According to the National Institute on Drug Abuse, more than half of individuals who suffer from drug addiction also have a diagnosable mental illness other than the addiction issue itself. Researchers, thus far, have been unable to determine the exact reasons behind this interesting fact, but there are several theories. In order to understand the treatments available to individuals who suffer from these types of Dual Diagnosis conditions, it is important to understand how they are similar.
One theory suggests that abuse of certain drugs can actually cause mental illnesses to develop. Marijuana, for instance, has been shown to induce psychosis. When it comes to cocaine, at least one study has shown that the effect of cocaine in the human brain creates a detrimental change in the ability of the brain to naturally produce feelings of pleasure, which can lead to depression in some individuals.
Another theory regarding the correlation between mental illness and drug abuse is that individuals who already suffer from a mental disorder are more prone to abuse drugs. The concept of self-medication espouses that individuals take drugs to feel better. On the surface, one might pose the question of whether there is anything wrong with this practice. If an individual feels better and functions better due to their drug use, whether the drugs are prescribed by a doctor or obtained through some other means, why shouldn’t they continue to do so? Unfortunately, the practice of prescribing medication for specific ailments, including mental illness, is a very specialized activity.
Individuals who self-medicate using illicit or illegally obtained prescription drugs – including taking drugs prescribed to a family member for a similar or the same condition – fail to take into account several important risks, such as:
- Some medications are prescribed by weight and height, leaving an individual who is self-medicating likely to ingest excessive amounts of the drugs in question.
- An incorrect self-diagnosis — even when symptoms appear that are very similar to those of a family member — can result in a serious mental health disorder going untreated or mismanaged.
- Drug interactions can be dangerous and without a professional’s input and diagnosis, severe health risks can be present.
- Illegal and illicit drugs can hide symptoms or create symptoms that would not otherwise exist, causing an individual to increase the amount of drugs he or she is taking.
- Dependence on and addiction to the drugs can develop without proper monitoring of dosages.
One final theory that the experts have developed concerning why drug abuse and addiction occur so frequently with other mental health disorders is the fact that many of the same risk factors are present for both conditions. For example, individuals who are exposed to certain physical or sexual abuse early in their lives run the risk of developing a mental illness as well as substance abuse. Stress is also a primary factor in both conditions. It may be that some individuals will develop a mental illness, such as anxiety or depression, around the same time that they begin to abuse drugs or alcohol, merely by coincidence based upon their own, unique family and personal histories.
Treatment Therapies for Dual Diagnosis Patients Include Behavioral Modification
One study published by the U.S. National Library of Medicine found that the treatments used for mental illness as a singular diagnosis are also effective for those who suffer from a Dual Diagnosis. On that same note, the treatments used to help those individuals who suffer from substance abuse are also effective for the treatment of substance abuse when there is another illness present.
So, what types of treatments work for an individual with a Dual Diagnosis? The answer to this incredibly important question depends upon the needs of the individual. Treating an individual as a person, and not a collection of symptoms or disorders, is one of the guiding principles of drug addiction and Dual Diagnosis treatment. The National Institute on Drug Abuse has established that the most effective treatment programs will have the ability to tailor a treatment plan to each person’s individual needs. What kind of drugs does the individual abuse? Stimulants can have a very different impact on withdrawal than opiates, for instance. The other issue to consider when designing a treatment plan is the type of co-occurring disorder that is present. Major depression has different impacts on a person’s psyche than bipolar disorder or a personality disorder. Anxiety issues may be addressed differently in one individual than another who suffers from panic disorder.
Cognitive Behavioral Therapy Is Helpful for Dual Diagnosis Patients
Cognitive Behavioral Therapy is a program of psychotherapy that has many benefits for both mental illness and the treatment of drug abuse and addiction. The program consists of a defined number of visits, averaging about 16, according to the National Association of Cognitive-Behavioral Therapists, during which the patient will unlearn preconceived notions about their life and the way they have chosen to make decisions. The structure behind CBT is based on the theory that we base our behaviors and our decisions to act in certain ways on our perception of the world around us. If we believe that we are not good enough, for instance, we may behave in a way that is unhealthy because we don’t believe we matter.
If an individual can change how they think about their self-worth, they can change their behavior as it pertains to drug or alcohol use and abuse. The benefits of this type of program for the treatment of Dual Diagnosis include:
- The patient takes an active role in goal-setting and accomplishments during the course of treatment; it is not simply “talk” therapy, but rather a proactive course of action.
- Trained therapists work with the patients with a specific game plan during each session to keep the process moving forward each week.
- CBT places profound importance on education and learning how to achieve one’s goals, which leads to long-term results that last beyond the end of the treatment program.
- Total immersion in the healing process, rather than focusing on recovering only during the sessions, is accomplished through the assignment of homework to be completed between visits.
- Patients learn to ask themselves important questions about their lives; for instance, an individual with OCD might learn to ask himself whether performing a ritual is truly likely to keep someone from harming his family rather than simply acting on an impulse to perform the ritual without rational thought.
Alternative Therapies Can Help Reduce Stress
According to the experts at the National Center for Complementary and Alternative Medicine, the use of certain relaxation techniques has been proven effective for the treatment of anxiety, depression and pain. When used as part of an overall treatment plan, the simple process of relaxing can change the way your body physically responds to the stresses of your life. For instance, breathing exercises, guided imagery, self-hypnosis and progressive relaxation as well as yoga and meditation exercises can help individuals control the “fight-or-flight” responses in their body and brain. As stress causes the body to react with a raised heart rate, increased breathing and higher blood pressure, relaxation techniques – which can be learned in Dual Diagnosis treatment – can lower blood pressure, reduce altered breathing and decrease the heart rate.
Relaxation techniques are safe for most individuals; however, the experts suggest that individuals learn these techniques from trained instructors because there is a chance that some symptoms can worsen when the techniques are used incorrectly.
Tailored Treatment Is Crucial for Continued Success
Regardless of the type of mental disorder that may coexist with drug or alcohol addiction, it is imperative that both issues are treated simultaneously. Suppose an individual who is using the prescription drug Xanax to self-medicate an anxiety disorder develops addiction. They seek treatment for the addiction and while they are in a treatment facility, they refrain from using the drug. They may feel safe while they are being cared for and eventually they are released. When they return to their everyday life, however, the anxiety they experienced before their drug use could return, causing them to engage in the same self-medicating behaviors they used prior to getting help. If they receive treatment for their anxiety issues while they are undergoing drug addiction treatment, they may be in a better position to avoid dangerous relapses.
Of course, in order to obtain treatment, a proper diagnosis is important. If you or someone you love is struggling with addiction, be sure to find a treatment program that specializes in identifying and treating Dual Diagnosis conditions through the use of a thorough assessment process as quickly as possible. If you have any concerns, please contact us today so we can help you get the care you need.
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