For centuries, mental illness and addiction have occurred comorbidly in people from across the world. Up until recent years, doctors and therapists wouldn’t even attempt to treat a patient presenting with symptoms of both a mental illness and a substance use disorder until that patient stopped drinking or using drugs entirely. What was not well-known then was that trying to end active addiction when mental illness is occurring can be extremely difficult, if not impossible. Today, it is well-known that a patient who presents with symptoms of both conditions can have them each treated simultaneously. This condition is known as dual diagnosis.
What is a Dual Diagnosis?
Dual diagnosis is the term used to describe a substance use disorder and a mental illness that occur simultaneously. For example, common forms of dual diagnosis include:
- Alcohol use disorder/antisocial personality disorder
- Stimulant use disorder/panic disorder
- Opioid use disorder/posttraumatic stress disorder
- Marijuana use disorder/schizophrenia
A dual diagnosis is especially tricky, as the longer it goes unaddressed, the more intense it becomes. Someone who is abusing an addictive substance is going to need to routinely increase how much they are consuming in order to feel high, which is then going to exacerbate the symptoms of the mental illness. People with dual diagnosis can easily find themselves spiraling downwards and fast because of how mental illness and substance use disorders interact.
Signs of Dual Diagnosis
A dual diagnosis is so pervasive in one’s life that it is impossible to hide the signs and symptoms of it. Many of the signs of dual diagnosis that a person will exhibit will be directly related to the type of substance they are abusing and what kind of mental illness they have. For example, a person with a dual diagnosis of opioid use disorder and posttraumatic stress disorder may display signs such as slowed movements, nodding off while talking, and avoidance tactics. Somebody addicted to cocaine and who has a panic disorder might behave erratically, experience severe mood swings, and has high respiratory and heart rates. In general, however, there are signs of dual diagnosis that are shared across the board regardless of the type of mental illness or substance use disorder a person has.
Family history of mental illness
Both substance use disorders and mental illnesses have biological components to them. If someone’s mother has bipolar disorder, then they are already 50% more likely to develop this or another similar disorder than someone who has a mother without a mental illness. The closer family members are genetically to one another, the more likely they are to pass their mental illnesses or predispositions to substance abuse down to their loved ones.
Feeling unable to function without drugs or alcohol
Many times, people turn to the use of drugs or alcohol to self-medicate symptoms associated with a mental illness. They might not even know what mental illness they have but know that they feel worried a lot or need an “extra boost” to help them out of an emotional slump. The idea of no longer using drugs or alcohol can be anxiety-provoking if a person is utilizing substances to help mitigate those symptoms, which is a very common sign that a dual diagnosis is occurring.
All mental illnesses can affect a person’s mood, with or without mind-altering substances being present. But when someone is addicted to drugs or alcohol, they can make these mood swings more severe and intense. For example, a person with anxiety might find it hard to relax because they are constantly worried about something. Abusing a drug like cocaine or Adderall can make the anxiety worse because it is speeding up the functioning of the brain, meaning it is triggering more powerful symptoms associated with the anxiety. Mental illness can make a person’s mood unstable and unpredictable. Substance abuse can do the same. When paired together, mood swings occur more often and usually more severely.
Having suicidal thoughts is an extremely scary occurrence. It is especially frightening for those who are looking on, as the person with the thoughts might not even realize that they are only having them because they are not getting the right treatment. Mental illnesses, such as depression for example, impact brain chemistry in ways that make some people irritable, angry, sad, or even hopeless. Mind-altering substances do the same thing. So, when both conditions are happening at the same time, a person becomes likely to develop suicidal thoughts. In most cases, suicidal thoughts can only be remedied with the help of a therapist and other professionals who can also assist in helping the individual get sober.
Continuing to use despite the consequences
People who are addicted to drugs and alcohol often find themselves continuing to use even though they know it will cause unfavorable consequences. The reason for that is because their cravings for continued use are so powerful that it suddenly seems worth it to take potentially fatal risks just to get high or drunk. Using despite consequences is even more pronounced in people with a co-occurring mental illness, as the instability of one’s psychological wellbeing can play into poor decision-making and bad impulse control.
Every person with a dual diagnosis is different and they may present with symptoms that are more unique to their situation. Keeping an eye out for the most common symptoms of dual diagnosis can be an excellent starting point if you want to help someone who is experiencing this issue.
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