Dual Diagnosis

Addiction is a chronic brain disease. When someone is suffering from a behavioural addiction or a substance addiction (e.g. drug or alcohol addiction), they are compromised in a way in which they are unable to function optimally.

This is because they will experience cravings, potentially excruciating or even fatal withdrawal symptoms, a lack of energy and interest in other things, and much more.

However, an addiction does not remain stagnant or stabilises by itself, it progresses over time.

If it is not dealt with by professional intervention at a drug and alcohol rehab, it can reach a point where it is affecting each facet of someone’s life, and it may even lead to the development of a severe psychiatric illness and mental health problems.

Many of the people who are suffering from a drug or alcohol addiction are also suffering from other mental health issues in addition to their substance use disorder.

In fact, a study conducted by the government in the United Kingdom in 2020 to 2021 discovered that 63% of patients who entered a drug and alcohol rehab required additional mental health treatment in addition to their addiction treatment.

Sometimes, their addiction is what causes them to develop a form of mental illness. On the other hand, however, a mental illness may be a driving factor in a person developing a substance use disorder.

They share a mutually destructive relationship and they can not only cause one another but significantly amplify their symptoms and complications.

What this means is that people are suffering from co-occurring disorders. That is, addiction and a mental health condition. When this is the case, a dual diagnosis will be made to ensure that they are treated for both forms of illnesses.

When someone is suffering from a drug and alcohol addiction alone, and not a mental health condition such as anxiety, depression, bipolar disorder, and so on, they will undergo a regular diagnosis.

This diagnosis will help health practitioners devise a plan for them to undergo the appropriate treatment for their addiction.

However, a dual diagnosis will be made if someone is suffering from addiction and also another mental health condition.

A dual diagnosis will ensure that patients receive treatment for both forms of illness while they are entering and undergoing treatment at a drug and alcohol rehab.

The Destructive Relationship Between Drug and Alcohol Addiction & Mental Health Issues

There is a strong and mutually destructive relationship between frequent and excessive drug and alcohol consumption, which then leads to addiction, and mental health issues such as depression, anxiety, bipolar disorder, schizophrenia, trauma, and much more.

However, there are many ways that one can affect, or even cause, the other.

Patterns of drug and alcohol consumption vary from person to person, as does their mental health state, medical history, genetic predisposition, and so on.

Therefore, there are a number of ways in which drugs, alcohol, and mental health disorders can combine to form a relationship which is destructive to one’s health.

In some cases, those suffering from mental health disorders, in order to cope with their symptoms, may turn towards drugs and alcohol. This is called self medicating.

Other circumstances may include a person who has developed a dependence and addiction to a substance such as drugs or alcohol, and their addiction as well as symptoms of excessive consumption leads to mental health issues.

How Mental Health Issues Leads to Substance Use Disorder

Many people suffer from substance use disorder, or addiction, because they are already suffering from mental health issues such as anxiety, depression, bipolar disorder, and so on.

This is because they are struggling to cope with the symptoms that they present, and as a result, they turn towards something intoxicating and addictive in search of feelings of euphoria.

Drugs and alcohol can release ‘feel good’ chemicals in the brain, which include dopamine and serotonin.

This can provide feelings of euphoria for the consumer in the long term. However, there are many long term physical and mental health complications associated with drug and alcohol use.

So, when someone is suffering from mental health issues which produce symptoms of low energy, anxiety, stress, worry, anger, confusion, or else, people may turn towards a substance which they think makes them feel better, at least temporarily.

Because these symptoms of mental health illnesses are long lasting, especially if they are not dealt with through health professionals or licensed counsellors, people will keep consuming drugs and alcohol to replicate this feeling of transient euphoria.

Inevitably, frequent and excessive consumption of drugs and alcohol will lead to substance dependence and addiction.

How Substance Use Disorder Leads to Mental Health Issues

On the other hand, many people who are suffering from addiction may not have been suffering from a mental illness beforehand, but end up developing mental illnesses because of their severe dependence on an addictive substance.

When someone develops an addiction, it is because the reward pathways (known as the mesolimbic pathways) in the brain are reconfigured and reinforced in a way which becomes dependent on addictive substances in order to release chemicals such as dopamine and serotonin.

This makes it much more difficult to produce these chemicals naturally. So, in order to keep experiencing these feelings of temporary euphoria and happiness, people who are suffering from addiction will be compelled to keep consuming their addictive substance.

They will experience physical and psychological cravings and compulsions, as well as withdrawal symptoms, which will make them keep consuming their addictive substance.

