Over the past five months, I have focused my columns on addictive behavior, specifically alcoholism. I discussed organizations that can help on the way to recovery, how the stigma attached to alcoholism can hinder that process and how the overall wellness of a recovering alcoholic is vital to battling addiction. Today, I am throwing another component into the mix that has been widely overlooked until the 1990s: What if alcohol is not your only problem? What if alcoholism was preceded by a mental disorder, or vice versa? For the longest time, the medical wisdom was that you had to overcome one disorder first before you could tackle the other. This is not the case anymore.
The concept of dual diagnosis, or co-occurring disorders, describes the situation when someone experiences a mental illness and a substance abuse problem at the same time. People with a mental illness may turn to alcohol or other drugs to deal with their symptoms and become addicted. As can be expected, the National Alliance on Mental Health points to research that shows that alcohol and drugs worsen mental health symptoms.
If you assume such a co-occurring disorder is rare, think again. According to a 2014 National Survey on Drug Use and Health, 7.9 million people in the U.S. experience both a mental disorder and substance use disorder at the same time. To make matters worse, the fields of mental health and substance abuse recovery did not always coordinate their efforts, which made it difficult to obtain integrated treatments. Patients were expected to get sober or clean first before they would receive mental health services. As it happens, substance abuse is often driven by an underlying mental illness, so treating one without the other did not lead to the desired long-term results.
The first step is recognizing that a person is suffering from substance abuse and a mental illness, which is why people now are often screened for both disorders. If a person seeks treatment for a substance abuse problem, professionals are also looking for mental health warning signs, such as extreme mood changes, confused thinking or problems concentrating, avoiding friends and social activities and thoughts of suicide.
If you are diagnosed for a mental health disorder (depression, bipolar disorder, anxiety disorders, schizophrenia, a personality disorder, etc.) and for an addictive disorder (alcoholism or behavioral addictions such as drugs, gambling, etc.), you may be classified as a dual diagnosis patient, and the road to recovery follows an integrated mental health and substance abuse treatment approach.
Common methods of a dual diagnosis treatment plan include detoxification, inpatient rehabilitation, supportive housing, psychotherapy, medications and self-help groups. Inpatient detoxification is often more effective for initial sobriety. Inpatient rehabilitation centers provide medication and health services to treat the substance abuse and its underlying causes. Residential treatment centers may help people who have recently become sober and try to avoid relapse. Psychotherapy helps people with dual diagnosis change ineffective thought patterns, which may contribute to the substance use. Certain medications can help treat mental illnesses and ease withdrawal symptoms during the detoxification process. Self-help and support groups allow members to share their problems, celebrate successes, exchange experiences with specialists and community resources. They also serve as a safe space for forming healthy friendships and provide encouragement to stay clean. Examples of such groups are Double Trouble in Recovery, Alcoholics Anonymous, Narcotics Anonymous or Smart Recovery.
Recovering from substance abuse is more challenging if you are also suffering from a mental illness, but once properly diagnosed and assisted by a team of integrated mental health and substance abuse professionals, you can start your journey to recovery.