Many people struggle with both addiction and a mental health disease, with addiction often serving as a catalyst for the development of the mental illness. Addiction and mental health often go hand in hand, making it more difficult for people to attain long-term sobriety since treatment for both issues is usually required. Dual diagnosis therapy may aid in long-term sobriety and improved well-being by offering holistic care that addresses the physical and psychological components of addiction and mental health.
When a person is diagnosed with both a substance abuse problem and a mental health disorder, they are said to have a dual diagnosis. Addiction is commonly accompanied by various mental health conditions for those who suffer from it. Treatment for a dual diagnosis may be challenging since the two conditions may affect one another. Constant drug abuse and worsening mental health might result from this.
The Connection Between Mental Health and Addiction
Those who have problems with their mental health are more likely to have problems with drug abuse. Those who suffer from mental health problems like depression, anxiety, or PTSD are more likely to turn to substance abuse as a coping mechanism than their non-ill counterparts.
A depressed person, for example, may seek solace in drink or drugs in order to cope with the overwhelming feelings of sadness and despair that accompany their condition. Similarly, those who struggle with anxiety may seek relief from opioids in order to lessen their worries and fears.
Yet, substance abuse may either initiate or exacerbate preexisting mental health conditions. Substance abuse may alter brain chemistry, perhaps leading to psychological problems. Long-term alcohol usage, for instance, has been linked to neurodegeneration, depression, and other negative emotions.(1) Furthermore, drug abuse may exacerbate the symptoms of underlying mental health disorders, making it much more challenging for individuals to take control of their symptoms and lead relatively normal lives.
Identifying and Diagnosing Dual Diagnosis
Dual diagnosis detection is crucial for effective treatment. A correct diagnosis may be difficult, however, because of the common overlap between the signs of addiction and those of mental health disorders. Many persons with mental health problems may not get help for their conditions because they attribute their problems to their substance abuse instead.
Addiction is often linked to a variety of mental health issues, including depression, anxiety, bipolar disorder, and post-traumatic stress disorder. To arrive at a dual diagnosis, medical professionals will conduct a thorough evaluation looking for signs of both illnesses. This phase may include the use of a screening tool, a medical history, and a mental examination.
Comprehensive Treatment for Individuals With Co-Occurring Disorders
Integrated treatment is an all-encompassing method of dealing with dual diagnosis, since it addresses both addiction and mental health disorders simultaneously. Concurrent care, another name for integrated care. One of the main goals of integrated treatment is to treat the full patient rather than just their symptoms.
Improved treatment outcomes, lower relapse rates, and a higher quality of life are just a few of the benefits of integrated therapy. Integrated treatment may include medication management, behavioral therapies, and peer support groups.
Medication-Assisted Treatment For Addiction and Mental Health Disorders
Medication-assisted therapy (MAT) refers to the practice of using medication to complement other forms of therapy for the treatment of addiction and other mental health disorders. These medications may be used in combination with other forms of behavioral therapy to give a more comprehensive approach to treatment.
Addiction may be treated with a variety of medications, including methadone, buprenorphine, and naltrexone. Patients who use these medications may have less cravings and withdrawal symptoms, making recovery from addiction easier. In addition, medications may be used to treat certain kinds of mental health disorders including anxiety and depression. Many individuals with dual diagnosis do not receive appropriate treatment due to lack of access to care, stigma, or misdiagnosis.(2)
Medication-assisted treatment has several benefits, including higher rates of treatment compliance, lower rates of relapse, and enhanced quality of life (MAT). Nevertheless, there are certain downsides to MAT that should be taken into consideration. These include the potential for unpleasant side effects and the risk of becoming reliant on the drug itself.
Commonly Used Behavioral Therapies
Subset of psychotherapy with the main goal of altering addictive behaviors and cognitive processes that contribute to mental health disorders. Treatments for these disorders might range from motivational interviewing to dialectical behavior therapy to cognitive behavioral therapy (MI).
- Cognitive behavioral therapy may help people recognize the negative thought and behavior patterns that contribute to substance abuse and mental illness (CBT). Cognitive behavioral therapy (CBT) helps people improve their mental health and reduces the likelihood that they may start abusing drugs by instructing them to evaluate their own ideas and to replace harmful ones with more realistic and helpful ones.
- Dialectical Behavioral Therapy (DBT) is a subset of CBT designed specifically for the treatment of BPD and other mental health problems that might lead to substance abuse. Symptoms of mental health disorders may be better managed with the help of DBT, which teaches individuals how to regulate their emotions and develop effective coping strategies.
