Dual diagnosis occurs when an individual has both a mental health disorder and an addiction disorder. It is often difficult to distinguish between the two, as the symptoms and disorders themselves are so closely intertwined. For this reason, it is absolutely vital to seek professional help in diagnosing and treating any co-occurring disorders.
That being said, if an individual has been diagnosed with a mental health disorder and abuses alcohol, or drugs, or has any other addictive behaviors, then it is clear that these are co-occurring conditions that need to be addressed simultaneously.
Addictions can be present in the form of substance abuse or behavioral addictions such as sex, gambling, and shopping. The list of possible behavioral addictions is never-ending. Even behaviors that have health benefits, such as exercise, become extremely unhealthy when they become an addiction. It is important to know the signs that someone’s habit has gone too far.
When does a habit become an addiction?
A behavior or substance becomes an addiction when the user no longer has control over the behavior or substance. Dependence typically occurs because the individual is physically dependent on the substance or needs a coping mechanism to deal with a particular mental disorder.
In addition, particularly regarding substance abuse, signs that a habit has become an addiction include building tolerance and exhibiting withdrawal symptoms when the substance is not available or behavior is not allowed. Oftentimes, individuals and/or loved ones do not realize their habit has become an addiction until these withdrawal symptoms come up the first time the substance or behavior is not accessible, as is the case in treatment facilities.
What to look for
The symptoms of a dual diagnosis can include those associated with addictions and/or mental health disorders. Unfortunately, these are very broad and vary depending on the psychological disorder and preferred drug or behavior.
It is important to seek professional help from a therapist, doctor, or other mental health professionals upon questioning whether there are co-occurring conditions.
General signs of addiction include:
- Sudden changes in behavior
- Tolerance and withdrawal symptoms
- Using substances or doing behaviors in dangerous situations
- Doing uncharacteristic things to maintain the habit
- Feeling a need for the drug or behavior in order to function
General signs of mental health disorders:
- Extreme mood swings and/or changes
- Trouble concentrating
- Avoiding friends, family, and social situations (isolation)
- Suicidal ideation
Common signs of both substance abuse disorders and mental health disorders:
- Inability to maintain employment
- Inability to maintain functional relationships
- Legal problems
- Financial issues
- Inability to control emotions
It is clear how these symptoms can affect and enable each other. This is why dual diagnosis treatment is essential. Addressing one disorder can often exacerbate the symptoms of the other, so they need to be managed and treated together. Without addressing all of the contributing factors to a disorder, the effectiveness of the treatment decreases, and the chance of relapse increases.
All of the symptoms outlined above can greatly complicate the co-occurring disorders, resulting in symptomatic relapses, hospitalization, financial problems, social isolation, family problems, sexual and physical victimization, incarceration, and even early death.
Drug and alcohol effects on mental health
It is important to note that those with severe and/or disabling mental health disorders often have a lower threshold for alcohol and drugs, making them more susceptible to abuse and addiction. In other words, a lower amount of alcohol and drugs is needed to produce the same effect in others. The more severe the disorder, the lower the amount of the substance that is needed to be harmful.
If an individual has been diagnosed with a mental health disorder and does not abuse drugs or alcohol but still uses these substances on a regular basis, it is a significant factor in treatment for the disorder. Whether or not this usage meets the criteria for substance abuse, the effects that drugs and alcohol have on the brain will inhibit and alter the effects of treatment and prescribed medication. For this reason, it is essential to alert the treatment team of any drug usage, even if it is minimal.
Alternatively, addicts who believe they are not dependent on a particular substance of choice might not realize their habit has evolved into an addiction, or how their crutch for their mental health issues has become a disorder of its own. Regardless, the two issues need to be addressed together for treatment to be most effective.