What Is Dual Diagnosis?
A dual diagnosis is the result of a person being diagnosed with two disorders: a psychiatric condition and a substance use disorder, commonly known as addiction. The concept of dual diagnosis is not a new one; the term has been around since the 1980s. Another scientific term used to refer to this condition is "co-occurring disorders" (COD). This describes the occurrence of two disorders simultaneously.
CODs can happen as different "pairs". Some people suffer from depression and alcoholism while others may deal with anxiety and opioid abuse. Any psychiatric illness and substance use disorder together can fall under this category of diagnosis.
It is not yet clear how exactly they are connected, but it is a fact that they are. The order in which someone might start manifesting symptoms is also not something set in stone. And as for the question "what disorder comes first", that is as complex as the "chicken or the egg" dilemma.
In some cases, people suffering from mental disorders might try to self-medicate by turning to substance abuse as a way to cope with their struggle. While some literally self-medicate by taking controlled substances, others might start excessively drinking or using illicit drugs for that same purpose. However, it has also been proven that early consumption of alcohol or drugs might trigger the development of mental disorders.
Even if you have not heard about it before, dual-diagnosis cases are not rare at all. In fact, they happen more often than single-diagnosis cases. According to the National Institute of Drug Abuse, about 60% of people struggling with addiction were also diagnosed with a co-occurring psychiatric disorder. A 2018 survey done by the National Survey on Drug Use and Health stated that 9.2 million Americans experienced co-occurring mental and substance use disorders.
Common Dual Diagnosis
Dual Diagnosis in Maryland
There is not much information on cases of dual diagnosis in Maryland. But the state's registered diagnoses of mental illnesses such as major depression have often been lower than the national average. However, the general scenario for addiction is not good. The number of untreated cases of mental disorders combined with that can be considered a red flag.
When it comes to mental illnesses in Maryland, 59.5% of adults with any mental illness did not receive treatment for it. This can make them more prone to substance abuse. However, it is not for lack of trying, as 1 in every 5 adults in the state reported their needs for treatment couldn't be met. This was either because of insurance or financial problems or simply because the options of treatment or providers available were not enough.
The mental health issue also concerns youths and teenagers. This is especially the case since substance abuse at that age can trigger both addiction and the development of a mental disorder.
For depression alone, about half of diagnosed youths aged 12-17 have not received treatment in the last few years. This is a problem, considering how the substance-related intoxication deaths involving victims younger than 25 years old have happened more and more often.
Recent data shows that the most lethal substance registered in Maryland has been fentanyl, as 78% of victims had traces of fentanyl in their system after death. Fentanyl use has been on the rise in Maryland since 2015. Unfortunately, the numbers have not gone down since then. Heroin-related deaths were the second most common since this fentanyl rise started. But, cocaine-related deaths surpassed heroin by 2018, as they have also been increasing in number since 2015.
Symptoms And Signs of Dual Diagnosis
The symptoms one might manifest when diagnosed with two different disorders can be as diverse as the many combinations that can make up a dual-diagnosis case. It’s true that mental disorders and addictions have their own characteristics. But, there are some signs and symptoms that are common to multiple illnesses. People who are dealing with co-occurring disorders might experience:
- Excessive use of alcohol and/or drugs and overdoing it both in dosage and frequency
- Not being able to keep up with their usual schedule and routine at work or school
- Failure to complete common daily tasks, like taking care of personal hygiene
- Changes in their social circles and places they usually go to
- Putting themselves in risky situations for no specific reason, impulsively or not
- Frequently avoiding people and events that they once enjoyed
- Uncomfortable withdrawal symptoms whenever not consuming drugs (and that might worsen their mental disorder symptoms)
- Experiencing changes in thought process, either becoming incoherent, disillusioned, and/or expressing dark and suicidal thoughts
- Sensory hallucinations, either caused by drug consumption or by mental disorders
- Having a family history of psychiatric disorders and/or substance abuse
- Showing difficulty accepting the idea that they need treatment or following through with it once it's started
One of the reasons why dual-diagnosis disorders are hard to diagnose and treat is because many symptoms of withdrawal are also symptoms of mental disorders, such as anxiety and depression. That is another reason why it is so hard to tell which disorder occurred first, too. Overlapping symptoms are a problem when deciding on how to approach each disorder and how to medicate and treat a patient.
Experts have said that an early diagnosis of a mental health condition can lower the chances of the development of a substance use disorder. Treatment in the early stages can cut the risk of substance abuse during the teenage years. And the same goes for substance abuse: early treatment of addiction can help prevent the onset or improve the outcome of mental illnesses that can be triggered by it.
Treatment For Dual Diagnosis
There are treatments available for both addiction and mental disorders in general. So, it is possible to treat someone suffering from co-occurring disorders. However, a dual-diagnosis treatment program will not be the same as a single-diagnosis one. There are many different ways to approach the co-occurring disorders.
A person who is suffering from two disorders needs to treat each disorder accordingly. It can be done sequentially (treat the most acute disorder first and the second one later). It can also be done at the same time. But they each require a different approach, separate tracking of improvement, and need to be addressed separately.
Usually, the first step in the addiction treatment process is detoxification. It works to flush all the toxins from the body in order to start the treatment fresh. Once this initial stage is over, a patient will then start treatment for their disorders. All programs include both medical and psychiatric procedures in order to treat symptoms, help the system start going back to normal, fix any major chemical and neurological imbalances, etc.
Another important part of the process are therapy sessions, both in individual and group settings. These sessions are a useful tool, and it is recommended that patients continue sessions even after their treatment, whether by going to the same groups or trying new ones. The patient can address their issues during these sessions. They will also have an opportunity to start new relationships and feel less alone in their journey, understanding themselves through others.
When choosing the right program, the options available tend to fall under two possible categories: inpatient treatment and outpatient treatment. The main difference between the two is that the former requires 24-hour stay in the facilities, while the latter lets the patient stay home and only come to the facilities for sessions of treatment. The duration of each depends on the patient's condition. Inpatient programs last at least a month or so. Outpatient rehab programs might take longer since treatment is not continuous.
For outpatient programs, there are different service settings to pick from. A partial hospitalization program, for instance, is almost as intense as an inpatient program. It requires up to 5 to 6 visits a week. Another more moderate option is the intensive outpatient program. Visits are less frequent and don’t last as long ‒ only a few hours a day. As a "rule of thumb", the milder the symptoms, the less visits are required, although only a practitioner can say how frequent they should be.
You Can Get Help Right Now
If you or a loved one suffer the afflictions of dual diagnosis in Maryland or any other state, we at The Freedom Center can understand and want to help. We offer programs with dual diagnosis plans that can help you address both disorders and transition at your own pace into sobriety.
Our programs offer everything from the basics, such as therapy and medical help, to holistic treatment and even legal aid - everything to make your life easier as you receive treatment. We are dedicated to helping our clients overcome and stay free from addiction.
Visit our website to learn more about our programs and our values and contact us today. Our team will be happy to answer your questions as you enter this new lifelong journey to reach the best version of yourself. So, call us at (888) 530-5023 to find out how we can help you!
Reference:
https://www.nami.org/learn-more/mental-health-conditions/related-conditions/dual-diagnosis
