Having a substance abuse problem or a mental health disorder can be frustrating. The symptoms of dealing with one or the other can cause physical, psychological, and emotional problems. Unfortunately, the presence of one can proliferate the other or the two can exist simultaneously. The case of co-occurring disorders (COD) is called comorbidity, or Dual Diagnosis. Comorbidity is actually more common than you might realize but it is difficult to diagnose.
Persons with mental illness are twice as likely to develop a substance use disorder (SUD); those with severe mental illness are even more likely to have an SUD. Similarly, those with substance abuse problems (37 percent of alcohol abusers and 53 percent of drug users) have at least one mental health disorder, as reported by the National Alliance on Mental Illness.
Why Is a Dual Diagnosis Hard to Diagnose?
Comorbidities are often difficult to diagnose because the symptoms of one can often contribute to or cause the other. For example, those with depression often may experience more intense side effects as a result of alcohol use. Some drugs like psychedelics may instigate certain symptoms of psychosis or schizophrenia in individuals. So, the nature of these complex and simultaneous illnesses can complicate an accurate diagnosis.
What can help with an accurate diagnosis is determining which illness came first. That can be hard to do sometimes as it requires a person to abstain from drugs or alcohol for a period of time. Once detoxification is complete, clinicians can then look at the symptoms that remain and address them.
A substance use disorder is classified as one where symptoms are brought on due to the use of drugs or alcohol. Sometimes the symptoms of substance abuse mimic the symptoms of mental illness; however, generally, symptoms of mental illness, whether it be depression, anxiety, erratic thoughts or speech, will subside after substance use stops. If a person has a mental health disorder that precedes and is independent of substance abuse, those symptoms will still remain.
A psychiatric disorder, on the other hand, may be considered the “primary” issue if substance abuse stops and symptoms remain. The DSM-IV has four criteria for determining the presence of a primary mental health disorder. There must be:
- Symptoms that are in substantial excess “of what would be expected given the type or amount of the substance use or the duration of use”
- A history of episodes that are unrelated to substance use
- Onset of symptoms precedes substance use
- Symptoms that persist for a considerable length of time
By determining which issue came first, doctors can better understand how your brain works and how to handle it. Our treatment programs at FRN are specialized and highly individualized with you in mind. Because comorbid conditions are unique and complex, our recovery plans are designed to address the many facets of Dual Diagnosis cases.
Getting Help for a Dual Diagnosis
If you have a substance abuse disorder and a mental health problem, it is useful for you to get your symptoms assessed by a professional. It can seem like a scary or intimidating thing at first, but there’s nothing to worry about. Getting tested for co-occurring disorders can only be beneficial and helpful to you in the long run. By allowing doctors to examine your symptoms, perceptions, and other health-or substance-related side effects, they can most appropriately develop a treatment plan that is particular to you.
We’re proud to have the best physicians, counselors, psychologists on staff at FRN. Our treatment and continuing recovery plans are developed specifically for you and your needs. You can call us at any time to learn more about the different treatment approaches we have available for you.
Further Reading About Testing for Dual Diagnosis
- Cognitive Testing
- Diagnosing Illness Through Neuroimaging Scans
- Diagnosing Patients Using Electroencephalography
- Neuropsychological Testing
- Personality Assessments
- Psychological Testing
- Testing for Dual Diagnosis
- Using Magnetic Resonance Imaging (MRI) to Diagnose Mental Illness
- Vocational Testing
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David W. Newton is a board certified pharmacist and also has been a board member for boards of examiners for the National Association of Boards of Pharmacy since 1983. His areas of expertise are primarily pharmaceuticals as well as cannabinoids. You can read an article about his expertise in CBD on the National Library of Medicine.
Reviewed by: Kim Chin and Marian Newton