulants)
• Tobacco

Dual diagnosis may include any combination of SUDs and mental disorders identified in the DSM-5. 

Is Dual Diagnosis Treatable?

Misconceptions like “your depression is untreatable because you’re still drinking” is outdated and harmful. 

The best treatment for dual diagnosis is integrated intervention. This approach combines treatments for mental illnesses and substance use disorders. 

Those struggling with dual diagnosis should seek a treatment provider who understands how each condition affects the other. Sequoia believes that, while many treatment plans may share elements in common, each should be tailored to the individual. 

What Treatment Plans are Available for Dual Diagnosis?

Treatment for dual diagnoses often targets each disorder at the same time. While every treatment is specialized, many programs can help solve many problems at the same time.

Misconceptions like “your depression is untreatable because you’re still drinking” is outdated and harmful.

Detoxification

For the sake of client safety and sobriety, inpatient detoxification tends to be more effective than outpatient detoxification. During inpatient detox, trained medical staff monitor an individual for up to seven days. These professionals help alleviate withdrawal symptoms by administering tapering amounts of the substance or its medical alternative.

Inpatient Rehabilitation

Physicians recommend inpatient rehabilitation centers for those needing 24/7 medical and mental health care for mental illnesses and dependent patterns of substance use. 

Inpatient rehabilitation centers provide support, therapy, medication, and other health services to treat substance use disorders and their underlying causes. 

Medications 

Medications may help treat specific mental illnesses. Some medications can also help those with SUDs ease withdrawal symptoms during detox, or even reverse an overdose. Your physician or psychiatrist can recommend the best course of action.

Psychotherapy 

Psychotherapy makes up the majority of any effective dual diagnosis treatment plan. A common form of psychotherapy for co-occurring disorders is cognitive behavioral therapy (CBT). CBT teaches people how to cope and change ineffective thinking patterns, which helps decrease the risk of substance use. 

Supportive Housing

Group homes and sober living housing provide newly sober people with living environments that help avoid relapse. 

Unfortunately, sober living homes have been criticized for offering varying levels of quality care, as licensed professionals do not typically run them. Before selecting, ensure that the housing is licensed by the state and accredited by the National Alliance for Recovery Residences (NARR).

Support Groups

Dual diagnosis can feel isolating. Support groups allow members to both share challenges and frustrations and celebrate successes. They also provide a space for forming healthy friendships, greatly increasing a person’s chances of staying sober long-term.

Common support groups include:

• Alcoholics Anonymous  and/or Narcotics Anonymous: 12-step groups for people recovering from alcohol or drug addictions. If recovering from a dual diagnosis, you will need to find a group that also focuses on the role of mental health treatment in recovery.

• Double Trouble in Recovery: A 12-step faith-based fellowship for people managing co-occurring mental and substance disorders.

• Smart Recovery: LGTBQ+ friendly sobriety support groups for people with various addictions and mental health issues. 

How Can I Get Help for Dual Diagnosis?

Although underlying psychiatric mental health conditions often drive substance use and addiction, dual diagnosis treatment is still a relatively new treatment approach for addiction recovery. 

Sequoia offers evidence-based treatment for the successful recovery of co-occurring disorders. Our licensed treatment team is uniquely qualified for treating dual diagnosis conditions. Contact us today for a consultation.