Dual diagnosis treatment brings the most successful aspects and methods of treatment from both mental health treatment and substance abuse treatment. Before dual diagnosis, there was mental health treatment and substance abuse treatment. Over time, experts and medical professionals have successfully blended those two together to make dual diagnosis treatment.
What is Dual Diagnosis?
Dual diagnosis is defined as “the condition of suffering from a mental illness and a comorbid substance abuse problem” at the same time. As a relatively new method of treatment, dual diagnosis treatment has been crucial in helping those with disorders or disabilities. Until the 1990s, those who suffered from mental health disorders such as depression, anxiety, delusion, or mood swings, went through entirely different treatment than those who suffered from substance abuse.
When drug addiction and mental health disorders overlap, treatment centers used to deny most clients from enrolling in mental health treatment until they were sober. Eventually, this was seen as counterproductive because many cases of drug addiction were fueled by underlying psychiatric disorders. Thus, those with a dual diagnosis of substance abuse and mental health disorders rarely got the proper treatment they need.
If you or someone you know meets the criteria for being diagnosed with a mental health disorder, from depression to bipolar disorder or schizophrenia, as well as an addictive disorder, a dual diagnosis would be the most effective and beneficial course of action. Dual diagnosis treatment can benefit both your mental health diagnosis and substance use disorder. There are little to no downsides of seeking dual diagnosis treatment as long as you meet the criteria.
Getting a Dual Diagnosis
To receive a dual diagnosis from a medical physician, you must meet specific criteria for a mental health disorder, which is defined by the most recent version of The Diagnostic and Statistical Manual of Mental Disorders. The American Psychiatric Association, who published the guideline, helps mental health professionals determine, diagnose, and treat individuals in a variety of clinical settings.
Only a psychiatrist, psychologist, physician, or counselor can provide someone with a dual diagnosis, and if you have a mental health disorder in conjunction with substance use or behavioral use disorder.
A dual diagnosis often comes as a relief to those who have lived with undiagnosed mental illness for extended periods. If you’ve experienced severe mood swings, episodes of hopelessness and sadness, suicidal thoughts, flashbacks to traumatic events, hallucinations, a diagnosis for this condition can help someone achieve a sense of hope. If the condition is named, it means that it can be treated.
Many individuals have suffered in silence for years, never understanding their urge to use drugs. Drugs often numb the intense sensations they feel inside, and it allows them to function normally.
Unfortunately, this risky behavior can cause sexually transmitted diseases, sharing needles, or behavior that can risk their livelihood long-term. Once treatment has finally been sought, and the condition is diagnosed, the healing process can start.
Because of the complications of mental health disorders and substance abuse disorders interacting with each other, the symptoms of dual diagnosis can vary greatly. To aid in dual diagnosis, many medical experts use evidence-based screening tools to detect whether or not someone may be dually diagnosed.
The drug-addiction-related symptoms include the following:
- Withdrawal from family and friends
- Uninterest in previously exciting activities
- Showing withdrawal symptoms (shaking, sweating, insomnia, agitation, etc.)
- Lack of control over substance intake
- In the case of prescription drugs, doctor shopping (going to multiple doctors for multiple diagnoses and thus multiple prescriptions)
Because dual diagnosis encompasses all mental health disorders, it would be too long of a list to name all of the symptoms of all mental health disorders. However, many mental disorders have common symptoms, including:
- Short temper
Though the different methods used to treat those that are dually diagnosed, the general process of treatment programs usually follows the same path. A client will start with medical detox, then go through either an inpatient or outpatient program, then finish with aftercare and relapse prevention.
As the first obstacle in drug treatment, detoxification may pose a challenge to those that have been dually diagnosed. Though outpatient detox and inpatient detox both can be used to clean the body of any residue or toxins from past addiction, inpatient detox is most effective in preventing relapse because the patient will be supervised and attended to 24-7 by medical experts.
