Dual Diagnosis: Substance Abuse and Mental Health

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When a person has both a drug addiction problem and mental health problems, such as depression, bipolar disorder, or anxiety, they are said to have co-occurring disorders or dual diagnoses. Dealing with substance misuse, alcoholism, or drug addiction is never simple, but it becomes much more challenging when accompanied by mental health issues.

In co-occurring disorders, both the mental health illness and the drug or alcohol addiction have their own symptoms that may interfere with your capacity to perform at work or school, have a stable family life, deal with life’s challenges, and maintain healthy interpersonal relationships. To further complicate the matter, the co-occurring disorders interact with one another. Typically, when a mental health condition is left addressed, the drug addiction problem worsens. And when substance addiction rises, mental health issues typically develop as well.

Substance misuse and mental health difficulties co-occur more frequently than many people believe. Reports published in the Journal of the American Medical Association indicate that:

  • Roughly fifty percent of people with serious mental problems are drug abusers.
  • 37% of alcoholics and 53% of drug abusers also suffer from at least one significant mental disease.
  • 29 percent of those diagnosed with mental illness misuse alcohol or drugs.

Despite the fact that drug misuse problems and mental health difficulties would certainly worsen if neglected, it is essential to realize that you do not have to feel this way. There are steps you may take to overcome your demons, mend your relationships, and go on the path to recovery. You can overcome a co-occurring condition, regain your sense of self, and get your life back on track provided you receive the appropriate support, self-help, and therapy.

Which Comes First: Substance Abuse or the Mental Health Problem?

Substance misuse and mental health illnesses, such as depression and anxiety, have a tight relationship, although one does not always cause the other. Substances such as marijuana and methamphetamine can create extended psychotic responses, whilst alcohol can exacerbate feelings of sadness and anxiety. Also:

  • Alcohol and narcotics are frequently used to self-medicate mental health issues’ symptoms. People frequently misuse alcohol or drugs to alleviate the symptoms of an undetected mental disease, to deal with uncomfortable emotions, or to alter their mood momentarily. Unfortunately, self-medication with drugs or alcohol has negative side effects and, in the long term, frequently exacerbates the problems they were first used to treat.
  • Abuse of alcohol and drugs can raise the risk for mental illnesses. Since mental health issues are the result of a complex interaction between heredity, the environment, and other variables, it is impossible to determine if substance abuse ever directly causes them. However, if you are at risk for a mental health condition, substance abuse may drive you over the brink. For instance, there is some evidence that persons who abuse opiate medications are at an elevated risk for depression, and frequent cannabis use has been associated with an increased risk for schizophrenia.
  • Substance misuse can exacerbate the symptoms of a mental health disorder. Substance addiction may dramatically exacerbate the symptoms of mental illness or even cause the onset of new symptoms. Abuse of alcohol or drugs can also interfere with prescriptions such as antidepressants, antianxiety meds, and mood stabilizers, reducing their effectiveness in treating symptoms and delaying recovery.

Signs and Symptoms of Substance Abuse

Prescription pharmaceuticals (including opioid painkillers, ADHD meds, and sedatives), recreational or street drugs (including marijuana, methamphetamine, and cocaine), and alcohol are abused substances (beer, wine, and liquor). A substance addiction issue is not, however, characterized by the substances abused or consumed. Rather, it boils down to how your drug or alcohol usage affects your life and relationships. You have a substance abuse issue if your drinking or drug usage is producing problems in your life.

Answering the following questions may aid you in recognizing the indicators of a drug addiction issue. The more “yes” responses you provide, the more probable it is that your alcohol or drug usage has become problematic.

  • Have you ever felt the need to reduce your alcohol or drug consumption?
  • Do you require increasing amounts of drugs or alcohol to get the same mood or outlook?
  • Have you attempted to cut back but failed?
  • Do you lie about the amount or frequency of your alcohol or drug consumption?
  • Are you using prescription medications at an accelerated rate?
  • Have your friends or relatives voiced worry about your substance abuse?
  • Feel horrible, guilty, or humiliated about your substance abuse?
  • Have you done or spoken about something under the influence of alcohol or drugs that you later came to regret?
  • Your alcohol or drug usage has produced issues at work, in school, or in your relationships.
  • Has your drinking or drug usage landed you in legal trouble?

Signs And Symptoms Of Common Co-occurring Disorders

The mental health problems that most commonly co-occur with substance abuse are depression, bipolar disorder, and anxiety disorders.