However, long term use of drugs or alcohol, regardless of whether someone is addicted or not, can present symptoms of anxiety and depression.

It is not a coincidence that people feel anxious when they are suffering from a hangover (or ‘hangxiety’) or the ‘come down’ following a night of consuming drugs or alcohol.

Addictive substances, whether a stimulant or depressant, exposes its users to a range of symptoms such as lack of energy, depression, anxiety, irritability, aggression, erratic moods, and more.

Furthermore, if someone drinks too much alcohol, or consumes too much drugs at a single time, regardless of whether they are addicted or not, they may suffer from psychosis.

Psychosis is the detachment from reality which someone suffers, due to excessive consumption of intoxicating substances or mental health problems such as schizophrenia.

Symptoms of psychosis include hearing things that do not exist, seeing things that are not there, and more.

Frequent and excessive drug and alcohol use can lead to the development of long term mental health issues such as schizophrenia and dementia.

While some of these symptoms can be reversed with adequate treatment and medication, many of the mental health illnesses associated with drug and alcohol addiction may not be reversible.

What Types of Mental Health Illnesses Are Associated With Addiction?

There are a range of mental health disorders which are associated with drug and alcohol addiction.

Some of the most common forms of mental health disorders which are found among dual diagnosis patients suffering from drug and alcohol addiction include but are not limited to:

Anxiety Disorder
Depression
Bipolar Disorder
Schizophrenia
Trauma & PTSD (Post-Traumatic Stress Disorder)

Anxiety Disorder

While people may experience symptoms of anxiety whenever they are worried or are going through an experience which involves high stakes, people with anxiety disorder experience symptoms of anxiety intensely and frequently.

These people will have an amplified sense of worry and trepidation over things which may seem insignificant to others.

When someone is suffering from anxiety disorder, it makes them much more susceptible to developing a drug or alcohol addiction.

This is because when they are experiencing symptoms of anxiety, they are more vulnerable to drinking higher quantities of alcohol or consuming more drugs to overcome the feeling, especially in social situations.

This is called ‘self-medicating‘, when a person will do something in order to overcome their mental illness symptoms.

In this case, they use drugs or alcohol in order to self medicate. The term ‘dutch courage’ comes from the idea of drinking in order to overcome your fears and anxiety, in order to become braver.

However, this will only create more problems in the long term, making it more difficult to overcome both their addiction and anxiety disorder.

Depression

Depression, a mental illness which is not only a fleeting moment or phase of sadness, but is a condition which is extremely persistent in its symptoms.

Some of its symptoms include sadness, disinterest, tiredness, lack of motivation, insomnia, lack of energy, self harming, self loathing, suicide ideation, and more.

Similar to anxiety, people who suffer from depression may turn towards consuming drugs or alcohol in order to relieve their symptoms.

Because drugs and alcohol can make people feel happy or euphoric temporarily, and alcohol and cannabis in particular can make people feel relaxed and sleepy, people may turn towards these in order to minimise the symptoms of depression without taking into consideration its long term effects.

However, while drugs and alcohol may temporarily cover up these feelings of negativity, they will exacerbate these symptoms in the long term, especially during stages of withdrawal.

People who are addicted to drugs or alcohol will find that it is harder to experience natural dopamine release and therefore feelings of happiness without consuming their addictive substance.

Bipolar Disorder

Bipolar Disorder is a mental disorder where someone’s mood and emotions may swing drastically regardless of the circumstances.

They may experience what is called hypomania, where they are high in energy, and then they may oscillate towards experiencing phases of depression and a severe lack of energy.

Drug and alcohol use exposes people towards developing bipolar disorder. Furthermore, people suffering from bipolar disorder may turn towards drug or alcohol consumption.

If someone is suffering from the genetic traits which expose them to Bipolar Disorder, they may also be exposed to developing a drug or alcohol addiction.

Additionally, when someone is suffering from the depression and emotional lows associated with Bipolar Disorder, they are more likely to turn towards intoxicating substances in order to cope.

Schizophrenia

Schizophrenia is a mental disorder where the person suffering has a severe detachment from reality. Their thoughts and perception are skewed significantly, and what they think is real may not be.

Common symptoms of schizophrenia include hearing things that are not there, and hallucinating things that do not exist in reality.

Much like other forms of mental health illnesses, having traits which make someone more susceptible to developing schizophrenia may also make them more susceptible to developing substance use disorder.

Because excessive drug and alcohol use can lead to psychosis and hallucinations, long term use of both makes people much more likely to develop a mental health condition such as schizophrenia.

