Dual diagnosis is when a person has both a mental health disorder and an alcohol or drug problem. These conditions often co-occur and the interaction of the two conditions can worsen both. According to the National Survey on Drug Use and Health (NSDUH), 9.5 million adults experienced both a mental illness and a substance use disorder in 2019. Either disorder, mental illness or substance use disorder can develop first, or they can occur simultaneously. It is important to recognize symptoms of dual diagnosis because in most cases, the conditions will influence each other in such a way that it exacerbates the other.
Some people may or may not realize that they have two conditions. A person who is struggling with underlying depression may have self medicated with alcohol or drugs but as the drinking or drug use progresses, the symptoms of depression may be exacerbated. Ultimately the person may realize they need treatment for addiction, but not realize that they have underlying depression issues. The other diagnosis may be discovered during an initial psychological evaluation, or may not truly emerge until later in treatment when alcohol and drugs have been removed for an extended amount of time. In the absence of drugs and alcohol, the symptoms of mental illness emerge.
Signs and Symptoms of Dual Diagnosis
The signs and symptoms of dial diagnosis can vary depending on the mental health disorder and the drug of choice. For example, if someone is struggling with alcohol abuse and bipolar disorder, that will manifest differently from someone who has depression and cocaine addiction. Mental Health America reports that certain mental health disorders have higher rates of risk for the development of substance use disorder. These disorders include: antisocial personality disorder, manic disorder, schizophrenia, panic disorder, depression, obsessive-compulsive disorder and phobias. Mental health illnesses can complicate the recovery process so it is important for an individual with dual diagnosis to receive treatment for both underlying conditions.
Some common physical symptoms of dual diagnosis include:
- Withdrawal symptoms
- Changes to sleep patterns (insomnia or excessive sleep)
- Sudden weight gain or weight loss
- Changes to appetite
- Lack of personal hygiene
- Red, dilated eyes
Some common behavioral signs of dual diagnosis include:
- Loss of motivation or energy
- Paranoia or anxiety
- Isolating from family and friends
- Issues with work, school or other priorities
- Delusions or hallucinations
- Feelings of despair, hopelessness and worthlessness
- Increased mood swings
While the symptoms of overlapping disorders are difficult to distinguish from one another, one red flag is when someone uses alcohol or drugs as a coping mechanism or to “self medicate”. Often a person might report that they can’t remember the last time they felt happy or satisfied without the influence of drugs or alcohol. In these cases, the alcohol or drug use might be masking an underlying mental illness.
Common Risk Factors for Dual Diagnosis
Dual diagnosis is relatively common, with nearly 1 in 4 with a mental illness also having a substance use disorder. Like with substance use disorder and mental illnesses alone, dual diagnosis can be caused by a combination of genetic and environmental factors. There is large genetic component that predisposes an individual to addiction and mental health disorders; research has demonstrated that there are specific genes as well as combinations of genes that appear to function differently for those with dual diagnosis. There are also environmental influences such as exposure to traumatic experiences, having an alcoholic parent, stressful events that can also predispose a person to dual diagnosis.
- Family history of depression or mental health illness
- Family history of addiction or substance use disorder
- Prenatal exposure to drugs or toxins
Treatment Options for Dual Diagnosis
Dual diagnosis is a complicated disorder and requires specialized treatment from specialists who are equipped to treat both underlying conditions for patients. While dual diagnosis is reportedly common, only about 50% of the individuals who require treatment receive treatment. Of those that receive care, only a small percentage get treatment for both conditions. Not treating a person’s underlying condition predisposes them to higher risk of relapse into their addiction or for a mental illness to persist.
Addiction Treatment in Florida
Because both conditions can influence each other, it is important to get professional care from someone who is able to treat all co-occurring disorders. If you believe that you or a loved one is suffering from dual diagnosis, it is important to know how to recognize warning signs and symptoms. At Genesis House, addiction treatment specialists are able to work with you or your loved one to assess your situation and determine an individualized treatment plan that will suit your needs. A professional will be able to take a thorough substance use and mental health history and determine if drug or alcohol treatment along with additional treatment is recommended.