DUAL DIAGNOSIS TREATMENT


Dual diagnosis treatment is the treatment of both addiction and/or alcoholism on the one hand, as well as a separate mental health disorder on the other hand. Addicts and alcoholics can suffer from any one of these disorders, and treating them is just as vital as treating addiction itself.

Addiction Recovery Network believes that co-occurring disorders such as bipolar disorder, depression, anxiety, and personality disorders must be treated in conjunction with the addiction. Our treatment for co-occurring disorders provides a different approach to the addiction recovery by tailoring our treatment program to the individual and the disorder they are suffering from.
If you suffer from mental health and substance abuse you are not alone. Approximately 50% of individuals with mental health disorders also suffer from substance abuse. Many times individuals who have mental health illness will use drugs and/or alcohol to self-medicate. That’s why we tailor our dual diagnosis treatment programs to the individual and provide education during the treatment. By educating the individual on their disorder, it will help them understand why they think or feel a certain way and help prevent relapse. Our goal is simple here, we don’t succeed until each individual is addiction free.

Dual diagnosis, sometimes called “co-occurring disorders” or “comorbidity,” is a crucial part of any addiction treatment program. Likewise, about 1 in every 4 addicts or alcoholics is said to experience clinical depression, anxiety, or another mental health issue.

Dual Diagnosis Disorders

Co-occurring disorders can be any mental or behavioral disease, but they are most often the following:

    • Depression
    • Anxiety/Panic Attacks
    • Bipolar Disorder
    • Schizophrenia/Psychotic Disorders
    • Trauma/PTSD
    • Borderline Personality Disorder

When addiction and mental health are both diagnosed in an individual, it is known as dual diagnosis. Addiction Recovery Network specializes in treating individuals who have been diagnosed with addiction and mental health by providing clinicians and therapists, who are experienced in dual diagnosis treatment.

Why Dual Diagnosis Treatment is So Important

The occurrence of mental and behavioral disorders is demonstrated to make recovery much harder for those in addiction treatment. Many addicts use drugs and alcohol to “self-medicate” their conditions. If these conditions go untreated during the course of their sobriety, they often relapse to cope with them. For example, a depressed alcoholic is liable to go back to drinking unless their depression is dealt with.

Because mental health and addiction are so intertwined, is crucial that they be treated equally and at the same time. Quality dual diagnosis treatment will balance traditional addiction treatment with medication, life coaching, and therapeutical services that are specifically tailored to the addict’s mental health issues.

Our dual diagnosis treatment process includes
    • Detoxification Support
    • Individual Therapy Sessions with a Dedicated Therapist
    • Educational Programs for Mental Health and Stress Management
    • Ongoing Medical and Clinical Support
    • Relapse Prevention
    • Trauma Informed Care Sessions
Pre-Existing vs. Substance-Related

One of the difficulties in treating dual diagnosis addicts is recognizing whether their conditions were pre-existing (before drugs and alcohol) or whether addiction induced them. Using substances can certainly lead to symptoms that resemble mental illness. For example:

    • Using cocaine causes feelings of grandiosity, which may resemble a manic episode from bipolar disorder
    • Benzodiazepines are used to treat anxiety disorders, and withdrawal is known to induce panic attacks as well as feelings of anxiety
    • Alcohol is a central nervous system depressant, and long-term use leads to chronic depression

Depending on the substance, it may be difficult to discern the cause and effect relation between drugs and mental health. Many treatment centers will wait until after detox — or even weeks into residential treatment — until treating symptoms of other mental health conditions.

Depression

Depression frequently goes hand-in-hand with addiction and alcoholism, and is a major dual diagnosis disorder that rehabilitation centers must accommodate. Many abused drugs actually depress the brain and central nervous system, causing depression on their own or making it worse when it is pre-existent. Chronically depressed addicts also have much higher relapse rates, and many unfortunates also attempt suicide before they can recover.

Depression, Addiction & Treatment

Depression encompasses a number of related mental illnesses that all fall under the category of “depressive disorders.” These include:

    • Major depressive disorder: One or more major depressive orders in which an individual is disinterested or cannot derive pleasure from their everyday life.
    • Seasonal affective disorder: Two or more depressive episodes that occur specifically during the autumn/winter and tend to resolve by springtime.
    • Dysthymia: Depression that is less severe than major depressive disorder, but tends to last longer (at least a few years).
    • Double Depression: Chronic dysthymia with intermittent major depressive episodes.
    • Depressive disorders can also accompany and be related to bipolar disorder, psychotic disorders and personality disorders.