- Treatments like motivational interviewing (MI) aim to help patients become aware of and eventually conquer any internal resistance they may have to adopting new, healthier habits. Motives and Impact (MI) is a method that may help people examine the positive and bad aspects of their drug usage, therefore increasing their motivation to make a change.
Patients’ coping skills, the severity of their mental health problems, and their likelihood of abusing drugs are all improved by behavioral treatment. Yet, it may be challenging for some individuals to fully engage in therapy, and the success of treatment may vary based on the patient’s want to heal. Risk factors for dual diagnosis include genetic predisposition, environmental factors such as trauma or stress, and social factors such as poverty and lack of social support.(3)
Dual Diagnosis in Special Populations
Dual disease may afflict people of any age or background, but there are unique challenges to treatment for certain populations.
Dual Diagnosis In Adolescents
Since their brains are still developing at this age, teenagers who are coping with a comorbid disease may be more vulnerable to the effects of medicines, which presents a unique set of challenges. Concerns about privacy and discrimination may discourage young people from seeking help.
Adolescents with a dual illness frequently get a combination of behavioral therapies, family therapy, and medication-assisted therapy. Including parents or other caretakers in therapy is important because they may provide support and help improve outcomes.
Dual Diagnosis In The Elderly
Dual diagnosis in the elderly may be challenging to diagnose and treat due to the complexity of geriatric health issues and the potential for medication interactions. It may also be more challenging for elderly persons to seek treatment for mental health issues and addiction if they live alone.
It is feasible to combine medication management with behavioral therapy for the treatment of elderly people with co-occurring disorders. Involving healthcare providers and caregivers is crucial to ensure patients get proper medication management and the necessary support to overcome addiction.
Dual Diagnosis In Veterans
There is a higher risk of dual diagnosis for veterans because of the possibility of both physical and psychological damage during service. It’s conceivable that veterans are more likely to turn to alcohol and drugs as a means of coping with the effects of PTSD and other mental health disorders.
Veterans with a dual condition may benefit from a combination of support groups, medication, and cognitive behavioral therapy. Moreover, it is crucial to provide veterans with individualized care that is tailored to their specific experiences and needs.
Challenges and Future Directions
There are several challenges associated with treating people with a dual diagnosis, including the stigma associated with mental health problems and addiction, the difficulties of treatment, and the likelihood of relapse. Further study is needed to learn the root causes of these diseases and provide appropriate treatments for those with a dual diagnosis.
On the other hand, some promising avenues for dealing with dual diagnosis therapy are now being investigated. Recent advances in neurology and genetics, for instance, may help pinpoint untapped therapeutic targets and improve the efficacy of individualized care. In addition, there is a growing recognition of the need for healthcare providers to work together and integrate their approaches to better serve patients with co-occurring mental health and drug use disorders.
Conclusion
Due to the complexity and difficulty of treating individuals with a dual illness diagnosis, it is essential that these patients have a comprehensive treatment plan. As it addresses both addiction and mental health disorders simultaneously, integrated therapy is crucial for improving treatment outcomes and reducing relapse risk. Dual diagnosis affects individuals of all ages, races, and genders. However, some studies have found that certain populations may be at increased risk, such as individuals who are homeless or incarcerated.(4)
Medication-assisted therapy and behavioral therapies are both effective choices for treating dual diagnosis. In general, it’s crucial to treat dual diagnosis so that individuals may obtain the help they need to overcome addiction and strengthen their mental health. This is because many people with a plethora of diseases also struggle with drug addiction and mental health issues.
- ACNP 61st Annual Meeting: Poster Abstracts P271-P540. Neuropsychopharmacology. 2022;47(Suppl 1):220-370. doi:10.1038/s41386-022-01485-0https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9714399/?report=classic
- Larsen JL, Johansen KS, Mehlsen MY. What kind of science for dual diagnosis? A pragmatic examination of the enactive approach to psychiatry. Front Psychol. 2022;13:825701. Published 2022 Jul 18. doi:10.3389/fpsyg.2022.825701https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9339962/?report=classic
- Abstract Book for the 27th Congress of the European Hematology Association. Hemasphere. 2022;6(Suppl ):1-4130. Published 2022 Jun 23. doi:10.1097/01.HS9.0000852292.38263.b8https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9429973/?report=classic
- Towers S, Wallace D, Walker J, Eason JM, Nelson JR, Grubesic TH. A study of SARS-COV-2 outbreaks in US federal prisons: the linkage between staff, incarcerated populations, and community transmission. BMC Public Health. 2022;22(1):482. Published 2022 Mar 11. doi:10.1186/s12889-022-12813-w https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8916071/?report=classic
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