A detox may include the tapering off of the previously addicted substance or substitute medications to ease a client out of addiction into full sobriety. Not only are medications effective, safer substitutes for previously addicted substances, but certain medications such as benzodiazepines are very useful in helping to treat the withdrawal symptoms associated with detox.
After detox, a patient that has received a dual diagnosis will either be admitted into an outpatient or an inpatient treatment program. Both are effective in treating dual diagnosis, and whether or not someone gets admitted into outpatient or inpatient depends on the severity of their dual diagnosis.
Outpatient treatment is tailored towards those who require treatment but have stable living conditions at home.
Only visiting the center a few times a week, for between three to nine hours each session, The patient in an outpatient program visits the center a few times per week between three to nine hours each session. They also have the ability to maintain their social life and other out-of-treatment responsibilities such as work, school, and family.
If not admitted into an outpatient program, the client with dual diagnosis will benefit significantly from inpatient treatment programs. In this case, the client will be provided 24-7 medical and mental health care similar to that of detox. The individual will experience different methods such as therapy (both group and individual), medication, and support groups to best combat their dual diagnosis.
Residential treatment falls under inpatient treatment, as both include the client living and participating in treatment on-site. The main difference between residential and inpatient treatment is that residential treatment programs grant much more freedom and responsibility than regular, intensive inpatient programs do. Clients will not be monitored 24-7 but will have access to the same resources that inpatients do.
Aftercare and Relapse Prevention
Just as important as detox, aftercare is essential in ensuring that a recent graduate will continue to stay sober outside of treatment. Failure in doing so is referred to as “relapse,” and it is common. Relapsing helps to understand the roots of mental health disorders and addiction. It very often leads to the building of another addiction. Relapse prevention and education can be useful.
Self-help and support groups are very effective in dealing with dual diagnosis and dual diagnosis aftercare. The 12-step groups and outpatient programs have been shown as effective in relapse prevention and being around other alumni that have suffered addiction and mental health disorders as you have may easily give you the support you need to stay sober.
Types of Dual Diagnosis Therapy Techniques
When it comes to addiction treatment, there are many different methods and techniques that are used. While some may be effective in certain cases, and some may not be as effective, there are a few that are especially effective in dual diagnosis treatment. Every professional, high-quality treatment center will create a recovery plan for you specifically, but there are a few types of therapies you will most likely encounter.
Cognitive Behavioral Therapy
As one of the most popular methods in addiction treatment, cognitive behavioral therapy (CBT) proves time and again to be very useful in combating substance abuse. CBT teaches clients how to make better life choices and other decision-making techniques. This type of therapy is exceptional in treating dual diagnosed clients. Participants in CBT have a more active, hands-on experience in therapy are involved than other addiction treatment methods that prefer a more passive approach.
Because it involves the client so extensively, CBT provides an entirely new way to experience recovery. Tasks like homework are great for those that require around-the-clock attention for their addiction, and CBT provides that and more.
Patients enrolled in cognitive behavioral therapy explore their mental health disorders in detail. CBT involves a professional asking questions pertaining to the mental health disorder, such as why the client may act or feel a certain way in a particular situation. In answering these questions, the client subliminally begins to develop a more thought-out, rational point of view of their mental health disorder.
Alternative therapies are less-intensive activities, the goal of which is to reduce stress levels and generally make recovery easier on the client. Stress plays a large role in determining the success of recovery, so decreasing stress levels of clients is always a priority. If a client is uncomfortable in recovery, it should be brought to their case manager’s or the treatment center management’s attention.
Common stress-reducing alternative therapies include:
- Guided Imagery
- Breathing Exercises
- Progressive Relaxation
To use these methods effectively, it is vital to learn these techniques from trained individuals. If done incorrectly, these methods may even increase stress and be counterproductive to a patient’s recovery process. Always make sure you are supervised by a professional when you start these techniques until you are able to engage in them by yourself.