Alcohol and Dual Diagnosis
Individuals with an alcohol use disorder sometimes also have a co-existing mental health disorder. In substance abuse treatment this is known as dual diagnosis. One of the conditions often goes undiagnosed and untreated which makes long-term recovery less likely. An individual with a dual diagnosis needs help for both the substance abuse problem and the mental health issue.
What is Dual Diagnosis
Dual diagnosis, also known as co-morbid or co-occurring disorders, is when an individual has a substance abuse problem such as alcohol use disorder (AUD) and a separate condition involving mental health. An individual with a mental health condition is more likely to suffer from AUD, and individuals who are dependent on alcohol are more likely to develop mental health issues.
There is a link between alcohol and mental health. Patients with mental health issues will turn to alcohol to self-medicate. It can then be difficult for the individual to stop drinking, be it for one night or an extended period. This, in turn, leads to alcoholism and can make the symptoms of the mental health condition even worse. The two play off of each other and the individual will drink more to stop the symptoms, but the symptoms only increase with the drinking.
In the past, alcoholism and mental health conditions were treated separately, if at all. Sometimes only one condition was treated. Now that experts see the links between the two and the benefit of treating both at the same time, the treatment process is more often successful.
Common Dual Diagnosis Conditions with Alcohol
One of the most commonly diagnosed mental health conditions today is depression. It also is the one most frequently paired with alcohol use disorder in a dual diagnosis. Individuals with depression often turn to alcohol to alleviate symptoms such as feeling lonely, hopeless, sad or suicidal. Unfortunately, that only exacerbates the symptoms.
With depression, the individual continues to drink to feel better, but only continues to feel worse. The vicious cycle continues until the individual finds the help they need, working on their alcoholism and depression. With the right treatment, both conditions can be relieved, helping the client to gain a strong sense of self and avoid the triggers associated with each issue.
After depression, anxiety seems to be the most common diagnosis when alcoholism is present. Anxiety comes in many forms, from feeling anxious in social situations to being on edge all the time. Anxious individuals often use alcohol to relax. Depending on the type of anxiety, the drinking issue may be mild to extreme.
Some individuals drink only in social situations to feel more confident but, over time, feel that they cannot function without drinking. The drinking inspires them to actions that result in more anxiety, reinforcing the feelings that led them to drink in the first place. Consequently, they develop a serious drinking problem.
Individuals diagnosed with a bipolar disorder are more likely to develop an addiction at some point, with alcohol the most likely. People with bipolar disorder (BPD) go through cycles of manic and depressive behavior. When alcohol is mixed in, these cycles can become dangerous, especially the reckless or careless behavior associated with a manic phase. That’s why the BPD must be treated as well as the AUD.
Obsessive-compulsive disorder (OCD) is a type of anxiety disorder that manifests in uncontrollable obsessions and compulsive repetitions. Some individuals may count items, others wash their hands over and over, and still others arrange items in a certain order.
Some people with OCD turn to alcohol as a distraction or to try to control their behaviors and intrusive thoughts. Unfortunately, it usually just makes the symptoms of OCD worse or adds health and emotional problems of substance abuse to their problems.
Symptoms of Dual Diagnosis
The symptoms associated with a dual diagnosis will vary depending on the mental illness, how long the individual has been drinking, and the frequency with which alcohol is consumed. Detecting the problem early requires learning and recognizing the warning signs of dual diagnosis. The sooner treatment begins, the greater the likelihood of success.
Common symptoms of dual diagnosis include isolating oneself from family and friends, eating much more or much less than usual, having less energy and motivation, and having trouble concentrating on or completing tasks. The individual may begin to neglect their responsibilities at home or on the job. The individual show irritation, anger, or anxiety. In cases of alcohol abuse, the individual may rationalize their excess drinking.
By recognizing these signs, you can help those you love to begin seeking treatment as soon as possible.
Dual Diagnosis Treatment Options
There is no standard treatment for dual diagnosis because there is no standard dual diagnosis. Both the addiction and the mental health issue require separate treatment. A recovery plan must be created for the individual based on their alcohol use as well as the associated mental condition.
If the alcohol abuse is ongoing, then the first step is usually detoxification. The alcohol needs to be eliminated before the individual can fully begin treatment and working on their recovery. From there, the patient will often go to a rehab facility as an inpatient or outpatient. With inpatient care, the individual lives at the facility during treatment with 24/7 care, including medical assistance, support groups, therapy sessions, and medication as needed.
With outpatient care, the individual visits the facility for treatment but lives at home.
Impact of Dual Diagnosis on Treatment
If an individual is only treated for half of a dual diagnosis, then the treatment is not going to work. If the mental health issue led to the alcohol use disorder and the mental health issue isn’t treated, the alcohol abuse is more likely to resume. If the addiction caused the mental health issue, the mental illness probably will return if the addiction is not addressed. When medical professionals identify and treat both conditions, the chances of success are better.
With dual diagnosis treatment, people with a dual diagnosis learn how to deal with everything they face, working towards being mentally healthy as well as physically healthy, avoiding alcohol and triggers. They learn to cope with their condition without alcohol.
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