Many people suffering from drug or alcohol addiction also struggle with mental health issues. This is generally known as dual diagnosis. It is also sometimes referred to as dual disorder or co-morbidity.
Dual diagnosis is certainly not a new issue but it is only comparatively recently that the scale and complexity of the problem have started to be recognised by policymakers and healthcare practitioners.
The interplay between addiction, substance abuse and mental illness is certainly a complex one. It’s believed that substance abuse can contribute to mental health issues and, at the same time, existing mental health issues can trigger problem drinking or drug use.
It can be extremely difficult to pick apart the root causes and relationships between some of these issues. Health and social care organisation Turning Point says that The Dual Diagnosis Good Practice Guide from the Department of Health identifies four possible relationships.
These are:
- A primary psychiatric illness precipitates or leads to substance misuse
- The use of substances makes the mental health problem worse or alters its course
- Intoxication and/or substance dependence leads to psychological symptoms
- Substance misuse and/or withdrawal leads to psychiatric symptoms or illnesses
There is an ongoing debate as to whether substance misuse actually causes mental illness and other mental health issues. Areas including drug-induced psychosis and the effects of cannabis on mental health are ongoing areas of study for example, but there is more consensus on the idea that substance misuse can trigger or exacerbate mental health problems.
If you think you might be suffering from a dual diagnosis you are certainly not alone. The NHS says that between a third and a half of all people who access mental health services in the UK experience co-existing problems with drugs/alcohol and mental health at some point in their lives. If this sounds like you, you might want to consider finding dual diagnosis drug rehab treatment centres or similar services.
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What is dual diagnosis treatment?
Simply put, dual diagnosis treatment aims to address both aspects of the condition, treating the addiction and the mental health condition. Treating one without the other is certainly not pointless but it will not address the whole situation.
As the two different aspects tend to have a tangled relationship, a person who is only treated for the addiction part is likely to relapse and start drinking or using again if their mental health is not addressed.
Similarly, a person whose mental health is treated without addressing their addiction may well find similar mental health issues arising in the future, even if they can be dealt with in the short term in the first place.
The first thing to do is to seek an expert diagnosis. Some people have multiple mental health issues exhibiting alongside addiction problems and it can be tricky to unpick them correctly.
Alcohol is a depressant for example and even professionals without extensive experience in dual diagnosis could assume that symptoms of depression in an alcoholic patient are part and parcel of the alcoholism, rather than a separate mental illness.
On the other hand, this could well be the case and individuals need to be assessed carefully on a case by case basis.
Once a diagnosis is reached, an individualised treatment and support plan needs to be drawn up. This may involve a joint approach with an NHS mental health team, local alcohol and drug services and addiction and dual diagnosis treatment centres.
Dual Diagnosis Treatment UK
It is important to provide dual diagnosis patients with information concerning how substance misuse and mental illnesses interact and the options that might be available to them.
Existing mental health conditions can sometimes be stabilised using a medication, talking therapies or a combination of different approaches. Therapies like cognitive-behavioural therapy (CBT) and group therapy can be useful in terms of both addiction treatment and mental health treatment, but the actual programmes will be tailored towards the individual and their own unique combination of issues.
One of the first and most important steps in dual diagnosis treatment is often some form of detox. Once a patient is clean or sober, this may provide clarity as to their other issues. A patient’s mental health may affect their ability to kick drinks or drugs successfully, however, so again a concurrent approach to both sides of the dual diagnosis may be required.
Detox, or detoxification, can be difficult enough for addicts without co-existent mental health issues. As well as cravings for the substance they will have to deal with a range of physical and psychological withdrawal symptoms. The psychological ones can be particularly difficult if there is also a pre-existing mental illness or mental health issue at play.
Treatments Include:
- Cognitive Behaviour Therapy
- Medications
- Personal Counselling
It is very important that experienced, professional therapists treat anybody with a dual diagnosis. A mental health issue could have contributed to an addiction or an addiction may have contributed to a mental health problem.
The therapists will need to unravel this so they provide the best treatment and improve the chances of a long term recovery, not only from addiction but from mental health issues also. If a mental health issue is not treated with a plan in place, it could be easier to fall back into a spiral of addiction.
How to find the best dual diagnosis treatment centres near me
If you’re looking for affordable dual diagnosis treatment centres in your area, Addiction Advocates can help. We’re experts in placing people with the best facilities for their individual needs, no matter how complex they might be.
We can help you get the best diagnosis from a CQC registered facility and a tailored rehab programme put in place at a convenient location.
Inpatient dual diagnosis treatment centres
Detox can be managed through a dual diagnosis outpatient treatment programme but it is generally safer and more likely to be successful if the patient is able to check in to a hospital or residential dual diagnosis treatment facility. This allows for 24-hour supervision and access to medical care or support.
It will also allow the patient to focus on both their addiction and mental health issues in a controlled environment with the support of trained professionals and clinicians.
As well as drug or alcohol detox, this could incorporate tailored programmes of talking therapies as mentioned above. Cognitive behavioural therapy has been shown to be particularly effective for a range of mental health conditions, as well as addiction issues.
Educational workshops in conjunction with talking therapies can help the patient to understand their issues and develop ways of coping and new ways of thinking. Alternative therapies such as meditation, mindfulness and art therapies may also be useful for some patients. Medication may also be used where appropriate.
References
- [1] contribute to mental health issues - https://www.mind.org.uk/information-support/types-of-mental-health-problems/recreational-drugs-alcohol-and-addiction/how-drugs-and-alcohol-can-affect-your-mental-health/
- [2] The Dual Diagnosis Good Practice Guide - https://amhp.org.uk/wp-content/uploads/2017/08/dualdiagnosisgoodpracticehandbook.pdf
- [3] NHS says - http://www.awp.nhs.uk/advice-support/conditions/dual-diagnosis/
Seth is an author, addiction recovery expert and fully accredited member of the national counselling society. He has experience working with a wide range of addictions and mental illnesses using a number of evidence-based therapies and programmes such as the SMART models of addiction recovery.
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