Addiction and schizophrenia can also cause irreversible damage.

While there is treatment available for schizophrenia, some people may experience symptoms so severe that it is difficult or even impossible for them to go back to a life of normalcy.

Trauma & PTSD (Post-Traumatic Stress Disorder)

When someone suffers from trauma in whatever form, they are suffering from disturbing thoughts and intense emotions for a long period of time.

Being unable to confront the challenges and events which lead to them developing this mental disorder, victims of trauma may turn towards drinking alcohol or consuming drugs in order to overcome these feelings of fear, guilt, shame, insomnia, irritability, and whatever else they may feel.

Things which can cause PTSD include but are not limited to physical abuse, sexual abuse, war, terrorism, death, witnessing death or violence, death threats, childhood abuse, and much more.

In the medical and scientific literature, there is a strong correlation between PTSD victims and substance abuse, particularly alcohol abuse.

In fact, some studies estimate that people who suffer from PTSD are over twice as likely to develop substance use disorder when compared to those who do not suffer from trauma.

Psychological Symptoms Associated With Addiction

Although there are many tangible and visible physical symptoms which include weight gain, weight loss, malnutrition, vomiting, dehydration, seizures, and more, there are also many short term and long term psychological symptoms associated with addiction.

Some people may be able to hide these symptoms in social settings, whereas others may be showing clear and visible signs that they are suffering psychologically due to addiction.

For example, it may be difficult to identify that someone is suffering from depression (but not always), however, someone suffering from psychosis or schizophrenia will exhibit their symptoms outwardly.

Many of the psychological symptoms associated with addiction include but are not limited to:

Anxiety: People may suffer from intense feelings of fear, worry, and trepidation throughout their addiction. Not only will they feel these symptoms during the withdrawal stage, but they may experience persistent symptoms of anxiety, and symptoms may be exacerbated because of their consumption habits.
Depression: Addiction may lead to experiencing symptoms such as low energy, lack of motivation, sadness, self loathing, suicide ideation, and more. Repeating cycles which are full of negative habits and damaging to oneself will only exacerbate feelings of depression among addicted people.
Insomnia: While substances such as cannabis and alcohol may make people feel more relaxed and sleepy, their sleep quality will suffer drastically if they are addicted to these substances. This is because these substances suppress REM sleep, which is crucial to facilitate learning, memorisation, emotional processing, and so on.
Psychosis & Hallucination: Frequent and heavy drug consumption can lead to psychosis or hallucination, where people are essentially detached from reality. They may see or hear things which are not there, and after frequent and prolonged use of the hallucinogenic substances, they may develop mental health conditions such as schizophrenia.

Who is at Risk of Developing Co-Occurring Disorders

Some people may have genetic predispositions which make them susceptible to developing mental health conditions or substance use disorder.

However, social and environmental factors also have a significant impact on exposing people to developing these mental health conditions, including addiction.

Some of the factors which expose people include:

Genetics: Some people may have genetic traits or characteristics which makes them more likely to develop substance use disorder or another mental illness such as depression, for example. Studies suggest that people can inherit traits which expose them to addiction from their parents.
Social and environmental: People who grow up in dysfunctional households or families, or are associated with people who indulge in a lifestyle of frequent and heavy drinking or drug consumption are much more likely to become addicted or develop other mental health issues.
Medical history: If someone has an illness or an injury which requires them to take medication, the side effects may harm their mental health and make them more susceptible to developing an addiction.

Treating Addiction and Mental Health Issues at Rehab

When undergoing a dual diagnosis, patients will be referred to a rehab which will optimise their treatment plan.

This treatment plan will be highly personalised in order to not only combat their addiction but to treat their additional mental health requirement.

While some people who are suffering from both may only enter rehab to treat their addiction, it is imperative that they are treated for both of their conditions concurrently.

This is because they may think that one condition is worse than the other. However, the truth is that these conditions may be facilitating each other and exacerbating the symptoms of the other.

Therefore, it is important that patients disclose that they are suffering from an additional mental health condition in addition to their addiction.

Co-occurring disorders require co-occurring treatment to optimise the patient’s recovery and help them go back to a life of normalcy.

Treatment for Co-Occurring Disorders

There is not only one form of treatment at rehab. This is especially the case with dual diagnosis patients who are suffering from additional mental illnesses.

In order to treat the patient effectively, they will need to undergo an addiction treatment programme which incorporates a range of treatment and therapeutic methods.

