Mental health is complex. Different conditions can interact with each other and exacerbate each other. This is especially true when it relates to substance use disorder. Many substance use disorders begin as a way to numb the pain from mental disorders; but, this can have a negative impact on mental health. When recovering from either, it’s important to understand the ways that they affect each other.
In this blog, let’s discuss dual diagnosis.
What Is Dual Diagnosis?
As the name suggests, a dual diagnosis occurs when a patient is given two diagnoses. However, in the mental health world, this means something a little more specific. A dual diagnosis is a case in which a patient is diagnosed with both a mental health disorder and a substance use disorder. According to the Substance Abuse and Mental Health Services Administration (SAMHSA), 21.5 million adults in the United States have a dual diagnosis.1
Common Co-Occurring Disorders
The co-occurring disorders that can be found in a dual diagnosis vary from patient to patient. Mind-altering substances like alcohol and drugs can have an impact on just about any mental health disorder. However, some are more common than others. Some common co-occurring disorders that we see in dual diagnoses include:
- Anxiety
- Mood disorders
- Schizophrenia
- Depression and bipolar disorder
- PTSD
- ADHD
- Conduct Disorders
Common Substances Used to Self-Medicate
For many, it may seem easier to use a mind-altering substance of their choice in order to feel better rather than to embark on therapy. Some dealing with substance use may not even be aware of any co-occurring mental disorders or may invalidate their own mental health. Some common substances used to self-medicate include:
- Alcohol
- Opioids (such as heroin, oxycodone or fentanyl)
- Hallucinogens (such as LSD, ketamine or ecstasy)
- Marijuana
- Nicotine
- Stimulants (such as methamphetamine, MDMA or caffeine)
- Misuse of prescription drugs
Risk Factors For Dual Diagnosis
Mental health disorders and substance use disorders have overlapping risk factors, which is why there is such a prevalent number of individuals with dual diagnosis. The first is genetics. Although the likelihood may vary depending on the condition, research has shown that genetics can play a role in developing both mental health disorders and substance use disorders.2
Environment is the other element that plays a role. A history of trauma or chronic stress can impact your mental health, as well as the urge to numb the pain with substances.
Can You Take Antidepressants With a Dual Diagnosis?
When you’re facing a dual diagnosis, it’s important to treat the mental health disorder, not just the substance use disorder. Without addressing mental health, it can be easy to fall back into old habits with your substance use. This can be tricky, however, when a common treatment for mental health disorders is prescription medication. This begs the question: can you take medication for a mental health disorder while also suffering a substance use disorder?
The truth is that it will vary for each person. If your substance use issue is with alcohol or nicotine, for instance, prescription medication such as SSRIs or SSNIs might not have much of an effect on you. On the other hand, if you struggled with misusing prescription drugs, this could be a concern. There is also a concern that alcohol or drug use could have dangerous interactions with medications prescribed to manage mental health symptoms.3
Speak to your psychiatrist honestly about your substance use symptoms. This will help them make safe and effective treatment recommendations based on your situation.
Other Treatments For Dual Diagnosis
If you want to treat a dual diagnosis, you will need to treat both the mental health condition and the substance use disorder at the same time. You will also need to stop using the substance, as continued use will make it difficult to recover on both counts. That may involve an inpatient detoxification program to help you get the substance out of your system. Your mental health professionals can help you find resources to lessen the effects of withdrawal.
Behavioral therapy such as Cognitive Behavioral Therapy (CBT) or Dialectical Behavioral Therapy (DBT) are often used to treat dual diagnosis. CBT involves working with a therapist to reframe certain thought patterns that lead to certain behaviors. DBT uses a similar principle to address target behaviors — such as substance use — and how to change those target behaviors without self-judgment. DBT utilizes both individual and group therapy.
Depending on the extent of your substance use, joining a sobriety program could also help you develop the support network and tools you need to recover from addiction or substance use. Talk to your mental health providers about a plan to treat both your mental health disorder and substance use disorder.
Rivia’s team of skilled and compassionate clinicians are here to help you with treatment for your co-occurring disorders. Contact us today to learn more or to schedule a free 15-minute consultation.
Resources:
- Co-occurring Disorders and Other Mental Health Conditions – Substance Abuse and Mental Health Services Administration
- Genes and Addiction – Genetic Science Learning Center
- Use of Antidepressants in Patients with Co-occurring Depression and Substance Use Disorders – Carey, Theadia L, 2019