Common Signs And Symptoms Of Depression

  • Feelings of helplessness and hopelessness
  • Loss of interest in daily activities
  • Inability to experience pleasure
  • Appetite or weight changes
  • Sleep changes
  • Loss of energy
  • Strong feelings of worthlessness or guilt
  • Concentration problems
  • Anger, physical pain, and reckless behavior (especially in men)

Common Signs And Symptoms Of Anxiety

  • Excessive tension and worry
  • Feeling restless or jumpy
  • Irritability or feeling “on edge”
  • Racing heart or shortness of breath
  • Nausea, trembling, or dizziness
  • Muscle tension, headaches
  • Trouble concentrating
  • Insomnia

Common Signs And Symptoms Of Mania In Bipolar Disorder

  • Feelings of euphoria or extreme irritability
  • Unrealistic, grandiose beliefs
  • Decreased need for sleep
  • Increased energy
  • Rapid speech and racing thoughts
  • Impaired judgment and impulsivity
  • Hyperactivity
  • Anger or rage

Also often co-occurring with substance misuse or addiction are Schizophrenia, Borderline Personality Disorder, and Post-Traumatic Stress Disorder.

Treatment for a Dual Diagnosis

The most effective therapy for co-occurring disorders is an integrated strategy that treats both the drug addiction issue and the mental condition concurrently. Whether your mental health or drug misuse issue began first, your long-term recovery depends on receiving treatment for both illnesses from the same clinician or team. Depending on your particular concerns:

Medication, individual or group therapy, self-help techniques, changes in lifestyle, and peer support may be used to treat your mental health condition.

The treatment for your substance misuse may involve detoxification, management of withdrawal symptoms, behavioral counseling, and sobriety-maintenance support groups.

Remember that there is always hope. Both mental disorders and alcohol and drug misuse issues can be treated. It takes time, dedication, and fortitude to recover from co-occurring illnesses, but people with drug misuse and mental health issues can and do recover.

  • Obtaining and maintaining sobriety is essential during therapy. If your doctor prescribes medicine for a mental health issue, combining it with alcohol or other substances might have severe consequences. Similarly, under the influence of drugs or alcohol, talk therapy is significantly less effective.
  • Relapses are part of the process of recovery. Do not become very disheartened if you relapse. Relapses and setbacks are inevitable, but with effort, the majority of individuals can recover from them and continue their rehabilitation.
  • Peer support is beneficial. Joining a self-help support organization such as Alcoholics Anonymous or Narcotics Anonymous may be beneficial. A support group provides you the opportunity to depend on people who are experiencing the same thing you are and to benefit from their experiences.

Finding the Optimal Treatment Plan

Ensure that the program is properly certified and accredited, that the therapy methods are supported by research, and that there is a relapse prevention aftercare program. In addition, you should ensure that the program has experience with your specific mental health condition. Some programs may have expertise in treating anxiety or depression, but not schizophrenia or bipolar disease.

Therapy programs may take a number of methods, but there are a few fundamentals of good treatment that you should look for:

  • The treatment targets both your substance misuse and mental health issues.
  • You participate in the decision-making process and actively participate in establishing goals and implementing change strategies.
  • The treatment includes teaching about the illness and associated issues.
  • You are taught healthy coping skills and ways to reduce substance misuse, build your relationships, and manage life’s pressures, difficulties, and distress.

Dual Diagnosis Programs

Finding the appropriate program can aid you in:

  • Consider the impact that alcohol and/or drugs have on your life. This should be done in confidence, without judgment or negative repercussions. People feel comfortable discussing these issues when they can do so without fear of legal repercussions.
  • Learn more about the effects of alcohol and drugs on mental illness and medicine.
  • Find employment and other resources that may aid the healing process.
  • Determine and define your own rehabilitation objectives. If you determine that your alcohol or drug use may be problematic, a counselor trained in dual diagnosis treatment can assist you in achieving your unique recovery objectives for both illnesses.
  • Experience counseling designed specifically for dual diagnosis patients. This can be accomplished on your own, with a group of peers, with your family, or a combination of these.

Veterans’ Treatment Programs For Co-occurring Disorders

Veterans have extra obstacles in regards to co-occurring disorders. The stresses of deployment or war can worsen underlying mental problems, and drug misuse is a typical coping mechanism among military veterans with PTSD for coping with the unpleasant sensations or memories associated with PTSD.

Often, these issues take time to manifest once a vet comes home, and may first be misinterpreted as readjustment. Untreated co-occurring illnesses can cause significant issues at home, at work, and in your everyday life, thus it is essential to get treatment.

Autotherapy For Dual Diagnosis

In addition to professional therapy, there are several self-help methods for addressing substance misuse and mental health problems. Remember that sobriety is just the beginning. In addition to ongoing mental health therapy, your sustained recovery is contingent upon developing healthier coping methods and making better judgments when confronting life’s obstacles.

Manage Your Stress and Emotions

Learn to deal with stress. Frequently, substance misuse results from misdirected attempts to handle stress. It is crucial to develop healthy coping skills so that you can deal with stress without turning to alcohol or drugs, as stress is an inescapable part of life. Stress management skills are crucial for preventing recurrence and controlling symptoms.

