Alcohol And Dual Diagnosis

Mental Health Disorders And Alcoholism

Dual diagnosis is a term often used in clinical settings to describe the simultaneous presence of addiction and mental health conditions.

As of 2022, the National Institute on Drug Abuse reports that around 8 million adults in the U.S. had both a mental disorder and a substance use disorder (SUD).

The Impact Of Alcohol On Mental Health

Alcohol affects the nervous system in profound ways that can impact emotional well-being. Initially, alcohol can cause mood fluctuations, impaired judgment, worse depression and anxiety, and aggressive behavior.

From a neurological standpoint, chronic heavy drinking takes a toll on the brain. Deficiencies in cognitive abilities like memory, problem-solving, attention, and decision-making develop over time. Alcohol-induced dementia is also a risk with long-term alcohol abuse. These cognitive and mental impairments make it difficult to function, maintain relationships and employment, and live a fulfilling life.

Common Mental Health Disorders That Occur With Alcohol Abuse

Some of the most common mental health issues that coincide with alcohol addiction include:

• Depression
• Generalized anxiety disorder
• Social anxiety disorder
• Post-traumatic stress disorder (PTSD)
• Bipolar disorder
• Borderline personality disorder
• Antisocial personality disorder

Sorting these conditions out from alcohol use is not always easy and requires professional assessment to receive an official dual diagnosis.

Alcohol Dependence And Depression

Depression and alcohol abuse is the most common dual diagnosis pairing, with a study in the Journal of Clinical Psychiatry finding that individuals with alcohol dependence are 3.7 times more likely to have major depression compared to the general population.

Alcohol affects the brain’s chemistry and nerve pathways, and these changes can intensify symptoms of depression. A low mood can become persistent with a loss of the ability to experience pleasure and feel happy. Fatigue and feelings of worthlessness can follow and can end in thoughts of suicide.

This emphasizes the two-way effects of a mental disorder and alcohol. Alcohol can trigger or worsen low mood, fatigue, and feelings of shame that can lead to suicidal ideation, while those with depression can turn to alcohol and other substances to self-medicate.

These two paths can then feed on each other, creating a vicious cycle of alcohol abuse and depression that often require therapeutic intervention.

Long-Term Risks Of Alcohol Dependence

The long-term consequences of not addressing these co-occurring problems will result in multiplying the physical and psychological aspects. Many will end up with:

• Liver disease (e.g., alcoholic hepatitis, cirrhosis)
• Heart problems (e.g., cardiomyopathy, arrhythmias)
• Increased cancer risk (e.g., breast, colon, liver)
• Brain damage, cognitive deficits
• A weakened immune system

Alcohol use can trigger the onset of new psychiatric conditions like psychosis or alcohol-related dementia. Disorders such as anxiety, bipolar disorder, or PTSD can become treatment-resistant and progressively worsen over time. This can lead to trouble maintaining relationships, employment, and life satisfaction.

Symptoms Of Dual Diagnosis

It can be challenging to discern the signs and symptoms of co-occurring alcohol addiction and mental illness, as there is usually overlap. Common indications of a potential dual diagnosis include:

• Excessive, compulsive alcohol use or inability to cut down despite consequences.
• Experiencing withdrawal symptoms like nausea, shaking, or anxiety when not drinking.
• Unpredictable mood swings and emotional instability.
• Changes in sleeping patterns (insomnia or excessive sleeping).
• Fluctuating appetite and weight changes.
• Impaired concentration, memory issues, or declining work/school performance.
• Social isolation, withdrawal from friends and activities.
• Engaging in risky, impulsive, or self-destructive behaviors.
• Suicidal thoughts or behaviors.

The presence of these symptoms warrants an assessment by a qualified health professional. Early intervention is key to achieving the best treatment outcomes.

How Is Dual Diagnosis Treated?

Effectively treating co-occurring AUD and mental illness requires simultaneously addressing both conditions.

Initial Treatment Steps

The first step is usually medical detox, which often takes place at an inpatient or residential treatment center to manage acute intoxication and withdrawal and stabilize the patient. During this time, medications are often used to reduce alcohol cravings, manage psychiatric symptoms, and support overall stabilization. To find a detox program near you, speak to a treatment provider for free today.

Ongoing Therapy

When stabilized, the patient is introduced to evidence-based behavioral therapies, which become the foundation of dual diagnosis treatment. Cognitive-behavioral therapy (CBT) helps modify unhealthy thought patterns and behaviors related to both conditions. Dialectical behavior therapy (DBT) teaches skills for regulating emotions. Motivational interviewing techniques enhance treatment engagement and readiness for change.

Group therapy sessions provide peer support to help patients feel less isolated in their struggles. Additionally, family therapy programs may be utilized to educate loved ones, rebuild relationships, and work towards building a strong support system.

Lastly, participation in a support group, like Alcoholics Anonymous or SMART™ Recovery, can provide crucial ongoing encouragement.

Medication-Assisted Treatment

Medication-assisted treatment (MAT) may continue after the initial phases. Anti-craving medications like naltrexone or acamprosate used for alcohol addiction may be combined with psychiatric medications like antidepressants or anti-anxiety meds.

Successful treatment adopts a long-term, holistic perspective. Lifestyle changes like developing new routines, ending toxic relationships, and building a sober support network are often integral to successful recovery. Regular engagement with addiction counselors, therapists, and other providers helps continuously adjust the treatment strategy as situations evolve.

Support For Alcohol Addiction And Dual Diagnosis

The effects of dual diagnosis and alcohol addiction can be hard to deal with on your own. Thankfully, with professional treatment and personal commitment, it is possible to achieve lasting remission and an improved quality of life.

Contact a treatment provider today to talk about the treatment options available to you.