Medically Assisted Therapy & Pharmacological Intervention

Dual diagnosis patients who are suffering from more severe withdrawal symptoms will need to undergo a medicated detox.

During the medicated detox phase, they will spend around one to two weeks receiving medication to treat their withdrawal symptoms which may be having an impact on their mental health.

Patients who are suffering from psychological symptoms such as anxiety, depression, or insomnia can receive medication for their symptoms.

Medications such as Benzodiazepines will be prescribed for dual diagnosis patients who are suffering from symptoms such as insomnia, whereas medications such as SSRI (Selective Serotonin Reuptake Inhibitor) antidepressants will be prescribed in order to treat those suffering from anxiety and depression.

The medicated detox and pharmacological intervention is done in a safe and comfortable facility which is highly supervised by health practitioners.

This stage will help patients overcome their initial symptoms associated with withdrawal symptoms, allowing them to undergo the rest of their addiction treatment in a better mental and physical state.

Cognitive Behavioural Therapy (CBT)

Cognitive Behavioural Therapy (CBT) is one of the most effective forms of therapy incorporated at most drug and alcohol rehabilitation centres.

This is because not only does it treat patients who are suffering from addiction, it is effective in treating patients who are suffering from other mental illnesses such as anxiety, depression, bipolar disorder, schizophrenia, trauma, and more.

It does much more than only addressing the symptoms of addiction.

While it certainly does address the symptoms which come from addiction, it also addresses many pre-existing problems, especially mental problems, which may have led to or exacerbated symptoms of addiction.

Examples of some of these mental problems may be experiencing anxiety, guilt, depression, self loathing, self hatred, cognitive distortion, and much more.

The licensed counsellor and patient will work together to understand which toxic and self destructive cognitive and behavioural patterns the patient exhibits, and they will work towards combating these tendencies in order to create a healthier lifestyle.

Cognitive Behavioural Therapy is also a form of individual therapy, and the structure is in a simple one to one format between the licensed counsellor and his or her patient.

This allows for maximised personalisation when it comes to treatment. Rather than applying knowledge and techniques within the context of addiction, the counsellor is applying his or her expertise in order to treat the unique case of addiction that the patient has.

There are many variables when it comes to addiction, therefore personalisation is imperative towards optimising recovery.

Dialectical Behavioural Therapy (DBT)

Another form of treatment which is effective in helping patients recover from not only addiction but poor mental health is Dialectical Behavioural Therapy (DBT), which is a branch of Cognitive Behavioural Therapy.

What makes Dialectical Behavioural Therapy different is that it focuses more on the emotional side of addiction treatment.

It is used to treat those who are suffering from addiction as well as those who suffer from trauma, anxiety, depression, and anyone who struggles to process their emotions in a productive and healthy manner in general.

Consistently attending Dialectical Behavioural Therapy sessions will allow dual diagnosis patients to develop the ability to manage their feelings more effectively.

While they will always be susceptible to experiencing sadness, anger, guilt, and more, just as any other person would, they will learn how to manage these feelings.

This includes stress management, mindfulness, among other techniques which will help them remain constructive and proactive in the face of adversity.

Holistic Therapy

Holistic Therapy benefits patients who are suffering from addiction as well as those who are suffering from mental health issues.

In addition to communication based therapies such as CBT and DBT, Holistic Therapy can be an effective addition in an addiction treatment programme as it can not only help patients improve their well being but develop hobbies and interests.

Patients who undergo Holistic Therapy will take part in activities and therapy such as adventure therapy, music therapy, art therapy, massages, acupuncture, meditation, mindfulness, tai chi, yoga, and much more.

It is incredibly diverse, and is likely to appeal to most patients because of the sheer variety in activities and benefits that it offers.

Benefits will range from activity to activity. For example, yoga and hiking can offer benefits such as improved fitness (in addition to psychological benefits), whereas art therapy and aromatherapy can offer stress reduction and relaxation.

Ultimately, patients will experience behavioural activation, which activates pleasant emotions in the brain.

Regardless of whether the activity or therapy is fitness based, or focuses more on mindfulness, and so on, they will each encourage behavioural activation.

Behavioural activation is effective in treating dual diagnosis patients suffering from addiction as well as conditions such as depression, as making people take part in engaging activities and completing tasks and objectives can incite positive experiences.

The benefits are holistic, meaning that it will improve their physical, mental, and spiritual health.

Patients who take part in Holistic Therapy typically leave rehab with significantly reduced levels of stress, improved mental well being and physical health, improved sociability, organisational skills, and self confidence, and much more.

