Dual Diagnosis

Dual diagnosis occurs when someone has both a mental disorder and an alcohol or drug problem. These conditions occur together frequently.

Sometimes the mental illness occurs first. This can lead people to use alcohol or drugs that make them feel better temporarily. Sometimes the substance abuse occurs first; that can lead to emotional and mental problems.   Often the psychiatric disorder develops first.  In an attempt to feel better, in an attempt to control mood changes, silence the auditory hallucinations; deal with emotional turmoil; this can lead people to use alcohol or drugs that make them feel better temporarily.  When a person with emotional symptoms drinks or uses drugs; doctors call this self-medication.  Frequent self-medication may eventually lead to physical or psychological dependency on alcohol or drugs.  If it does, the person then suffers from not just one problem, but two.  In adolescents, however, drug or alcohol abuse may merge and continue into adulthood, which may contribute to the development of emotional difficulties or psychiatric disorders.  In these cases, alcohol or drug dependency is the primary condition.  A person whose substance abuse use has become severe may develop symptoms of a psychiatric disorder:  perhaps episodes of depression, manic rage, hallucinations, or suicide attempts.

To get better, someone with a dual diagnosis must treat both conditions. First, the person must go for a period of time without using alcohol or drugs. This is called detoxification; rehabilitation for the substance abuse and treatment for the mental disorder.  Both illnesses should be treated concurrently.  For any substance abuser, however, detoxification should take place under medical supervision.  It can take a few days to a week or more, depending on what substances the person abused and for how long.  Doctors are able to give hospitalized substance abusers medications which can significantly ease withdrawal symptoms.  When detoxification is done under medical supervision, it’s safer and less traumatic.

Once detoxification is completed, dual treatment; rehabilitation for the alcohol or drug problem and treatment for the psychiatric problem is started and a maintenance treatment plan is established.

Rehabilitation for a substance abuser usually involves individual and group psychotherapy, instruction on alcohol and drugs, exercise, proper nutrition, and participation in a recovery program. 

Treatment for a psychiatric disorder depends upon the diagnosis.  For most disorders, individual and group therapy as well as medications are utilized.  A support group of other people who are recovering from the same condition has shown to be effective. 

The more that is known about dual diagnosis, it is easier to understand how substance abuse can coexist with another psychiatric condition.  A person with dual diagnosis can improve once proper care is given.  By seeking out information, you can learn to recognize the signs and symptoms of dual diagnosis and possibly help someone live a healthier and rewarding life.