Dual diagnosis – what is it?
One of the terms I’ve frequently heard in the various “recovery” circles I’ve encountered over the past five years is “dual diagnosis.” People would talk of their loved one or themselves as having a “dual diagnosis.” I was curious what that was about and learned that a person who has an alcohol (or drug) abuse problem or an alcohol (or drug) addiction and also suffers from an emotional/psychiatric problem (mental health illness) is said to have a dual diagnosis. (The other term often used is “co-occurring disorder” – the mental health illness and alcohol abuse/addiction co-occur.)
Research is now showing that “many, if not most, people who are addicted to alcohol or other drugs suffer from another mental health disorder at some point.” (1) Mental health illnesses that frequently co-occur with alcohol addiction or abuse, include:
- ADHD (attention deficit hyperactive disorder),
- bipolar disorder,
- conduct disorder,
- post-traumatic stress disorder, and
It generally occurs as follows: 1) a person with an untreated minor or major mental health illness starts drinking to self-medicate; or 2) a person develops signs of a mental health illness after alcohol use. (2)
It is critical to understand that both the addiction and the co-occurring mental health illness must be addressed at the same time. (3) To accurately assess the mental health illness, the drinking of alcohol must be stopped. Only then can treatment providers determine the proper medication and/or treatment regime needed to successfully treat the mental health illness. Bringing the mental illness under control then helps reduce the compulsion to self-medicate (with alcohol or other substances) and assists with effective treatment of alcohol abuse or addiction.
If the co-occurring mental health illness is not treated or dealt with at the same time, however, it is less likely the alcoholic will be able to successfully abstain from alcohol if addiction is involved (a.k.a. alcoholism). (4) This is because the alcohol is their coping mechanism. If there is no other coping mechanism(s) in place, such as therapy and/or prescribed medications, h/she will likely turn to alcohol to self medicate. Additionally, the medications an individual takes to treat his/her mental illness are not effective if alcohol is being consumed.
So why is this helpful to know? If your one is grappling with their alcohol use – talks about wanting to cut back or you observe they’re drinking frequently and/or abusively on repeated occasions – they may, in fact, be suffering from a mental health illness and trying to cope with that by abusing alcohol (or other drugs, for that matter). This knowledge may be especially helpful if you are dealing with a teen with ADHD, a spouse with depression or a loved one who is a veteran or has recently returned from deployment in Iraq or Afghanistan with PTSD. AND, if your loved one has been diagnosed with a mental health illness, it may be helpful for them to know the potential consequences of alcohol abuse (or in some cases, even use).
I’ll provide a list of additional resources in a future blog, but for now, let us know your thoughts.
©2008 Lisa Frederiksen, Rev. 5.7.10. This entry has been included to provide information. Every effort has been made to make it as accurate as possible, but no warrant of fitness is implied. The information provided is on an “as is” basis and readers should consult a therapist, attorney, treatment center program manager, medical doctor and/or other professional for dealing with emotional and/or legal issues or if seeking advice.
(1) HBO.com/addiction, <http://www.hbo.com/addiction/understanding_addiction/142_co-occurring_disorders.html>