Facts & Statistics About Depression

    • 8.5% of the world’s population suffers from some form of depression
    • Depressed women are 2x more likely to cope with their depression with alcohol
    • Teens with untreated depression are 2x more likely to abuse drugs and alcohol
    • Depression has caused or is linked to about 60% of suicides, and drugs/alcohol are involved in over half of suicide attempts

Depression & Substance Abuse

Abuse and addiction to drugs and alcohol are firmly linked to major bouts of depression, but it is unclear what their exact relationship is. Many alcoholics drink to self-medicate their depression. Many others already exhibited signs of depression, which their drug use exacerbated.

Regardless of which factor caused the other, it is clear that depression is a major obstacle in both active addiction and treatment. Depressed alcoholics are liable to continue drinking if their symptoms are not attended to. Usually, they are treated with a combination of medication (i.e. antidepressants) and therapy. However, these methods do not provide the quick solution that drugs do. They take time to work, and many addicts feel they are too far gone to stay sober.

Dealing with depression and addiction/alcoholism at the same time is difficult, but it is by no means impossible. It requires a dedicated and professional treatment center, as well as commitment and discipline on the part of the addict him or herself.

Post Traumatic Stress Disorder

Post traumatic stress disorder (commonly referred to as PTSD) is a form of anxiety in which an individual undergoes a traumatic experience and is unable to cope with it in an otherwise healthy manner. It can be brought on by anything graphically traumatic to the individual, which varies from person to person. Nevertheless, common causes include sexual assault, experiences in combat and warfare, or any scenario in which a person felt threatened or faced a life-or-death situation.

Post Traumatic Stress Disorder (PTSD)

A key factor when diagnosing cases of PTSD is that its symptoms are not present until after the traumatic event in question. That is, it is not until someone is assaulted, for example, that they experience flashbacks, nightmares and negative associations with the setting and location of their experience.

Diagnosing Post Traumatic Stress Disorder

The criteria for diagnosing PTSD is as follows:
Traumatic Event – Involving BOTH the risk of serious harm to one’s self or others AND a stimulated response of fear and/or helplessness.

Re-Experiencing – Reliving the traumatic event in some way that is pervasive and intrusive, such as flashbacks and nightmares.

Avoidance – Attempting to cope with the trauma through drugs, compulsive behavior, denial, rationalization, or refusing to speak about or avoiding anything that reminds one of it.

Arousal/Agitation – Characteristics that were not present before the traumatic event, such as insomnia, detachment, or outbursts of anger.

Time – PTSD symptoms must be experienced for over a month, or else it is diagnosed as acute stress disorder.
Impairment – These symptoms must prevent the person from functioning as they normally would, inhibiting or altering certain parts of their lives.

Treating Post Traumatic Stress Disorder
PTSD gets worse over time if it is not addressed, and it should be treated as soon as symptoms are recognized. There are many ways to treat post traumatic stress disorder, and no one is more or less effective than another. They include on or a combination of the following:

Medication – There is no currently accepted medication on-label for the treatment of PTSD. However, psychiatrists may prescribe antidepressants, anticonvulsants (if panic attacks are experienced), mood stabilizers, anti-psychotics (if hallucinations or delusions are experienced), or even placebos where they are effective.

Cognitive Behavioral Therapy (CBT) – a broad form of therapy that seeks to change thoughts by changing behavior and vice versa. CBT is considered especially effective for dealing with persistent feelings of shame or guilt.

Exposure Therapy – therapy wherein avoidant behaviors are dealt with by forcing traumatized persons to personally confront their experiences, either gradually or all at once.

Eating Disorder

Eating disorders are mental and behavioral conditions wherein a person eats abnormally, either restricting their diet or eating too much for their health. It is commonly believed that these mental illnesses are a problem of the white, middle- to -upper class female. However, they are not restricted to any one kind of person, and they completely transcend race, gender and social class.

Eating Disorders

There are multiple types of eating disorders, with each one being extremely dangerous to the physical and mental health of those who suffer it.

