Dual diagnosis: a closer look at the relationship between mental illness and addiction

Dual diagnosis: a closer look at the relationship between mental illness and addiction

Dual diagnosis is a two-edged sword. Also known as co-occurring conditions, it essentially refers to a co-existing mental illness and substance-related addiction. According to numerous epidemiological studies and statistics, the fact that mental illnesses and addiction have often been  closely associated cannot be denied. Statistics show that around 50 percent of psychiatric patients also battle substance abuse disorders. The Substance Abuse and Mental Health Services Administration (SAMHSA) believes this percentage amounts to an alarming figure of 8.9 million adults out of which only 7.4 percent are receiving treatment for both conditions.

The concept of dual diagnosis surfaced only 20 years ago, making it a relatively new phenomenon in addiction recovery. Up until the 1990s, people experiencing mental health symptoms and those dealing with addiction problems were given treatment that looked at these issues separately. Hence, when these conditions overlapped, clients were often denied treatment for mental illnesses till they were cleaned up and sober. The health care system still has a long way to go to fully understand the complex dynamics of dual diagnosis, as the treatment for co-occurring conditions is never straightforward. The rates of co-occurring disorders are much higher in patients dealing with conditions like post-traumatic stress disorder (PTSD), bipolar disorders, schizophrenia and generalized personality and anxiety disorders.

Dr. R Andrew Chambers, director of the Addiction Psychiatry Training Program at the Indiana University School of Medicine in Indianapolis, primarily investigated the relationship between substance abuse and mental disorders in his career. He believes this situation to be complex because the co-occurring conditions go hand in hand, calling it a “pesky self-medication dogma.” He stresses the importance of differentiating between addiction and self-medication, reiterating that they are not the same thing (Swanson, 2014).

Individuals with mental illnesses often intend to treat their disruptive mental health symptoms with the use of alcohol or drugs, which, unfortunately, do little to help the situation. Contrarily, it may end up creating new problems alongside worsening existing mental symptoms. Certain drugs can trigger mental health problems such as paranoia, anxiety and depression when under the influence. If these conditions persist after the influence has worn out, then this may indicate a co-occurring condition.

Treating a dual diagnosis is not as simple as just avoiding alcohol or drugs; it involves two  illnesses that exacerbate each other in a synergistic fashion. Drugs can create psychiatric symptoms, some of which may go away if the use of those particular drugs is refrained from. However, some symptoms might not disappear as easily. Consequently, many patients who do eventually become sober may continue to experience several psychiatric issues that were not addressed before.

Digging deeper into dual diagnosis, Dr. Chambers came to the understanding that mental illnesses and substance abuse disorders are essentially the same diseases. His studies have shown that a person with a mental illness is more vulnerable to falling prey to an addiction. The regions of the brain that are affected by a drug or alcohol addiction are the same as those that are affected by schizophrenia, which include the nucleus accumbens, the hippocampus and the frontal cortex.

An important point that Dr. Chambers believes is that mental illnesses are not specific to a particular drug. “If there’s any common denominator, it’s severity,” Chambers said. “The relationship is between addiction and mental illness, not between the drug and mental illness.” However, another similarity that cannot be overlooked between both disorders is the unpredictability and impulsiveness. Both addicts and individuals with mental disorders act on  impulses (Swanson, 2014).

Patients who endure dual diagnosis suffer more as they experience harsher mental, emotional and social repercussions. Since they are compounded by two disorders that exacerbate each other, they are more susceptible to a co-occurring disorder relapse or a worsening psychiatric condition. Therefore, patients with dual disorders may need more extensive treatment, have a more gradual progression and may experience more setbacks.

For such at-risk individuals, the Dual Diagnosis Helpline is an easy and efficient service available to provide help to those seeking dual diagnosis treatment and connecting them with expert professionals. Within the United States, the number of facilities providing high-quality treatment for both conditions at the same time is limited. This is why we are here for you and your loved ones to get the help you deserve. If you’re seeking more information about dual diagnosis or require immediate treatment, you can always call the Dual Diagnosis Helpline at 855-981-6047.