Dual Diagnosis: Treatment for Co-Occurring Disorders
Dual diagnosis refers to a condition in which one person is affected by two or more mental health disorders, one being the disease of addiction. According to the National Institute on Drug Abuse, it also implies that the two illnesses often interact and worsen the course of both. The condition of dual diagnosis is very common in people who are addicted to drugs – in fact, they are twice as likely to suffer from mood or anxiety disorders when compared with the general, non-addicted population. Which causes the other is unclear though it is thought to depend on a case-by-case basis.
Generally, however, the National Alliance on Mental Illness shows that there are three possibilities in terms of causality. First, drugs and alcohol can be a form of self medication for an individual with mental illness. Someone may have an untreated mental illness with which they feel better when they are using drugs or alcohol. Next, drugs and alcohol may worsen an underlying illness that was not affecting the individual much prior to substance abuse but was certainly there. Lastly, dual diagnosis may occur when a person without mental illness experiences the symptoms of one as a result of drugs or alcohol.
Treatment for Dual Diagnosis
Dual diagnosis requires a specialized, integrated treatment approach that focuses on treating each issue in its entirety while making sure treatments to do not interfere. Before treatment can happen, however, the condition must be properly diagnosed. This is difficult and mental health problems are often overlooked while treating substance use disorders as well as the reverse situation. In this case, the treatments for either disorder are usually ineffective as their substance use brings on mental health problems again, or the mental health problems lead to relapse. Integrated treatment is the solution.
What is integrated treatment?
The integrated treatment approach consists of one setting where the same health professionals provide treatment for both the substance abuse and mental health issues an individual is affected by in a coordinated manner. Treatment is consistent and complimentary, and there is no need to consult separate teams or programs, thus no break in the continuity and less of a possibility for confusion and lack of attention for the individual being treated.
Treatment for co-occurring disorders happens in stages, starting with the building of trust between the individual and their caregivers. This kind of trust helps keep the individual motivated to continue and succeed with their treatment. Counseling and motivational interventions help individuals realize what their goals are and how important they are to their well-being while giving them the proper coping skills to achieve them. Another essential feature in dual diagnosis recovery is the management of social support and relationships. Effective dual diagnosis treatment is comprehensive, including aspects of life such as jobs, housing, and activities.
One major factor in the treatment of co-occurring disorders is the fact that it is a long-term, community based process. Because of the long-term nature of dual diagnosis treatment recovery, individuals with dual diagnosis have been shown to be less likely to achieve lasting sobriety. The interaction of their disorders makes it very difficult to maintain recovery, and keeps the risk of relapse relatively high. According to the National Alliance on Mental Illness, people with a co-occurring disorder are statistically more prone to violence, noncompliance with their medication, and failure to respond to treatment. In addition, it is more likely for these individuals to end up homeless or in jail. For these reasons it is incredibly important that diagnosis and treatment of dual disorders improves, and that access to effective integrated treatment improves as well.