Kinds of Eating Disorders

The Diagnostic and Statistical Manual of mental Illnesses (DSM, the primary database for diagnosing mental/behavioral abnormalities) currently recognizes 4 types of eating disorders:

    • Anorexia Nervosa: unhealthy and unrealistic perception of weight and body, with an obsession with maintaining or losing weight. There are 2 types of anorexics:
      1. Restricting – restricting food and diet in order to lose weight
      2. Binging & Purging – loss or maintenance of weight through overeating (binging) and then purging (e.g. vomiting, laxatives)
    • Bulimia Nervosa: compulsive eating followed by purging, similar to binging and purging anorexic types, except bulimics’ body weights are not considered underweight (whereas anorexics’ are severely underweight)
    • Binge Eating: overeating on at least 2-3 occasions within a week, usually accompanied by eating-induced feelings of shames as well as sometimes obesity or weight problems
    • Otherwise-Specified Feeding or Eating Disorder: atypical instances of the above 3 disorders (e.g. an anorexic who is not underweight)

Eating & Other Mental Health Disorders

Abnormal eating habits may accompany other mental health conditions, whether substance abuse or mental illnesses such as depression and anxiety. Overeating is commonly used as a remedy to deal with feelings of depression, shame, anger, and anxiety. Eating disorders are also commonly associated with body dysmorphic disorder, in which a person’s view of their body is severely distorted and interferes with their life. About 15% of body dysmorphics have either bulimia or anorexia nervosa.

Eating disorders are extremely detrimental to a person’s health, both physically and mentally. Undereating (or binging/purging) restricts a person’s nutrition and therefore their access to vital vitamins, minerals and nutrients. This can lead to a whole host of problems, including immune system weakness, mental/development deficiencies, and cardiovascular problems. Overeating can also lead to obesity, diabetes, and heart diseases.

If you or a loved one may be suffering from an eating disorder, it is imperative to find help ASAP. Unattended, such disorders can cause permanent damage or even be deadly.

Gambling

Gambling addiction (sometimes called “ludomania” or referred to as “problem gambling”) is defined as a compulsive urge to gamble in spite of negative consequences. It is just as serious of an addictive disorder as alcoholism or substance abuse. As of 2013, Gambling has been recognized as an addiction rather than a disorder of impulsive behavior, which it was long assumed to be.

Gambling Addiction

Since problem gambling has been re-classified as an addiction, psychologists have re-evaluated how an individual is classified as a gambling addict. In order to be diagnosed with gambling addiction, one must have experienced four or more of the following 9 symptoms within a year:

    • Needs to constantly gamble with more money in order to feel the same level of pleasure/excitement
    • Any attempt to change gambling habits significantly affects mood
    • Has tried and failed to either cut back on gambling or stop altogether
    • Thinks obsessively about gambling when not partaking in it
    • Gambles to deal with other problems in life
    • Gambling escalates after losing money
    • Lies to hide gambling
    • Has experienced negative social consequences (e.g. losing a job, marriage, etc.)
    • Cannot financially sustain gambling habits on own, so must rely on others (through borrowing, stealing, etc.)

Gambling & Other Addictions

As the list above makes clear, gambling compares quite similarly to substance addictions. For example, both gambling and drug addicts lie, steal and persist in their addictions in spite of the consequences. Both go through “withdrawal,” wherein the gambling addict becomes restless, irritable and discontented when not gambling.

The biological basis for gambling addiction is also not unlike other addictions. A study has found that gambling stimulates endorphins, the same area of the brain affected by most addictive drugs. Endorphins are naturally opiates created by the brain to give people pleasure, but behaviors like pathological gambling release too many endorphins and thus lead to addiction.

Gambling Addiction & Dual Diagnosis

Like other addictions, gambling addiction is also likely to accompany other mental and behavioral illnesses. The co-occurrence of addiction with such disorders is referred to as dual diagnosis, and gambling addicts are very often dually diagnosed. They are also commonly cross-addicts, which means they are addicted to both a substance (drugs or alcohol) and a behavior (gambling). A 2011 study reviewed the prevalence of mental disorders and substance addictions in pathological gamblers:

    • Over 60% were addicted to nicotine
    • Over 57% were addicted to drugs and/or alcohol
    • About 38% had mood disorders (bipolar, depression, etc.)
    • About 37% had anxiety disorders (generalized anxiety, obsessive-compulsive disorder, etc.)

Like many other cases of dual diagnosis, it is difficult to separate the mental disorder from gambling addiction. In order to qualify as a gambling addict, gambling must NOT be related to manic episodes experienced in bipolar disorder. It is also difficult to tell if addicts are replacing one addiction with another (e.g. giving up alcohol but taking up gambling).

Nevertheless, these findings do confirm that gambling addiction is a serious disease, much like other addictions, that must be reckoned with, and that gambling addicts are in desperate need of help.