Understanding a Dual Diagnosis in Addiction Treatment

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Drug addiction and mental illness often occur together, something called a dual diagnosis. When starting treatment at an inpatient addiction treatment center, you or your loved one will receive a thorough evaluation to determine a diagnosis. For some clients at The River Source, they are diagnosed with a co-occurring disorder such as depression, bipolar disorder or anxiety. Based on this diagnosis, an individualized treatment plan is created and implemented by our staff.

For our clients and their families, receiving a dual diagnosis can send emotions into a tailspin. Some family members may have suspected an underlying psychological disorder, but others must go through the process of accepting both an addiction and an illness. Since co-occurring disorders are quite common in addiction, The River Source has a lot of experience working with clients who have been given a dual diagnosis.

The question that begs, then, is, “Why does mental illness and addiction occur together so much of the time?” There are several theories that surround the onset of a dual diagnosis, which we will look at now.

Can Drugs Cause Mental Illness?

Some researchers believe that drugs bring out mental illness in people who are vulnerable. Personality disorders like depression and anxiety have a genetic component, making some people more susceptible to developing them than others. If individuals who are predisposed to mental illness abuse drugs, they have a higher chance of developing these symptoms.

Others believe that using drugs is like igniting a flame underneath the person. Maybe they have been keeping their illness under control or are unaware that they even have the pre-genetic disposition, but using drugs speeds up the process. Additionally, when looking at certain types of drugs, they have a direct effect on the mind. Methamphetamines cause people to have hallucinations, while stimulants can cause anxiety attacks, mania and sleep disorders, all symptoms that occur with mental illness.

The Use of Self-Medication

According to some research and testimonies from recovering addicts, those who experience symptoms of depression or anxiety tend to self-medicate themselves to alleviate the symptoms. For instance, people who suffer from depression turn to drinking or using drugs to help with feelings of sadness and anxiety. These drugs can stimulate the reward pathways to more ‘normal’ levels, and then the individual returns to underactive reward centers when not on the drugs.

Of course, using drugs or alcohol to bring pleasure only creates a downward spiral. And, this behavior can work hand-in-hand with the theory that drugs speed up mental illness, causing the person to develop more serious symptoms at a faster rate. What medicine and science have been trying to uncover for decades is what comes first, the addiction or the illness? By understanding a dual diagnosis and the causes for each disorder, we can better treat our clients.

Addiction and Psychological Disorders Share Brain Biology

What is interesting is that brain diseases do share the same biology. Since addiction and mental illness are both diseases of the brain, it makes sense that when a person has one, they may very well have the other. For example, serotonin is associated with both mood disorders and alcoholism, and increased dopamine is associated with schizophrenia and stimulant abuse.

The brain is so complex and involves endless pathways, molecules and chemicals. It can be very difficult to understand and interpret, but researchers hope to one day identify more of the genes that are responsible for determining how a person will react to drug abuse.

What do these Findings Mean for Addiction Treatment?

When a client is diagnosed with both addiction and a psychological disorder, the treatment plan will address both conditions. Not all addiction treatment centers work with psychological disorders because they treat only substance abuse, but The River Source is well versed in working with people who have co-occurring disorders or chronic pain. By strengthening the mind, body and spirit, clients are able to work on both their addiction and underlying disorder, such as depression or bulimia.

Holistic treatment centers offer the best options for those with co-occurring disorders since the whole individual is addressed, and alternative therapies are offered such as acupuncture, hydrotherapy and prolotherapy. Physical and emotional pain is learned to be managed through journaling, self-reflection, meditation and fitness and wellness. By strengthening the individual as a whole, brain disorders can be managed better, and clients have a deeper understanding to their behavior.

Working with a dual diagnosis has unique challenges, and it can be more difficult to work with than a substance abuse problem on its own. Still, many clients need this diagnosis to fully understand themselves and how they landed in their current situation. It’s through recognizing and accepting both diagnoses that true progress can be made and clients can learn to be more accountable for the choices they make.