Group Therapy

Group Therapy is an effective way to help people overcome addiction and mental health problems, especially if it is incorporated in a programme which includes individual therapy.

While individual therapy does offer benefits which cannot be had from Group Therapy, such as maximised focus and personalisation from counsellors, Group Therapy can offer many benefits which individual therapy does not.

The benefits that Group Therapy can offer includes but isn’t limited to social reinforcement, emotional purging, establishing a support network, being heard by others, and much more.

Since most members and patients are suffering from similar conditions and are striving towards the same goals, they will offer social and positive reinforcement which can encourage patients to adopt healthier lifestyle habits.

Additionally, it will create a non-judgemental and supportive environment in which patients can share their feelings and experience with others.

Not only will they widen their perspective by gaining insight into other people’s experiences on how they dealt with addiction, sharing with others who resonate with them is the perfect opportunity to experience emotional purging.

While patients can remain anonymous much like the support sessions in Alcoholics Anonymous, patients will find a strong sense of community and support network through Group Therapy.

If they wish to continue the relationship and bonds developed with other patients of Group Therapy, they can do so following rehab life to reinforce their support network.

Family Therapy

Regardless of the relationship that a patient has with his or her family, Family Therapy is an effective way to create a healthier and more hospitable living and recovery environment.

Family Therapy is incredibly diverse and can assist patients who have a positive relationship with a supportive family as well as those who have a negative relationship with their family.

Because of the sheer variety of family dynamics, there are different variations or branches of Family Therapy which cater towards different dynamics. Some of these examples include:

Brief Strategic Family Therapy
Multisystemic Therapy
Family Behaviour Therapy
Functional Family Therapy
Multidimensional Family Therapy

For example, while Brief Strategic Family Therapy may cater towards patients with family members who may display negative habits, Multisystemic Therapy caters towards younger patients in order to help their parents understand their unique needs and requirements to recover from addiction (and other mental conditions).

The benefits of Brief Strategic Family Therapy are that they address problems which stem from childhood or the household.

Family members may display and even encourage unhealthy habits, whether it is consuming addictive substances or displaying hostility to others, and these negative habits will influence the patient dramatically.

Not only could they develop negative behavioural patterns, it may result in them developing mental disorders and a substance addiction.

Multisystemic Therapy, on the other hand, caters to younger patients. The benefits lie in allowing parents or guardians who have more responsibility over the addicted patient to understand the complexities of their conditions.

By educating and informing them on the difficult nature of addiction, they will be more capable of supporting their loved one and their home environment will serve as a fitting place for recovery.

Other forms of therapies, such as Family Behaviour Therapy, Functional Family Therapy, and Multidimensional Family Therapy, are used in order to improve the general wellbeing of patients and his or her family members, as well as improving the level of communication.

Not only do the patients suffer, their family members may suffer from emotional trauma and stress which will not only decrease their quality of life or their ability to support their loved one, it may lead to the development of mental health conditions.

These forms of therapy will help family members cope with their struggles.

Furthermore, these forms of Family Therapy will help patients improve their level of communication in a way which will create a non-judgemental environment which will also serve as an optimal living or recovery environment.

It is important that patients, once they have left rehab, are able to sustain their recovery while living in a location which does not present relapse triggers.

Contact Us Today For Addiction and Mental Health Treatment

If you have already accepted the idea that you are suffering from co-occurring disorders, that is a drug or alcohol addiction and another mental disorder, you have made the first big step towards initiating your recovery.

This is a monumental step, because only when you acknowledge that you are suffering will you be able to proceed with recovery at an optimal treatment provider.

When you reach out to us, you you will be greeted by a friendly and experienced member of staff whose purpose is to answer any of your concerns or to help you initiate your recovery journey.

This member of staff will be there to help you with whatever you’re looking for, and will not proceed with admission into a drug and alcohol addiction treatment provider until you are ready to do so.

At Rehab Recovery, your requirements are at the forefront of our priorities.

When you are ready to proceed and undergo the admission process, the admissions officer at Rehab Recovery will help you undergo a health assessment.

This will be cost free, and swiftly done at your convenience over the phone.

This assessment is only composed of a series of questions related to your medical history, addiction condition, mental health conditions, physical health, and so on.

Once the health assessment is completed, consultant psychiatrists and addiction specialists will analyse the information that you have provided in order to locate a suitable rehabilitation centre.

Your chosen centre will be one that can cater to your co-occurring disorders – both your addiction recovery and your mental health needs – through a range of effective treatment.