Treating mental health and addiction is challenging for medical professionals, as it involves a comprehensive approach that involves both medication and psychotherapy. However, this comprehensive approach offers a more effective path for clients looking to recover from a substance use disorder (SUD). What does a dual-diagnosis treatment plan offer for those suffering from two disorders simultaneously?
What Is Dual Diagnosis?
Dual diagnosis refers to individuals who are suffering from an SUD as well as a mental health disorder. People with co-occurring disorders typically need customized treatment plans so the disorders — and their effects on each other — can be treated.
Individuals with co-occurring disorders usually suffer from mental health disorders such as bipolar disorder, schizophrenia, anxiety disorder, or depression. Their substance use disorders may include an addiction to heroin, cocaine, prescription drugs, or alcohol.
Individuals with dual diagnosis face increased challenges, as there is often an overlap between the symptoms of their mental health disorder and their substance use disorder. In addition, symptoms from one disorder may exacerbate the second disorder.
It’s also difficult for medical professionals to determine whether the substance abuse was an attempt to self-medicate, or the mental health disorder was a result of the substance abuse. These diagnostic challenges call for treatment plans tailored to each individual.
According to SAMHSA’s 2021 National Survey on Drug Use and Health, about 9.2 million people in the United States suffer from co-occurring disorders. This makes finding effective treatment crucial.
What Are the Different Kinds of Dual Diagnosis?
Because co-occurring disorders differ — sometimes drastically — healthcare professionals must customize treatment plans based on individual needs. Here are some mental health conditions that commonly occur alongside SUDs.
Depression is characterized by feelings of hopelessness and sadness, and it is often long-lasting, enduring for months or even years. People suffering from depression tend to lose interest in their usual activities. Other notable changes include changes in their sleep patterns, appetite, and energy levels. In extreme cases, people with depression may contemplate or attempt suicide.
When depression is combined with substance abuse, it can be challenging to determine which disorder came first. Individuals suffering from depression may turn to substances to self-medicate. Alternatively, their substance abuse may lead to depression.
Medical professionals must try to distinguish the effects of depression from the effects of substance abuse, as depression may intensify substance use disorder symptoms, and vice versa.
Medicating those with depression is another factor that healthcare professionals must approach cautiously when treating clients with a co-occurring disorder. It’s important to make sure that medications prescribed for depression — such as Zoloft or Prozac — do not adversely affect any drug or alcohol withdrawal symptoms.
Although anxiety is a normal part of our body’s reaction to stress or threats, excessive or uncontrollable anxiety can become a disorder. An anxiety disorder is characterized by an intense and overwhelming fear or worry. There are various types of anxiety disorders.
- Generalized anxiety disorder (GAD)
- Social anxiety disorder
- Panic disorder
- Separation anxiety disorder
Besides excessive worrying and irrational fears, anxiety can also manifest as muscle tension, a rapid heartbeat, and restlessness. Those with anxiety often have difficulty relaxing, concentrating, and sleeping. In extreme cases, they may isolate themselves or suffer panic attacks.
Like with other co-occurring disorders, medical professionals must determine whether clients have turned to substance use because of their anxiety or if their substance use disorder triggers anxiety symptoms.
Although there’s no cure for anxiety disorder, doctors can prescribe medication to help ease anxiety symptoms. Medications such as benzodiazepines and Xanax have a sedative effect and can help clients feel calmer.
One of the more concerning co-occurring disorders is schizophrenia. This is a severe mental disorder that can cause hallucinations, delusions, and paranoia. The symptoms can be wide-ranging, which makes the condition complex and difficult to diagnose.
People with schizophrenia may display positive symptoms, such as delusions and hallucinations. They may also exhibit negative symptoms such as minimal speech or emotional expression or difficulty enjoying activities. Some people with schizophrenia may have trouble distinguishing reality from hallucinations or delusions. Others may be unable to perform routine day-to-day tasks.
The cause of schizophrenia is not clear, but many professionals point to a combination of genetic, biological, and social factors, such as psychological trauma early in life.
Unfortunately, substance use disorder can intensify the symptoms of schizophrenia and interfere with the antipsychotic medications used to treat it. As a result, treating clients suffering from both schizophrenia and SUD can be challenging, as the symptoms of severe addiction can mask some of the symptoms of schizophrenia.
Bipolar disorder is characterized by extreme mood swings of intense mania followed by severe depression. Mental health specialists categorize bipolar disorder into three distinct types:
- Bipolar I Disorder: Individuals experience at least one manic episode and one major depressive episode.
- Bipolar II Disorder: Individuals experience major depressive episodes but no intense manic episodes. Their manic episodes tend to be less intense than the full-blown manic episodes that those with Bipolar 1 Disorder experience.
- Cyclothymic Disorder: Individuals swing from mild depressive episodes to mild manic episodes, but neither are full-blown.
Individuals with bipolar disorders are likely to self-medicate with alcohol or drugs in an attempt to smooth out their manic or depressive episodes.
Cognitive-behavioral therapy (CBT) can be effective in clarifying whether the individual has bipolar disorder and where the symptoms may be overlapping with those of a substance use disorder.
Obsessive Compulsive Disorder (OCD)
Obsessive-compulsive disorder (OCD) is characterized by obsessive and repetitive behavior or mental acts. Although obsessive thoughts or behavior can be part of many people’s makeup, people with OCD are unable to carry out their daily routines without their obsessions taking over.
