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If your loved one is suffering from substance abuse and addiction, you may also have concerns about their mental health.
Oftentimes, the symptoms of drug abuse and addiction can seem similar to the symptoms of mental illness, making it hard to determine whether a patient developed mental problems as a result of addiction or if he or she was already suffering from pre-existing mental illness. Such a condition may or may not have contributed to the problem of addiction in the first place.
In 2011, the National Survey on Drug Use and Health released findings showing that nearly 8 million people with mental illness, or 17.5% of adult patients, were also suffering from substance abuse issues. The data shows the issue of dual diagnosis is a serious concern in treating addiction and substance abuse.
In this blog, we’ll look at the following:
- What is dual diagnosis?
- What are the risks of dual diagnosis?
- How do you treat dual diagnosis?
- What are the components of dual diagnosis interventions?
- How should I help someone with dual diagnosis?
What Is Dual Diagnosis?
When a patient suffers from a mental illness that coexists with a substance abuse issue, a professional would say the patient has a dual diagnosis. The phrase itself is something of an umbrella term. It can refer to anything ranging from depression paired with alcoholism to schizophrenia coupled with cannabis abuse or a more minor mental issue such as anxiety that leads to a serious drug problem like opioid dependence.
Because dual diagnosis is a complex matter by definition, it can be difficult to identify, and it comes with unique challenges in terms of intervention and treatment.
What Are the Risks of Dual Diagnosis?
Because of the complicated nature of dual diagnosis health concerns, patients suffering from coexisting addiction and mental illness face some added risks on the road to addiction recovery.
To begin with, dual-diagnosis disorders are difficult to identify because the symptoms of addiction can mask the underlying mental issue.
If the mental issue remains untreated, the patient has a high likelihood of relapsing after initially recovering from addiction. Moreover, patients with mental illness – whether diagnosed or undiagnosed – often have a hard time understanding the severity of their problem, which can make it more difficult to get them the help they need.
How Do You Treat Dual Diagnosis?
In the past, clinicians treated dual diagnosis with a method known as a parallel treatment, meaning that one set of care providers treated the mental issue while another dealt with the substance abuse problem. However, this proved ineffective, and since the 1980s, treatment has shifted to take a more integrated approach.
Since dual diagnosis is a combination of both mental health problems and substance abuse and addiction, mental health professionals generally treat patients in a way that integrates mental health care and interventions for addiction. This means the same team of clinicians provides care to the patient for both mental illness and substance abuse in the same setting.
There’s often no outward distinction in how the two separate problems are treated. These methods of treatment remove the patient’s need to deal with a different set of caregivers for each separate disorder, increasing the chances that treatment will be successful.
Although it seems simple and natural to say that we treat a combination of disorders with a combination of treatments, the process of integrating interventions for a dual-diagnosis patient is actually quite complex.
Treatments aren’t simply combined; they’re modified to make them more effective in addressing both mental problems and corresponding substance abuse. For example, professionals modify social training for psychiatric patients who also suffer from alcoholism to provide explicit support in avoiding alcohol in social situations.
Likewise, support for family members and caregivers of dual-diagnosis patients helps them understand how their loved one’s two disorders interact.
The goal of this integrated approach is to help the patient learn how to manage his or her addiction and the corresponding mental illness, thereby reducing the risk of relapse and enabling the individual to lead a normal, healthy life.
What Are the Components of Dual Diagnosis Interventions?
Researchers have identified a number of different components of dual-diagnosis treatment that appear to result in consistently successful outcomes for the dual-diagnosis patient consistently. Treatment programs that include the following practices are nearly always successful, while their absence in treatment results in a high rate of failure.
Staged Intervention for Addiction and Mental Health
In this case, the term “staged intervention” does not refer to a gathering of loved ones addressing the patient who needs help (although we will address that later in this article). Rather, this clinical practice refers to interventions that come in different stages. These stages are:
- Engagement – Caregivers form a trusting relationship with the patient so that he or she becomes “engaged” in the treatment.
- Persuasion – Treatment focuses on helping the patient become motivated to participate in interventions that will specifically drive recovery.
- Active treatment – Interventions that help the patient develop the skills and supports that he or she needs to manage both mental illness and addiction to recover fully.
- Relapse prevention – Interventions designed to help the patient put strategies in place to maintain his or her recovery.
These stages aren’t always linear, as patients can enter treatment at different stages of recovery. However, the idea of staged intervention has proved highly successful in treating dual-diagnosis patients, regardless of in which stage they enter treatment.
Dual-diagnosis patients are even less likely than substance abuse-only patients to recognize the severity of their problems, possibly due to a lack of understanding about how their mental illness affects their addiction – or even a lack of awareness that mental health is at play.
Therefore, these individuals are often not ready to begin treatment that addresses abstinence from addictive substances.
Motivational interventions help dual-diagnosis patients develop personal goals and slowly come to the realization that they must treat and manage their illnesses – both mental and addictive – in order to achieve the goals they’ve set.
Addiction and Mental Health Counseling
Counseling helps dual-diagnosis patients develop the skills and support that will help them both manage their mental illnesses and abstain from their addictions.
Counseling can take a number of different forms, including group and individual, as well as family counseling. Counseling is most effective once the patient has gone through motivational interventions and shows a vested interest in recovery.
Social Support and Long-Term Perspective
Social support interventions are important to a dual-diagnosis patient’s recovery because they equip not only the patient but also his or her loved ones with the support needed to manage the illness over the long term. Family therapy is a key type of social support intervention.
Additionally, effective dual diagnosis interventions recognize that full recovery is a long and slow process, and they thus take a long-term perspective in treatment aimed at preventing relapse far down the road.
How Should I Help Someone with Dual Diagnosis?
If you have a loved one who seems to be suffering from the combined effects of both mental illness and addiction, he or she may not be aware of how severe the situation is or may not believe that he or she needs help. In this case, an intervention from loved ones can be a motivating factor that prompts your loved one to seek needed treatment.
Staging an intervention isn’t a last-ditch, desperate attempt to help someone. Rather, it is a proven motivational strategy for getting dual-diagnosis patients to seek help. The Johnson model of intervention, in which the individual faces a surprise confrontation from family and friends, is one popular approach – and perhaps the most well-known – but there are others as well.
In the ARISE model of intervention, the addict’s family comes together to address the problem without surprising him or her. In the invitational model, friends and family invite their loved one to a scheduled meeting with a treatment specialist. The “Love First” model has the addict’s friends and family share letters they’ve written to the addict, encouraging him or her to get help.
Handle Interventions Carefully
When dealing with a dual-diagnosis patient, you should handle these staged interventions delicately. Individuals dealing with both addiction and mental illness tend to react with powerful emotions, such as anger and fear.
If you think your loved one needs a staged intervention from friends and family, it’s important to seek help from a professional in planning the intervention to achieve the best possible outcome for everyone involved.
The combination of mental illness and addiction can have a devastating effect not only on the patient but also on everyone that he or she cares about. It’s important to understand that both mental illness and addiction are treatable and that you should respond to your loved one’s illness in a way that conveys your compassion, concern, and love.