Deal with bad emotions. Numerous individuals use alcohol or drugs to numb painful memories and emotions, such as loneliness, melancholy, and worry. HelpGuide’s free Emotional Intelligence Toolkit may educate you on how to cope with tough emotions without reverting to your addiction, even if you believe that using drugs is the only way to address unpleasant emotions.

Know your triggers and formulate a plan of action. When you are suffering from both a mental disease and a drug misuse issue, it is more vital to recognize symptoms of your sickness worsening. Common causes include stressful experiences, major life changes, and poor sleeping and eating habits. It is crucial to have a strategy in place to prevent relapse during these periods. Whom will you speak with? What precautions must be taken to prevent slipping?

Develop Relationships

Prioritize face-to-face communication with friends and family. The simplest approach to relaxing your nerves is to develop a positive emotional connection with others around you. Try to maintain regular contact with those who care for you. It is never too late to meet new people and create meaningful connections if you have no close pals.

Observe the doctor’s directions. Once sober and feeling better, you may believe you no longer require medication or therapy. However, abruptly discontinuing medication or therapy is a significant cause of relapse among individuals with co-occurring illnesses. Always with your physician before altering your prescription or treatment regimen.

Participate in counseling or a support group. Participating in a social support organization like Alcoholics Anonymous or Narcotics Anonymous or receiving counseling increases your chances of remaining sober.

Make Healthy Lifestyle Modifications

Exercise frequently. Physical activity is a natural approach to combat stress, alleviate anxiety, and enhance your disposition and perspective. Aim for at least 30 minutes of aerobic activity on the majority of days in order to gain the greatest effect.

Practice relaxing methods. Regular use of relaxation techniques such as mindfulness meditation, progressive muscle relaxation, and deep breathing help reduce stress, anxiety, and depression symptoms and enhance sensations of relaxation and emotional well-being.

Adopt wholesome eating practices. Breakfast should be the first meal of the day, followed by several little meals throughout the day. A prolonged absence from food causes low blood sugar, which can increase feelings of tension and anxiety. A diet rich in healthy fats can assist to improve one’s mood.

Get adequate sleep. A lack of sleep can increase stress, anxiety, and depression; thus, you should aim for 7 to 9 hours of excellent sleep every night.

Find New Significance in Life

To remain alcohol- or drug-free indefinitely, you must create a new, fulfilling life in which substance addiction has no role.

Develop new hobbies and activities. Find new meaningful pastimes, volunteer opportunities, or employment. When you engage in activities that you enjoy, you will feel better about yourself, and substance abuse will become less appealing.

Avoid the triggers of your desire to use. If specific individuals, locations, or activities trigger drug or alcohol cravings, you should avoid them. This may necessitate significant adjustments to your social life, such as finding new activities to do with your old pals or even abandoning them in favor of new relationships.

Group Assistance

As with other addictions, meetings are not only useful for keeping sober, but also as a secure place to get support and share obstacles. Occasionally, co-occurring disorder treatment programs provide groups that continue to meet on an aftercare basis. Additionally, your physician or treatment provider may be able to recommend you to a support group for persons with co-occurring disorders.

In most cases, it’s ideal to join a group that treats both drug addiction and your mental health issue. However, twelve-step programs for substance abuse may also be useful, and they’re more prevalent, so you’re more likely to locate one in your region. These peer-led, free programs employ group support and a set of guiding principles, known as the twelve steps, to achieve and maintain sobriety.

Verify that your organization accepts the concept of co-occurring illnesses and psychiatric medicines. Despite their good intentions, some members of these groups may misinterpret the use of psychiatric medicine for another sort of addiction. You seek a place where you may feel secure and not under duress.

Helping A Loved One With A Dual Diagnosis

Helping a person with a drug addiction problem and a mental health issue may be a roller coaster. Treatment resistance is frequent, and the path to recovery can be lengthy.

Accepting what you can and cannot do is the greatest approach to helping someone. You cannot compel someone to remain sober or to take their medicine or attend their appointments. You can make healthy decisions for yourself, urge your loved one to get assistance, and provide your support without losing yourself in the process.

Seek help. The mental illness and substance misuse of a loved one may be distressing and lonely. Ensure that you are receiving the necessary emotional support to cope. Discuss your difficulties with someone you can rely on. Additionally, counseling and support groups may be beneficial.

Set parameters. Be realistic about how much care you can offer without becoming overburdened or resentful. Set and enforce boundaries on disruptive conduct. Allowing co-occurring disorders to control your life is unhealthy for you and your loved ones.

Inform yourself. Learn everything you can about the mental health issue and drug addiction therapy and recovery of your loved one. The more you comprehend what your loved one is experiencing, the more you will be able to facilitate recovery.

Be patient. Recovery from co-occurring disorders is not instantaneous. Recuperation is a continuous process, and relapse is common. It is essential that you and your loved one have ongoing assistance as you work toward recovery, but you can get through this tough period and take control of your life together.

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