Some common obsessions include fear of germs, fear of making mistakes, obsessing over violent thoughts, fear of hurting others, or fear of hurting oneself. Common compulsions include activities like excessive handwashing or cleaning. Some people with OCD may repeat behaviors like checking to see if they locked a door, counting and recounting items, repeating words, or mentally going over lists.
Individuals with OCD may turn to drugs or alcohol to sedate themselves and reduce their compulsions. Once they have detoxed, medical professionals can address their OCD behavior. Effective medication for OCD is typically an antidepressant, which can go hand-in-hand with alleviating drug or alcohol withdrawal symptoms.
Post-Traumatic Stress Disorder (PTSD)
Post-Traumatic Stress Disorder (PTSD) refers to a mental health disorder that develops after an individual has experienced a traumatic event, such as war, physical abuse, sexual abuse, or an accident. There are four major PTSD symptoms:
- Avoidance: Individuals suffering from PTSD often try to avoid remembering anything to do with the traumatic event.
- Intrusive Thoughts: People with PTSD usually experience nightmares, flashbacks, or random memories related to the event.
- Changes in Mood: People with PTSD experience a dramatic change of mood. Depending on the traumatic event, they may become fearful and depressed. They may also start isolating themselves.
- Changes in Reaction: There will often be changes in how individuals with PTSD react to people around them as well as sounds. Those with combat PTSD, for example, may suffer emotional distress when they hear loud noises.
Individuals suffering from PTSD may turn to drugs or alcohol as a way of dealing with their memories and nightmares. Once they have completed the detox phase, medical professionals can address the traumatic event through behavioral therapy. However, it can be difficult for healthcare professionals to distinguish drug or alcohol withdrawal symptoms from PTSD symptoms, as symptoms such as nightmares and mood swings can overlap.
What Is the Best Treatment for a Dual Diagnosis?
Treating patients with dual diagnosis is often complicated. A thorough assessment is necessary to determine what the co-occurring disorders are, if these conditions interact or influence each other, and what kind of treatment is required. Following an assessment, healthcare professionals will put together an integrated treatment plan that takes into account both the SUD and the mental disorder. Clients may also be prescribed medication, such as antidepressants, to help manage symptoms.
Integrated treatment plans include individual psychotherapy sessions, such as cognitive behavioral therapy (CBT), and group counseling. Some clients may choose to have family therapy sessions as well. Depending on the needs of the individuals or their preferences, holistic therapy may be integrated into their treatment plan. Holistic therapy, such as yoga, can help clients better cope with stress and mood swings.
Integrated Treatment for Dual Diagnosis
At Granite Recovery Centers, we offer integrated treatments for these substance use disorders:
Which Therapies Treat Dual Diagnosis?
Treating dual diagnosis involves a combination of psychotherapy and medication for medical professionals to effectively treat both the mental health disorder and the substance use disorder. The approach aims to provide comprehensive care to improve the client’s mental health, provide skills to prevent relapse, and tackle the root causes of the person’s addictive behavior. While psychotherapy addresses the psychological issues of both the mental disorder and substance use disorder, medication mitigates the client’s alcohol or drug withdrawal symptoms as well as any symptoms displayed by their mental health disorder. This approach calls for addiction specialists and mental health professionals to collaborate when providing care for their clients.
Here are some therapies that we use to treat dual diagnosis:
- Cognitive behavioral therapy (CBT)
- Dialectical behavioral therapy (DBT)
- Post-traumatic stress disorder (PTSD) therapy
- AA meetings
- Goal setting and aftercare planning
- Holistic addiction therapy
Dual Diagnosis Treatment at Granite Recovery Centers
At Granite Recovery Centers, our goal is to treat you as an individual. We tailor a treatment plan for every client entering our treatment program to ensure you get the best care possible. Some of our treatment programs include:
- Residential rehab: Residential rehab centers are ideal for people who have just completed the detox phase. Our residential rehab centers offer 24/7 supervision within a structured environment. Clients stay at the center and receive individual therapy, group therapy, and medication. There are prepared meals and recreational activities. Clients also work with a counselor to develop an aftercare plan.
- Outpatient rehab: Our outpatient rehab is ideal for individuals who have just completed a residential rehab program. We offer individual counseling, therapy sessions, holistic therapy, and Big Book workshops. Our structured environment is similar to that of our residential rehab program, except that clients return home at the end of the day.
- Detox programs: At Granite Recovery Centers, we believe in making the detox process as manageable and comfortable as possible. Once you check into the facility, you will receive 24/7 supervision for at least 24 hours. We then assign clients to a level of either acute or sub-acute medical detoxification. At Level 4 acute care, we offer full hospital resources. At Level 0.5 sub-acute care, we deem the client has little or no withdrawal risk. Some clients may need medication to help with their withdrawal symptoms, which can be severe. These symptoms include changes in mood and appetite, chills, congestion, pain, fatigue, runny nose, tremors, and nausea.
- Gender-specific: We also offer gender-specific rehab programs that are tailored to the needs of either men or women. There may be a mental health disorder that stems from abuse by a person of another gender. Effective recovery can only be addressed within specific environments. We recognize these challenges and strive to create an environment that supports our clients’ needs.
At Granite Recovery Centers, we are here to help you at any stage of your recovery. Whether you need an intensive inpatient rehab program or an aftercare program, we are happy to provide you with all the resources you need. Contact us today at 855-712-7784 if you’re ready to make a change.