What is Dual Diagnosis?

Finding the right kind of help recovering from substance abuse demands the right diagnosis. Sometimes, however, pinpointing the problem can be easier said than done. In more complicated cases, a person can suffer from more than one disease simultaneously, also called comorbidity. When those diagnoses include psychological conditions (including but not limited to bi-polar, anxiety, panic, and ADHD), and alcohol or drug addiction it is a dual diagnosis. But who’s more at risk for disorders existing in tandem?

The majority of the time, psychiatric disorders are pre-existing and substance abuse results in an individual’s desire to cope with their disorder’s symptoms. Some psychiatric disorders leave people more at risk for alcohol or drug abuse; for example, somebody suffering from antisocial personality disorder is nearly sixteen percent more likely to turn to substances in order to self-medicate. With enough time, self-medicating behavior can create a dependency on the user’s substance of choice. In some situations though, someone may have substance abuse problems first and develop specific behaviors of a psychological disease such as increased anger or manic episodes after.

Dual Diagnosis: Finding the Underlying Issue

One tough question to answer regarding a person’s dual diagnosis is how to discover the primary problem. The difficulty posed in diagnosing and treating instances of comorbidity are the shared symptoms of different problems. Usually what a physician needs is for the patient to undergo withdrawal from alcohol or drugs to find any psychiatric issues. As scared addicts are of detoxification, clearing the body of alcohol and/or drugs must happen before the road to recovery can really begin. Contrary to common opinion, an addict does not need to go “cold-turkey” – cutting all drugs or alcohol completely and abruptly – in order to detoxify. Under medical supervision a user is administered small doses of controlled medications in order to relieve some of the intense pain and sometimes danger linked to quitting substances. Thankfully, under the right supervision, the process is far less traumatic and physically taxing than it can be without the right help. 

In cases of dual diagnosis, once the detoxification is complete, it’s necessary that the individual be treated for both her substance abuse, and her psychological condition. For both psychological and substance abuse diagnoses, group therapy is usually recommended. For alcohol and drugs, newly substance free users are encouraged to use programs like narcotics anonymous in re-learning how to productively and purposefully function without addiction. For psychiatric problems, support groups can be really helpful. Other therapies can help individuals figure out how to communicate more clearly or express their feelings in healthy ways. Depending on the psychological disorder, an individual may be prescribed different medications alongside therapy for more comprehensive recovery. Where recovery happens, whether in a hospital or rehab facility or at home, completely depends on the individual.

Dual diagnosis is hard, not only for the diagnosed individual but, for family and friends of the sick person. It’s important to learn how to be supportive without enabling your loved one. Enabling includes any behavior that allows someone with substance abuse problems to maintain their addiction; ignoring a husband or sister “borrowing” cash to buy drugs or alcohol can be just as counterproductive as giving him/her their substance of choice directly. It’s also important to remain supportive, warm, and understanding as opposed to being cold or seemingly alienated. Most importantly with the right encouragement a friend of family member can become a driving force toward serious positive change for someone dealing with dual diagnosis.