When Two Conditions Become One Journey: Dual Diagnosis Treatment at Agape

One of the reasons why it is so difficult to identify whether someone has co-occurring disorders is due to the fact that the signs and symptoms of mental illness and substance abuse can overlap. 

Signs that both disorders may be present include:

• Using alcohol or drugs as a way to treat emotional pain, anxiety, intrusive thoughts, or other mental health-related symptoms
• Mental health symptoms continue to worsen despite periods of abstinence from substances
• Psychiatric symptoms seem to correlate directly with patterns of substance use
• Multiple previous failed treatments for either mental health or substance abuse
• A history of trauma, mood disorders, or other psychiatric diagnoses in addition to a history of substance abuse
• Family members express concerns regarding both mental health and substance use
• Withdrawal symptoms seem to either trigger or worsen psychiatric symptoms

The high frequency of co-occurrence between mental health and substance use disorders lies in the shared mechanisms that underlie both types of disorders:

• Self-medication — Those with untreated or undertreated mental health conditions frequently self-medicate with substances. While this may temporarily reduce uncomfortable symptoms, it ultimately causes further damage and can lead to dependency.
• Shared neurological vulnerabilities — Research suggests that substance use disorders and many mental health conditions share neurobiological mechanisms in the reward pathways, stress-response systems, and neurotransmitters such as dopamine and serotonin.[6] People who are vulnerable to developing mental health disorders are also more likely to develop an addiction.
• Trauma — Childhood adversity and past trauma dramatically increase the risk for both mental health conditions and addiction. PTSD in particular is highly correlated with both.[7]

Professional clinical help is warranted for your dual diagnosis when:

• Substance use has continued, despite significant negative consequences, and multiple attempts to quit 
• Mental health issues continue to develop and return even while sober or using less frequently
• Previous treatment only dealt with one aspect of the dual diagnosis, either substance abuse or the psychiatric issue, and did not result in sustained recovery
• There is a circular feeling about the relationship between the substance use and mental health symptoms; it feels like you cannot get out of the cycle on your own
• You suspect a family member may be suffering from both a psychiatric disorder and an alcohol or drug-related disorder
• Medical detox or withdrawal management is needed before you can be medically stabilized and start treatment for your mental health

The evidence supporting the integrated, simultaneous treatment of dual diagnosis disorders is strong and consistent. Studies funded by The Substance Abuse and Mental Health Services Administration (SAMHSA) and the National Institute on Drug Abuse (NIDA) indicate that participants receiving an integrated approach to their disorders — in other words, receiving treatment for their dual diagnosis from the same group of professionals working together as part of one coordinated program — have demonstrated significantly superior results in terms of substance abuse, symptom severity related to their diagnosed psychiatric conditions, functional recovery, and overall long-term sobriety rates compared to those who received separate treatments for each disorder.[8]

This makes sense: if you do not treat a person’s mental health issue, they may continue to use drugs or alcohol as a way to cope with it. Likewise, if you do not address a person’s substance use problem, they can continue to experience a decline in their mental health. Breaking this cycle requires that the two be treated at the same time, and ideally by the same treatment team that understands the full picture of what is happening in that individual’s life.