Tuesday, February 2, 2010

Dual Diagnosis part 1

Did you know that mental illness and chronic substance abuse frequently go hand-in-hand?

It's true. Many people who are addicted to or dependent on alcohol or drugs also suffer from a serious mental disorder. Treatment professionals generally refer to this condition as a co-occurring disorder, or dual diagnosis.

Just how common is dual diagnosis?

  • Roughly 50 percent of individuals with severe mental disorders are affected by substance abuse.
  • 37 percent of alcohol abusers and 53 percent of drug abusers also have at least one serious mental illness.
  • Of all people diagnosed as mentally ill, 29 percent abuse either alcohol or drugs.
So which comes first? The mental disorder or the substance abuse?

This question is a little like the chicken and the egg. Sometimes people with mental disorders turn to drugs or alcohol as a way to self medicate. Habitually doing so can create physical or psychological dependencies. In these situations the mental disorder leads to the substance abuse. A diagnosis of Schizophrenia, for example, puts a person at 4 times the risk of developing a substance abuse problem.

In other cases long term exposure to certain substances can alter brain chemistry and lead to the development of a mental disorder. For example: the chronic use of Ecstasy can cause long term serotonin deficits in the brain. This in turn can lead to the development of major depression or an anxiety disorder.
In some cases it is hard to say which came first, or whether the two issues simply developed independently of each other.

So what does it mean to be a chronic substance abuser?

The National Drug Intelligence Center defines chronic drug abuse as the
"habitual abuse of licit or illicit drugs to the extent that the abusesubstantially injures a person's health or substantially interferes with his or hersocial or economic functioning. Furthermore, any person who has lost the power of self-control over the use of drugs is considered a chronic drug abuser."
What are the symptoms of dual diagnosis?

It can be tricky to identify someone suffering from dual diagnosis. Many of the symptoms of substance abuse are similar to symptoms of other psychiatric conditions. Often people with dual diagnosis are diagnosed with either a mental disorder or a substance abuse problem, but not both.

Dual diagnosis does tend to intensify the symptoms of both the mental disorder and the substance abuse which can lead to more severe physical and emotional consequences.

Should you treat the substance abuse or the mental disorder?

Research shows that the most effective treatment plans for people with a dual diagnosis is to treat both conditions at the same time. This is called integrated treatment. It means that "the same health professionals, working in one setting, provide appropriate treatment for both mental health and substance abuse in a coordinated fashion" (NAMI).

This approach is still relatively new, so consult your local NAMI chapter for help finding integrated treatment in your area. You can also reference the Dual Recovery Anonymous World Services Central Office, or call their Toll-Free Number:(877) 883-2332

If you or someone you know is in crisis now, you can call 1-800-273-TALK (8255) to reach a 24 hour crisis center or dial 911 for immediate assistance.

Do you suspect that a friend or family member might be struggling with dual diagnosis? Come back next week, I will be writing a follow up post with tips on what to do to help a loved one struggling with these issues. In the meantime, the resources linked to in this post all have a plethora of helpful information. Please remember you are not alone in this. And remember that there is always room for hope.


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