by Lisa Frederiksen
Thirty-seven percent of alcohol abusers and fifty-three percent of drug abusers also have at least one serious mental illness, such as depression, PTSD, bipolar, anxiety, schizophrenia. (1) (2) The common term for this condition in treatment circles is a “dual diagnosis,” which refers to someone having both a mental illness and an addiction. Often what happens is the person starts to drink or use drugs to self-medicate the mental illness. This self-medication can sometimes make the mental illness worse; however it does not cause the mental illness. Mental illness is also a brain disease with its own brain changes.
If your loved one has a dual diagnosis, it will be important that both be treated at the same time, preferably by the same treatment team (when care is being provided at a treatment facility). For if the substance is removed but the mental illness is not treated, their chances of relapse increase significantly. The same is true if the mental illness is treated but the substance misuse continues. The treatment provider needs to help the patient understand their addiction, their mental illness and the impact one has had on the other. (3)
Resources:
The Substance Abuse and Mental Health Services Administration (SAMHSA) of the U.S. Department of Health and Human Services offers a Locator database with comprehensive information about mental health services and resources in the United States.
The National Alliance of Mental Illness (NAMI) offers excellent, free self-help programs. Visit www.nami.org for information and locations in your community.
Sources:
(1) “Factsheet: Dual Diagnosis,” Mental Health America, <http://www.nmha.org/index.cfm?objectid=C7DF9405-1372-4D20-C89D7BD2CD1CA1B9>
(2) “Dual Diagnosis and Integrated Treatment of Mental Illness and Substance Abuse Disorder,” National Alliance on Mental Illness, <http://www.nami.org/Content/ContentGroups/Helpline1/Dual_Diagnosis_and_Integrated_Treatment_of_Mental_Illness_and_Substance_Abuse_Disorder.htm>
(3) Ruiz, M.D., Pedro, et al., The Substance Abuse Handbook, Philadelphia: Lippincott Williams & Wilkins, 2007, pgs. 403-404.
For years alcohol and drug addiction was viewed only as a primary diagnosis. To suggest dual diagnosis especially suggesting that often substance abuse problems were secondary to a primary mental health condition was heresy.
Luckily, the field now often recognizes the tendency to self-medicate for an underlying mental disorder. The condition that I have found that most often is the cause of self-medication is unrecognized and untreated ADD/ADHD. I call it the Great Chameleon because many times alcohol and drug abuse, anxiety, depression, OCD symptoms, and anger problems are really ADD.
I have developed an all natural supplement called ADD-care that we have shown by SPECT brain imaging and the Conner’s ADD test to work as well as Adderall without the side effects. The research is at http://www.ADD-care.com.
Thank you, Jef, for your comment. As you stated, for years, the addiction was viewed as a primary diagnosis and therefore treatment of a person with both an addiction and mental illness was to stop the addiction for a month, first, and then treat the mental illness. If one is using the drug/alcohol to self-medicate the mental illness, taking away their “medicine” without treating their illness (the mental illness) was/is a set-up for relapse. As with treatment for addiction/alcoholism, there is no “one way” to do it, although the objective is the same – healing/changing the brain’s neural networks. Treating mental illness is no different. I encourage readers to take a look at your research.