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Dual diagnosis is the simultaneous occurrence of a mental health disorder and substance abuse issues (co-occurrence). This complex condition poses a greater challenge to healthcare providers since both issues must be addressed concurrently to achieve successful treatment outcomes.
In the UK, over 55% of individuals receiving treatment for substance misuse also have a co-occurring mental health disorder. These figures show the importance of developing comprehensive and tailored treatment plans for those affected by a dual diagnosis of psychiatric disorders and behavioural addiction or substance abuse.
Why Are Co-occurring Disorders Common?
Co-occurring disorders are common because they can be intertwined. For example, someone suffering from depression may turn to drugs or alcohol to cope with negative emotions or lack of motivation. Co-occurring disorders are also common because they can often go undiagnosed for long periods. Someone may be self-medicating with substances to cope with the symptoms of anxiety or even panic attacks, without even realising it. For example, drinking alcohol ‘to soothe the nerves might be your way of self-medicating and hiding the symptoms of a mental health condition.
Although a dual diagnosis refers to a mental disorder coexisting with substance abuse, sufferers may experience other co-occurring conditions or compulsive behaviours such as problem gambling.
What Are the Most Common Co-occurring Disorders?
The most common co-occurring mental disorders include:
- Depression
- Anxiety disorders
- Post-Traumatic Stress Disorder (PTSD)
- Bipolar disorder and other mood disorders
- Attention Deficit Hyperactivity Disorder (ADHD)
- Schizophrenia and other psychotic disorders
- Bordlerline, Histrionic and other personality disorders
According to data from the ONS, mental health concerns continue to rise in the wake of the COVID-19 pandemic. As of 2021, surveys show that the proportion of adults in England reporting symptoms suggestive of depression has increased from 10% pre-pandemic to 21% in 2021. This means that the prevalence of co-occurring disorders is likely to increase as well.
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Mental Illness or Addiction: What Came First?
The relationship between mental illness and addiction can be bidirectional. For instance, an individual with a mental health condition may turn to substances as a form of self-medication to alleviate their symptoms or cope with emotional distress. Additionally, substance abuse can exacerbate severe mental illness or even trigger new disorders due to the neurochemical changes that drugs or alcohol induce in the brain. Some studies link cannabis use in young adults, which, when combined with genetic predispositions, raises the chance of developing schizophrenia.
Given the intricacies of this relationship, it is crucial for treatment approaches to be tailored according to individual needs and based on medical history, the severity of substance use, personal preferences, and other mental illnesses.
Risk Factors
Those with a history of trauma are at higher risk for developing co-occurring mental health disorders and substance abuse problems.
Other risk factors can include:
- genetic predisposition
- environmental factors
- and social circumstances.
For those who are exposed to stress, poverty, or intimate-partner violence, there is a higher risk of experiencing mental health issues, being gaslit into distrusting traditional therapies and treatments, and looking into substances to cope. Additionally, family members or peers who use or abuse substances may influence an individual and increase his/her likelihood of engaging in risky behaviours.
It is important to note that many of these risk factors are commonly associated with substance abuse issues in isolation.
Recognising the Signs of a Co-Occurring Disorder
Recognising the signs of co-occurring mental health problems, such as mood, behaviour, or social functioning changes, is crucial for early intervention and timely treatment. Common signs of both can be difficult to distinguish since they overlap but may include:
- Changes in sleep habits, such as difficulty falling asleep or sleeping more than usual
- Decreased energy, motivation, or interest in activities that used to be enjoyable
- Isolating from family and friends
- Increased feelings of guilt, worthlessness, hopelessness and/or helplessness
- Risky behaviours such as drink or drug driving
- Uncontrolled use of drugs or alcohol as a coping mechanism for difficult feelings or emotions
- Suicidal thoughts or behaviours
How Do Mental Disorders and Addiction Affect Relationships?
Addiction and mental health disorders can significantly impact relationships, often causing strain and distress. Both conditions can further exacerbate relationship difficulties, as each disorder may amplify the adverse effects of the other.
