Millions of American adults are diagnosed with both a mental health condition and a substance use disorder. These are called dual diagnosis, co-occurring, or co-morbid conditions. At Highland Hospital Behavioral Health, our board-certified psychiatrists, social workers, nurses, support workers, and recreational therapists provide evidence-based treatment for patients with dual diagnosis disorders. We think it’s important for our patients and their families to have good information about this phenomenon.
Fact #1: The Human Brain Is Complicated
This might seem pretty obvious; however, it is important to remember that when we think about causes of mental health and substance use disorders, the human brain is a complex machine. It’s easy to blame someone with dual disorders for causing their mental illness by using alcohol or other drugs, but the research does not seem to indicate anything that simple to be true in many cases.
Fact #2: Dual Diagnosis Disorders Are Complicated
It is suggested that substance use disorders and mental health conditions are frequently found together because:
- They share the same risk factors, such as stress, trauma, genetics, and brain differences.
- Mental illness often leads to substance use. Alcohol and other drugs are a way that people with mental illness sometimes try to self-medicate their symptoms. While substance use often provides temporary relief, it can make the problems far worse in the long run.
- People who already have co-occurring disorders may develop additional mental health conditions. Someone who uses substances to cope with mental illness may find that the substance triggers new mental health symptoms they had not experienced previously.
Fact #3: People Who Have Dual Diagnosis Should Be Treated for Both Conditions Simultaneously
Years ago, it was common for practitioners to attempt to discover which diagnosis came first or which was more severe and to try to treat that first, before attempting to address the other condition. This is no longer considered best practice. It is now generally recommended that people receive help for their mental health and addiction at the same time, as it can be difficult to make progress on one while leaving the other condition untreated.
Integrated treatment has been found to improve:
- Ability to abstain from substance use
- Psychiatric symptoms
- Success of recovery from both conditions
- Quality of life
- Ability to manage symptoms without hospitalization
- Housing stability
- Lawfulness
Fact #4: People With Dual Diagnoses May Need More Steps and Time to Recover
It is more common for inpatient treatment to be recommended for people with co-occurring disorders because their recovery process is often more difficult and complicated. People recovering from mental health and substance use disorder simultaneously often have case plans that include:
- Detox. This may include medical supervision to ensure the person remains safe while the alcohol or other drugs leave their body.
- Inpatient treatment. Around-the-clock supervision and support may be necessary for a period of time before the person is ready to step down to outpatient care.
- Therapy. Many different therapeutic modalities may be used, depending on a person’s age and diagnoses, to support the person’s mental health needs. These may be offered individually, in a group, or with family members.
- Medication. There may be medications to help with the person’s mental health symptoms, as well as their addiction recovery.
- Supportive housing. It may make sense for the person to continue to live among other people who are in recovery, following their completion of inpatient treatment, particularly if their home environment is not safe or supportive of their recovery.
- Recovery groups. AA, NA, Celebrate Recovery, and SMART Recovery are just a few options for peer support. Double Trouble in Recovery is a 12-Step group that is especially for people with dual diagnosis disorders.
Fact #5: People With Dual Diagnosis Disorders Are Also at Greater Risk for Medical Conditions
As if they didn’t already have enough to deal with, people with mental illness and substance use disorders are also at increased risk for:
- Certain types of cancer
- Chronic pain
- Heart disease
- HIV
- Viral hepatitis
- Sleep disorders
For this reason, people with a history of addiction and mental illness need to maintain consistent, open communication with their medical providers.
At Highland Hospital Behavioral Health, we treat mental health disorders and co-occurring substance use disorders. We offer compassionate, trauma-informed care for our patients and their families.
