A dual diagnosis, also known as a co-occurring condition, is when a mental health disorder and substance use disorder occur simultaneously. Dual diagnoses are not uncommon, as those with a mental health disorder are at higher risk for developing a substance use disorder and vice versa. Experiencing more than one condition at once poses unique challenges for the individual, especially with securing long-term recovery.
Mental health disorders and substance use disorders feed off of each other. If both disorders are left untreated, or if an individual is only receiving treatment for one disorder, both conditions will exacerbate one another over time. It is essential to understand the many factors that play into dual diagnoses, such as signs and symptoms, causes, and treatment challenges, to be better aware of how to support individuals struggling with recovering from multiple conditions at once.
The Causes of Dual Diagnosis
There are several misconceptions surrounding the causes of dual diagnosis. These misconceptions include:
- Mental health disorders and substance use disorders are unrelated
- It does not matter which disorder developed first
- Successful treatment must either treat substance use disorder or addiction first
It is vital to understand that both mental health disorders and substance use disorders are considered complex mental health conditions. This means that they both deeply affect an individual’s brain and result in abnormal or self-destructive behavior. Brain areas that are affected by mental health disorders, such as the brain’s reward center and areas associated with emotional regulation and self-control, are also affected by substance use disorders.
Consider the unique causes of mental health or substance use disorders separately. The causes of a dual diagnosis are similar in that they vary based on several factors. Some risk factors that increase an individual’s likelihood of developing a dual diagnosis include:
- An individual’s subjective chemistry
- Inherited genes, such as having a relative that has struggled with either a mental health disorder or substance use disorder
- Environmental factors, such as experiencing stressful or traumatic events
- Having an undiagnosed mental health disorder
- Having an undiagnosed substance use disorder
- Using or relying on alcohol or other drugs as a way to self-medicate
Although mental health disorders and substance use disorders commonly occur together, that does not always mean that one disorder caused the other. The National Institute of Mental Health (NIH) suggests three possible causes of why these conditions may occur together:
- Mental health disorders and substance use disorders develop from the same risk factors
- Mental health disorders can contribute to substance use disorders, especially when individuals turn to substances as a way to self-medicate
- Substance use and substance use disorders can contribute to the development of other mental health conditions. This is because substance use can trigger long-lasting changes in brain structure and function that may make a person more likely to develop a mental health condition, such as depression.
Signs and Symptoms of Dual Diagnosis
It can be challenging to pinpoint the signs and symptoms associated with a dual diagnosis, mostly because each person will experience different symptoms based on their unique conditions. It can also be challenging because one condition may be more severe than the other, resulting in more severe symptoms. However, there are general signs and symptoms that you can familiarize yourself with to better recognize a dual diagnosis in yourself or your loved ones.
Unique signs of a dual diagnosis may include:
- Extreme mood swings, especially due to substance use or substance use withdrawals
- Inability to control emotions, resulting in aggressive or excessive outbursts
- Neglecting personal responsibilities, such as work, school, or other important commitments
- Experiencing financial issues
- Social isolation
- Engaging in risky behavior
- Loss of control over how many substances they are consuming or using
- Seeming to always need more of a substance to achieve the desired effect (increased tolerance)
- Extreme agitation, especially when not using substances
- Periods of disorientation, loss of consciousness, or confusion
- Poor hygiene
- Significant changes in weight
- Spending more time with people that use substances
Treatment for Dual Diagnosis
The main goal of dual diagnosis treatment is to treat both conditions simultaneously. Since these conditions occur together so often, anyone seeking treatment for any single condition should also be assessed for any undiagnosed conditions so that treatment can target any and all conditions at the same time.
Behavioral therapy has proven its effectiveness in treating dual diagnosis, among many other individual conditions. One advantage of therapy in treating these conditions is that they can be customized to fit the unique needs and goals of clients. Occasionally, medication may be offered in combination with therapy to help clients manage severe symptoms. Some leading behavioral treatments include:
- Cognitive-behavioral therapy (CBT)
- Dialectical behavioral therapy (DBT)
- Acceptance and commitment therapy (ACT)
- Therapeutic communities (TC)
An individual can expect treatment for a dual diagnosis to begin with detox. Detox allows the body and mind to get rid of any traces of substance use, which is crucial in the healing process. Treatment facilities may offer support groups and other life skills groups, and individual psychotherapy that can help people make meaningful, sober connections and supportive relationships. Social support serves as an important protective factor against relapse and for maintaining long-term recovery.
Dual diagnosis is when a mental health disorder and substance use disorder occur together. A dual diagnosis is common, as having a mental health disorder increases your risk for developing a substance use disorder and vice versa. It is essential to recognize that there is no one root cause of dual diagnosis and that each condition develops on its own or as a result of the other condition. For treatment for a dual diagnosis to be successful, treatment must work to address each condition simultaneously. SoCal Mental Health is a treatment center that offers dual diagnosis treatment. We recognize that more likely than not, there is a mental health disorder present in those seeking treatment for a substance use disorder. No matter where you are in your treatment journey, SoCal has a place for you. Give us a call today at (714) 328-4760 to hear how we can be a part of your healing journey.