Substance abuse can lead to strained relationships with family, friends, and colleagues due to dishonesty, financial problems, and neglect of responsibilities. It can also contribute to mood swings, aggressive behaviour, and impaired decision-making, negatively affecting interpersonal relationships.
Mental health disorders can impact personal relationships by causing mood swings, irritability, or social withdrawal. Individuals with mental health disorders may struggle to communicate effectively or engage in social activities, leading to feelings of isolation.
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What Are the Unique Challenges Associated with Dual Diagnosis?
Dual diagnosis presents unique challenges. As healthcare providers, we take great responsibility for ensuring the highest levels of safety and care. One of the primary difficulties associated with dual diagnosis and addiction recovery is the necessity for collaboration between healthcare providers from different fields. Some may also require longer treatment durations than those with only substance abuse issues.
At CATCH Recovery, we provide an interdisciplinary approach to effectively address the complex interplay between mental health disorders and substance abuse. As part of our treatment offering, our clients might need to be assessed by a psychiatrist before any counselling plan is agreed upon.
Breaking the Stigma
Individuals with dual diagnoses often experience stigma and discrimination, leading to shame, guilt, or isolation. These negative emotions further complicate the recovery process, creating barriers to seeking help and adhering to treatment plans.
Our experienced mental health professionals understand the challenges associated with the stigma of both conditions. Our goal is to provide a safe, non-judgmental space for individuals to talk about their substance use and mental health concerns.
How We Can Help You
If you need dual diagnosis treatment, the first step is to complete a free, confidential assessment with our team here at CATCH Recovery. We will review your mental health, family history, substance use patterns, and any prescribed psychiatric or other medication you are currently taking.
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Mental Health Screening
As part of our in-depth assessment, you will be assessed by a specialist in co-occurring mental health disorders. This process is assigned based on your individual needs and may take up to 90 minutes and is necessary in determining the appropriate course of action for your treatment.
Medication Adjustments
Medications used for psychiatric symptom management will need to be monitored, as some could interact negatively with other substances you are taking. We will consider potential risks and benefits to ensure treatment efficacy. Our team would like to be in contact with your treatment specialist that has prescribed your current medications so that we can agree on any necessary changes.
If medication adjustments are required, close collaboration between you, the psychiatrist, and our therapeutic team will be ongoing.
Therapeutic Care
A dedicated therapist from the CATCH Recovery team will work closely with you to create a personalised treatment plan that addresses both conditions concurrently.
Your sessions will focus on:
- The role your psychiatric illness has on your substance misuse
- Relapse prevention strategies to help you recognise triggers, develop healthy coping mechanisms, and build resilience against potential setbacks
- Psychosocial therapy and evidence-based behavioural therapies are proven effective in treating both substance abuse issues and mental health problems
- Group therapy and peer support
The goal of treatment will not only focus on abstinence but also on improving the overall quality of your life through symptom reduction and functional improvement.
We recognise the difficult nature of dual diagnosis and the wider impact it has on family members and loved ones, therefore, we extend our treatment offering to include both couples therapy and family counselling sessions. Contact our team today to learn about the family therapy options we offer and how we can help you improve your relationships.
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Long-Term Recovery Success
Ongoing support is crucial for long-term recovery, enabling you to continually address the challenges in managing a dual diagnosis. This support may come in various forms, including regular check-ins with our healthcare professionals, participating in support groups, or continued engagement in therapy sessions.
To help facilitate long-term success, we offer many optional post-treatment services to help you stay on track.
What Sets CATCH Recovery Apart?
CATCH Recovery sets itself apart from other addiction treatment providers through experience, flexibility, and a comprehensive range of mental health services. With over 40 years of experience in the field of mental and addiction, CATCH Recovery has established a strong foundation in providing evidence-based therapies and quality care if you are struggling with addiction, substance abuse, compulsive behaviours, and mental health disorders.
Another key aspect distinguishing CATCH Recovery is its ability to offer online and in-person treatment options tailored to individual needs, circumstances, and work commitments. This flexibility ensures everyone can access the support they require, regardless of location or schedule constraints. We are committed to providing quality and effective care that promotes long-term recovery and improved quality of life for those struggling with mental illnesses and substance use disorders.