What Is a Dual Diagnosis and How Is It Treated?

dual diagnosisA person with a dual diagnosis has a mental health disorder and a substance use disorder. Dual diagnosis, also called co-occurring disorders or comorbidity, affects many people. The National Institute of Mental Health (NIHM) reports that at least half of all people seeking substance use disorder treatment also have a mental health diagnosis. Research from the Journal of Clinical Psychiatry highlights the importance of treating both mental health and substance use disorders, reporting that people who received appropriate treatment for their mental health diagnosis maintained sobriety longer than those who only received substance use treatment.

What Is a Dual Diagnosis?

A dual diagnosis can include almost any mental health disorder, some more severe than others. Many people with a substance use disorder do not realize they have a mental health disorder since some people cover up the symptoms of their mental health issues with substance use. Why do substance abuse and mental health disorders occur together so often? NIMH explains that three main factors play a role:

  • They Share Common Risk Factors: Mental health issues and substance misuse share many common factors that put people at greater risk of one or both disorders. These factors can include, but are not limited to:
    1. History of trauma or abuse
    2. Stressful living situations
    3. Major life disruptions
    4. Genetics and family behavior

In addition, people who grow up in a home where people use or misuse substances develop a greater chance of use or misuse as an adult. Since adults who misuse substances may also not provide a healthy environment for children, these children may develop a dual diagnosis later in life.

  • Mental Health Disorders Can Lead to Substance Misuse: People with mental health disorders may struggle to receive the care they need or may not realize they even have a treatable disorder. As a result, they might choose to self-medicate with substances to help manage their symptoms. People who misuse substances to self-medicate may find some short-term relief from their mental health issues, but in the long term, substance misuse causes more problems and can worsen the mental health disorder. For example, substances like cocaine and methamphetamine that influence the brain’s dopamine system can cause changes to the dopamine receptors in a person’s brain.
  • Substance Use Disorder Can Lead to Mental Health Issues: As confirmed by the National Institute on Drug Abuse (NIDA), substance use or misuse can cause changes in the brain. These changes can, in some people, contribute to the development of a mental health disorder.

How Is a Dual Diagnosis Treated?

A person with a dual diagnosis requires treatment for both issues to succeed in recovery. While some programs may focus on treating the substance misuse, the chances of this behavior recurring skyrocket if the person’s mental health disorder has not been treated.

For people in substance use disorder treatment, the mental health component of the dual diagnosis may often be treated with the same types of therapy. Since the disorders may share similar environmental factors and behaviors, some forms of treatment can work well to address both disorders. Recommendations from NIDA and other organizations include a combination of medications when needed and behavioral therapy. A person may need medication for their mental health disorder, and most of these have a low potential for misuse.

Cognitive-Behavioral Therapy

A staple treatment for substance use treatment, cognitive-behavioral therapy (CBT), is also commonly used by counselors and mental health professionals. The treatment focuses on changing negative or harmful beliefs and behaviors.

Dialectical Behavior Therapy

Designed to treat people with borderline personality disorder, dialectical behavior therapy (DBT) can also help people who need intensive mental health treatment, especially those at risk of self-harm, including relapsing when in distress.

Acceptance and Commitment Therapy

While less tested than CBT, Acceptance and Commitment Therapy (ACT) helps people with a dual diagnosis learn to tolerate distress, use mindfulness as a coping skill, and establish long-term values and goals for themselves.

Other Types of Therapy

Specific types of treatment also exist for specific mental health disorders. DBT, for example, began as a treatment for borderline personality disorder but can be effective for many others. NIDA has recommended these treatments for specific disorders:

  • Assertive Community Treatment: used for schizophrenia and other severe disorders
  • Exposure Therapy: used for some anxiety disorders and phobias
  • Integrated Group Therapy: designed for people with a dual diagnosis of bipolar disorder
  • Seeking Safety: focused on PTSD and other trauma-related disorders

Many other types of therapy exist for general use or specific disorders. Some may be more effective than others for different people.

People with a dual diagnosis have a mental health and substance use disorder. They need treatment for both of these disorders to succeed in treatment and recovery. Substance use disorders and mental health disorders have similar genetic and environmental roots, so dual diagnoses are common. Treatment professionals must learn to recognize and treat both components since the mental health component may not have been diagnosed yet. At Lakehouse Recovery Center, we understand the importance of holistic treatment that addresses all a person’s unique needs. We use safe, recommended, and proven therapy methods to increase each person’s treatment success, including cognitive-behavioral therapy techniques, mindfulness, and other methods to treat co-occurring disorders. Lakehouse’s trauma-informed, clinically trained staff will help you understand your diagnosis and how we plan to treat it together. To find out how we can help you move past your dual diagnosis and achieve recovery, contact us at (877) 762-3707. Learn how our unique treatment platform helps set you up for a successful treatment experience.