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About Dual Diagnosis Treatment
by Kirk Brown
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Overview
About Dual Diagnosis Treatment
Individuals with both an alcohol or drug dependency and a mental disorder are classified as having what's known as a dual diagnosis.
Drug and alcohol problems have a tendency to occur with depression and anxiety, as well as other mental illnesses such as bipolar disorder, personality disorders and schizophrenia.
For some people, substance abuse problems are a cause of their emotional and mental difficulties. Others have psychological problems that lead them to abuse alcohol and drugs as a form of self-medication.
Under either scenario, a person must be treated for both problems to fully recover.
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Prevalence
Patients with a dual diagnosis are not uncommon. 60% of people with a substance abuse problem also suffer from another form of mental illness, according to a 2007 research update from the National Institute on Drug Abuse.
The institute also reported that:
Compared to the overall population, persons with anxiety or mood disorders are about twice as likely to also suffer from a drug or alcohol disorder.
Among dual diagnosis patients in treatment, antisocial personality disorder is more common among men, while women are more likely to suffer from anxiety disorders, depression and post-traumatic stress.
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Causes
Researchers have found that genetic, environmental and developmental factors can all help set the stage for an individual's substance abuse problems and mental illness. Genetics may predispose certain people to both addiction and mental illness. Stress, forms of abuse and an early introduction to drugs are among the environmental triggers that may lead to substance abuse or mental illness. Substance abuse during adolescence also can cause changes in the brain that increase the risks of mental illness.
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Treatment Process
A dual diagnosis patient must make a choice to get better in order for treatment to have the best chance of success. The process also will require courage, hope and time.
For individuals with a serious substance abuse problem, the first step in treatment is often a detoxification period. Ideally, this should be followed by an integrated treatment approach in which clinicians seek to simultaneously address the patient's substance abuse problem and mental illness. Inpatient or outpatient treatment may include the use of psychotropic medications, behavior modification strategies, support groups and talk therapy.
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Barriers to Effective Treatment
Although a consensus has emerged in the medical community regarding the benefits of integrated dual diagnosis treatment, barriers exist that can hinder the implementation of this approach. Traditionally, the systems for treating mental illness and substance abuse have been disconnected and inefficient. In addition, many alcohol and drug treatment centers are unwilling to use any medications, even those needed by patients with severe psychological disorders.
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Role of Family and Friends
Family and friends can play a key role in the treatment of dual diagnosis patients by educating themselves about the condition and providing support. The better a family understands the problems, the more likely that a patient will achieve a lasting recovery. Friends and relatives also must learn not to enable dual diagnosis patients. For instance, they can refuse to give them money to buy alcohol or illegal drugs.
Friends and family may provide support by being calm, positive and understanding. They also can encourage compliance with treatment protocols and set limits that discourage disruptive behavior.
