Dual Diagnosis
The term dual diagnosis is given to an individual who has both a mental disorder and an alcohol or drug problem. These conditions occur together frequently. Trying to manage just one of these problems can be extremely stressful. It can be extremely difficult to diagnose a client with a co-occurring disorder and substance abuse problem. This is because the mix of multiple symptoms overlaps and ultimately makes a diagnosis very complex. Both diagnosises must be treated simultaneously because the cumulative effect influences all aspects of the individual’s life and greatly increases their risk for relapse.
The first step in treating a dual diagnosed client is to rid the body of non-prescribed drugs and alcohol. Though the detoxification process has been completed, there are always lingering effects of withdrawal remaining. Some of these are sweats, continued diarrhea, shakes or tremors, nausea, sleeplessness, and irritability. These lingering effects can mimic a few of the mental health disorders including anxiety and depression.
In deciding which comes first, the emotional issues or the substance abuse problems, often the psychiatric problem occurs first. Trying to feel better the individual self-medicates with alcohol or drugs leading to addiction. In other cases, the alcoholism or drug dependency is the primary condition which over time can lead to depression, anxiety, or more severe emotional problems.
Statistics on dual-diagnosis indicate:
- Fifty-three percent of drug abusers and thirty-seven percent of alcohol abusers have a least one serious mental illness
- Roughly 50% of individuals with severe mental disorders are affected by substance abuse
- Twenty-nine percent of all people diagnosed as mentally ill abuse either alcohol or drugs
- Sixteen percent of jail and prison inmates are estimated to have severe mental and substance abuse disorders
Dual diagnosis can be difficult to identify because the symptoms of one disorder often mimic the symptoms of the other disorder. Many of the symptoms of drug abuse, such as extreme anxiety, depression, paranoia, delusions, and hallucinations are similar to symptoms of mental illness.
Treatment for Dual Diagnosis
People struggling with mental illness and chemical dependency have unique problems that need to be addressed simultaneously. Mental health services on the whole are not well prepared to deal with people who have both afflictions. Often only one of the two problems is identified. This in turn only causes the client more problems with fragmented and uncoordinated services creating gaps in treatment. In addition to standard therapy and medication management our program uses a treatment team approach combining board certified psychiatrists and experienced mental health/substance abuse therapists as the optimal way to treat clients. We also provide recreational activities and life skills training to greatly improve activities of daily living which in turn provide opportunities to socialize in a sober, healthy environment. When a multiple team approach is used, the chances for recovery greatly improve. Thus families and those suffering from co-occurring disorders receive hope and optimism.
Challenges to Treating Dual Diagnosis
Some clients identified as dual diagnosed have difficulty developing social relationships. Those in sobriety find themselves more easily accepted by groups whose social activity is based on drug use. An identity based on drug addiction/alcoholism is sometimes more acceptable than one based on mental illness. Environmental factors come into play when as a consequence of their mental illness they may find themselves living in marginal neighborhoods where drugs are easily accessible, increasing the risk for relapse. In still other cases, dual diagnosed clients are non compliant with their medications due to certain side effects, or just tired of taking medication. Clients who are manic-depressive sometimes enjoy the manic phase of their illness and again, stop taking their medication.
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