10 Things to understand about dual diagnosis and treatment

If you or your loved one have been given a ‘dual diagnosis’ by a treatment professional, it may add another layer of confusion to a drug or alcohol addiction. Here are ten things to understand about what it means to have a dual-diagnosis, and why it is common in those with a substance use disorder.\

1. What is a Dual Diagnosis?

A dual diagnosis is when two or more conditions occur in a person at a single time. This may present as drug or alcohol addiction and another mental health disorder. Dual diagnosis may also be referred to as co-occurring disorders, or co-morbid disorders. Each diagnosis interacts with each other and can impact the recovery process.

2. Addiction is a mental health disorder

In order to have a Dual Diagnosis, it is important to understand that addiction is a mental health disorder characterised by a pre-occupation with, or craving for, the substance; and/or difficulty controlling consumption. Addiction, or substance use disorder, changes the way that the brain functions. Greater attention is allocated to thinking about drugs and trying to obtain drugs, while the parts of the brain that are responsible for behavioural control and decision making can become less active. Professional treatment is usually required to achieve recovery.

3. Comorbidity in addiction is common

Substance use disorders and other mental health disorders are very likely to occur together.

In fact, anywhere between 40-80% of people in Victoria that seek help for a mental illness have also experienced issues with substance abuse. On the other hand, individuals with a substance use disorder are also more likely to have a mental health disorder.

4. Mental health disorders can increase the risk for drug and alcohol addiction

Substance use problems are more common among those who have pre-existing mental health problems than among the general population. Those with a mental health disorder may turn to alcohol or drugs as a way to self-medicate their symptoms.

5. Addiction can also lead to mental health disorders

Drug addiction can lead to the development of mental health disorders. Chronic drug use has been associated with short-term and long-term changes in the brain which may lead to depression, anxiety, paranoia, hallucinations, or other mental health symptoms.

6. Common risk factors can contribute to both diagnoses

There are shared risk factors for substance use disorder and mental health disorders, such as genetics and high-stress environments. For example, genes can influence how rewarding a drug is perceived to be, and how stressful a situation or environment is perceived to be. These shared risk factors may increase the possibility of developing both substance use disorder and mental health disorders.

7. Anxiety and mood disorders are among the most prevalent co-occurring disorders

Individuals with drug or alcohol addiction are about twice as likely to experience anxiety and mood disorders as the general population. In Australia, those with alcohol use disorder are at least 2.5 times more likely to experience an anxiety disorder.

8. How will a dual diagnosis impact recovery?

Recognising a secondary disorder will greatly improve the opportunity for recovery. Symptoms that are associated with mental health disorders, such as feelings of anxiety or depression, may trigger an individual to use drugs. Focusing on both addiction and mental illness when treating substance use disorders may help to enhance coping skills that can protect against relapse.

9. The benefit of a Therapeutic Community

Long-term residential treatment can be beneficial for someone with a Dual Diagnosis. The Therapeutic Community focuses on helping individuals to practice socialising with other residents in a safe and supportive environment, which is beneficial for a person experiencing problems with addiction and other mental health disorders.

10. Best chance of recovery

It is important to remember that addiction is a mental health disorder and not a choice. People with substance use disorders do not choose to continue using drugs or alcohol despite the harmful consequences they pose. When a mental health disorder is also experienced at the same time as an addiction, your loved one may be working on understanding any harmful beliefs and modifying other behaviours that are not serving them well. If your loved one has a dual diagnosis, encourage them to see their treatment plan through and offer them continued love and support as they navigate their way to recovery.