What Does It Mean To Have A Dual Diagnosis?

Also known as co-occurring disorders, dual diagnosis is the presence of both a mental illness and substance use disorder (SUD). Nearly half of those who are diagnosed with a mental illness will, at some point in their lives, struggle with substances as well. The same is true for the inverse.

While they are correlative, there is not enough evidence to claim whether or not one causes the other. However, studies have shown a positive relationship between mental illness and addiction; often, the desire to self-medicate for the unpleasant symptoms of many mental health disorders can lead to increased substance use. Conversely, excessive substance use can alter the brain chemistry specifically in the reward system which not only makes the individual more likely to continue using, but can change the brain structure and function in such a way that makes them more susceptible to developing a mental disorder.

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Do Rehabs Treat Mental Illnesses And Addiction?

Yes, rehabs treat both mental illnesses and addiction with a specialized approach. Because each mental illness is different, treatment varies, but must involve a plan of action for both. Anxiety, bipolar disorder, schizophrenia, and depression are just a handful of disorders that can co-occur with that of an addiction.

These conditions and many others affect the functionality of the brain and body differently and thus require diverse medications and therapies. Of all to be concerned with dual diagnoses and recovery treatment, it is pertinent that both illnesses are addressed; without comprehensive care, there is a strong chance at least one will come back.

Addiction specialist Dr. Ashish Bhatt, MD, MRO says that many are often misdiagnosed with mental health conditions when they only reveal part of their symptoms to a physician, as opposed to disclosing their use of any excessive and/or illicit substance use.

…When they’re labeled incorrectly, they’re taking medications that often may not work because they’re being given for a disorder that they don’t have. And unfortunately, this can lead to a pattern of frustration, lack of remission of symptoms, and it can lead to failure of dressing the primary underlying condition that could be this substance of abuse…

- Dr. Bhatt, MD, Addiction Center, 2021

Common Forms Of Treatment

Depending on a multitude of factors such as the severity of both the mental illness and the addiction as well as personal preference (in cases where symptoms might not be very severe), the approach to treatment can vary. Usually, treatment consists of therapy or prescribed medications, and often a combination of multiple modalities in order to effectively treat both conditions.

Therapy

There are multiple kinds of therapy used to treat those with comorbid conditions, or dual diagnosis, including, but not limited to:

Integrated Dual Disorder Treatment (IDDT)

Considering that effective treatment should address both conditions in equal measure and at the same time, Integrated Dual Disorder Treatment (IDDT) is a great option. Evidence-based and advantageous, IDDT utilizes the same team of people in the same establishment to treat both the mental illness and the substance use disorder. Change and recovery and other big themes of sobriety and wellness are emphasized as a journey that takes time to manage and maintain.

Cognitive Behavioral Therapy (CBT

Cognitive Behavioral Therapy (CBT) invites and encourages introspection regarding thought processes and assists individuals in understanding and ultimately changing their behavior. The practice is based on 3 fundamental principles:

  1. Psychological problems are (partly) rooted in thinking processes.
  2. Psychological problems are (partly) rooted in learned patterns or unhelpful behavior.
  3. There are more effective ways to cope with various psychological problems which can alleviate symptoms.

Because of the emphasis on internal investigation, CBT encourages individuals to be their own therapists; the focus is on the present and ways in which the individual might alter their response/behavior in varying circumstances. By bringing awareness to some of the “whys” and “whens” of substance use, CBT helps to promote self-efficacy.

Dialectical Behavior Therapy (DBT)

Derived from CBT, Dialectical Behavioral Therapy (DBT) emphasizes mindfulness and emotional regulation. A connection between the mind and body is important in treating any unseen illness or disorder since the physical body and its sensations is often neglected, especially in times of intense mental turmoil. When the senses take over and the mind is quieted, it becomes easier to listen to the wants and needs of the body thus allowing the emotions to follow suit. Through strategies such as this, an individual comes to know themselves and their triggers and has a better handle on the management.

Support Groups

While support groups might not be considered universally effective treatment, per se, they provide fantastic benefits and opportunities for those in recovery. There are of course common communities like Alcoholics Anonymous (AA), Narcotics Anonymous (NA), Al-Anon, and Nar-Anon. There is also a group called Double Trouble in Recovery (DTR), an organization designed specifically for those suffering under the weight of a dual diagnosis, recognizing the unique challenges those with comorbid illnesses face. Based in the 12-step method, DTR stresses the importance of community and the notion of strength in a unit to support each other in overcoming the obstacles of battling two illnesses.

Medications

Unlike therapy which invites a certain level of adaptability, medications cannot be so easily altered. There are medications designed and prescribed to treat symptoms of various substance addictions and mental health issues separately, but more research is needed to determine the effectiveness and function in individuals with dual diagnosis. Some of the medications prescribed for various mental health concerns, however, also treat some substance abuse symptoms. Bupropion, for instance, is commonly used as an antidepressant, but can also help in Nicotine withdrawal symptoms. Contact a treatment provider to discuss options; they can assist in helping you find the treatment you need.

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Seeking Treatment For Dual Diagnosis

As with other illnesses, there is no one “right” way to approach receiving proper and adequate care. Treatment providers are available at no cost to you to answer any questions you might have about available treatment options. If you’re feeling totally stuck with how or where to move forward, start by asking questions such as these:

  • Do you offer individualized treatment plans for all residents?
  • Is therapy structured to treat a dual diagnosis?
  • Will I or my loved one be evaluated by a licensed psychiatric professional or physician before admission?

  • Are both of my disorders viewed as interconnected health issues, or are they viewed as separate illnesses?
  • If I or my loved one relapses during rehab, how would that be handled?
  • Does your facility offer aftercare referral services?

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Published:

Author

Hannah Zwemer

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  • Hannah Zwemer graduated with a BA in dance and a minor in educational studies from Denison University in 2017 before moving to Orlando to work as a performer at Walt Disney World. While at Disney, she discovered her passion for writing and pursued a master’s degree in creative writing with an emphasis in nonfiction. She is passionate about helping people in any way she can while simultaneously sharing stories that remind us that the best of us are still only human.

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Reviewed by Certified Addiction Professional:

David Hampton

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  • A survivor of addiction himself, David Hampton is a Certified Professional Recovery Coach (CPRC) and a member of the National Association of Alcohol and Drug Abuse Counselors (NAADAC).

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