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Dual diagnosis, also known as co-occurring disorders and co-morbidity, is when an individual is experiencing both a substance use disorder and a mental health condition. A crippling state, considering that interactions between the two disorders can aggravate each other’s condition, people with dual diagnosis often find it hard to seek a viable and efficient treatment.

The link between the two disorders may often lead to hazy prevention and treatment methods. As such, dual diagnosis is considered to be a constantly evolving disorder type that needs further implementation of focused strategies.

The connection between mental illness and substance use disorder has been established during the 1980s. As documented by the American Psychiatric Association (APA), federal health agencies and various health experts have slowly pieced together the connection of mental illness and exposure to chemical abuse. Citing that individuals diagnosed with a combination of said disorders are more likely to stay longer in hospitals.

The prolonged stays in hospitals by these individuals pushed both the health industry and policymakers to focus on how to address this problem in an organized manner. Two areas on who to tackle the issue emerged: on how to conceptually help these individuals, and on how to practically make use of resources to fix the problem.

Additionally, it has been noted that the term “dual diagnosis” may in fact be a misnomer. There have been cases of different co-occurring disorders. Other possible combinations can be developmental disabilities and mental health disorders. Another would be psychological disadvantages and substance abuse.

Still, the term dual diagnosis was used to quickly define the said state. By 1989, dual diagnosis had been included in the Hospital and Community Psychiatry subject index. Considering the growth of individual types of disorders, studies on dual diagnosis continues to evolve as of today.

• 45% of individuals living in the United States suffer from a dual diagnosis.
• Approximately 5 million from 24.6 million Americans living with a substance abuse disorder also suffer from a co-occurring mental illness.
• Alarmingly, 23% of homeless individuals in the United States were recorded to have co-occurring disorders.
• More than 50% of Americans suffering from a dual diagnosis do not get any treatment for either disorder.
• From the remaining 50% who sought treatment, around 34 million individuals with dual diagnosis have been reported to solely seek help for mental health alone.
• 12% of those who sought treatment followed through with the integrated dual diagnosis treatment that specifically addresses both disorders.
• The remaining 2% of those who sought treatment have been reported to solely seek help for substance abuse alone.
• Around 17.5 million Americans age 18 and above have been recorded to have symptoms of serious mental illness.
• 4 million individuals from the mentioned 17.5 million Americans are known to be substance abusers.
• Focusing in prisons, a high prevalence of dual diagnosis exists, ranging anywhere from 18% to 56% of prisoners suffering from co-occurring disorders.

It may be difficult to pinpoint dual diagnosis due to the various symptoms attached to a single disorder. However, there are general warning signs that can point out the possibility of dual diagnosis. Here are some of them:

• A clear neglect of one’s health and personal hygiene.
• Loss of focus in managing everyday tasks.
• A sudden shift in conventional behavior.
• Cases of cognitive impairment.
• Loss of drive in school or the workplace.
• Problems managing finances.
• Refusal to seek help.
• Suicidal behaviors.

The overlap of disorders needs to be identified to properly create and implement effective treatment strategies. Here are some factors that need to be seen in order to avoid any potential aggravation on either disorder:

Genetic Factor

An individual’s genetic predisposition may be a link to either substance abuse disorder or mental health disorder.

Environmental Triggers

Stress from the workplace or school may be a cause of mental illnesses or addiction on various substances.

Chemical Triggers

Abusing substances may directly create mental imbalances. A good example is psychosis, which may be a result of various drug abuses.

Social Stigma

The negative stigma that the public views on both mental illnesses and substance addiction can be overpowering. Social isolation may be the result of these negative views, in which the afflicted individual may not be able to seek out the proper treatment plan.

Improper Medication

Solely focusing on the treatment of a single disorder may result in aggravating the other. The unwanted interactions between prescribed medication and chemical abuse may result in side-effects that will further damage one’s physical and mental state.

Mental Health Link

On the flipside, mental health disorders can influence substance abuse. Depression, for example, may result in experimentation with drug or alcohol consumption.

Exposure to Harmful Substances

Individuals exposed to drugs or a culture promoting substance abuse are more likely to suffer from a similar condition.

A specialized treatment plan needs to be in place that would address both psychiatric and substance abuse issues. Integrated care, as noted by the Substance Abuse and Mental Health Services Administration, will not only help in treating both conditions in co-occurring disorders but help prevent suicide attempts as well. Here are some vital reasons why integrated care is the best way to address dual diagnosis:

• Integrated care involves group therapy. This proves to be an effective tool in dealing with both addiction and mental health disorders. This is because group therapy creates a strong support group for individuals suffering from dual diagnosis.
• Identifying and treating both mental illnesses and substance abuse at the same time will help individuals to properly associate their own unique relapses, and the best ways to counter them.
• It has been noted that medication is more effective when the created pharmacological plan will address both substance abuse and mental health conditions.
• Integrated care also involves support from licensed individuals who identify and balance both issues from a psychiatric and substance abuse standpoint.

 

Integrated care also needs to highly take into consideration the age of the individuals with dual diagnosis. Some factors to note down are:

Young People

Young people with dual diagnosis have been recorded to be more vulnerable to both mental health and substance abuse disorders. A keen, thoughtful, yet assertive treatment method needs to be set in place for younger individuals.

Older People

Older individuals, especially those who belong in the supposed age of the workforce (or the lack of it), need to be treated in a different manner. An important factor to take into consideration is social isolation – some afflicted individuals tend to pull themselves away from both reality and society. As such, experts need to carefully approach these individuals in a respectful yet focused manner.

 

Additionally, integrated care for dual diagnosis also involves several treatment options. Here are some that focus on both disorders:

Medication Plans

As noted above, integrated care has plans in place that directly address substance abuse and mental health disorders. Antidepressant drugs in a combination with anti-addiction medication may be prescribed in tandem to help treat dual diagnosis.

Individual Therapy Approach

Taking a page out of psychiatry, a deep focus on individual care helps in self-development to address both mental health and substance abuse disorders. A non-confrontational and collaborative approach towards a patient is being promoted by integrated care to better confront dual diagnosis issues.

Residential Treatment Strategies

Individuals suffering from dual diagnosis may also seek help from rehabilitation centers. By making use of the available resources in these centers, integrated care advocates can focus on the proper treatment for afflicted individuals.

Outpatient Integrated Care Treatment Solutions

Some individuals may also seek help in an outpatient format. This approach helps afflicted individuals by maintaining a work/study and life routine, with the benefit of setting aside time for proper treatment for dual diagnosis issues.

Holistic Approach

Given that dual diagnosis is an evolving field, holistic approaches on how to treat both mental illnesses and substance abuse are accepted and appreciated. Some holistic treatments included in some integrated care plans are hypnotherapy, acupuncture, yoga, and specialized massages.

Education and Advocacy

Integrated care also deals with spreading the right information, especially to an afflicted individual’s family and loved ones. Proper care can only be done if the issues are identified and addressed.

Support Network Creation

Integrated care helps in creating a reliable support network for afflicted individuals. This approach helps assure individuals suffering from dual diagnosis a long term treatment plan, with experts and like-minded peers ready to help when the time arises. Prioritizing ongoing support as well (even after the rehabilitation period for patients in residential treatment setups), relapse is further prevented.

Overcoming dual diagnosis is possible, once the right factors have been identified and addressed. Knowing that there is a possible link between mental health disorders and substance addiction is important. It is through this connection that an individual can better understand the best approach in tackling both disorders. Also, understanding the totality of the dual nature of the two disorders will help individuals properly communicate their needs to expert medical support.