Addiction and mental health disorder often co-occur, and when this happens, it’s known as a dual diagnosis or co-occurring disorder treatment. Dual diagnosis is very common, and it requires specialized treatment that addresses both the addiction and the mental health disorder at the same time. Here’s what you should know about dual diagnosis, including how it develops and how it’s diagnosed and treated.
Dual Diagnosis: Mental Health Disorder Defined
Mental health disorder causes changes in mood, emotion, thinking, or behavior—or a combination of these. Mental health disorder can interfere with healthy social functioning, and it can cause problems in relationships and elsewhere. It reduces feelings of wellness and can even lead to physical illnesses.
Around 20 percent of Americans have a mental health disorder, according to the American Psychiatric Association1 . Anxiety and depression are the most common mental disorder. Anxiety disorders like social anxiety or panic disorder affect nearly 40 million American adults, and another 15 million are suffering from major depression at any given time.
Mental health disorder is treatable, but many people resist treatment due to the persistent stigma of mental health disorder. The best way to treat mental health disorder is through a combination of medication and counseling.
Dual Diagnosis: Substance Use Disorders Defined
Substance abuse, addiction, and dependence are diagnosed under the umbrella of a “substance use disorder,” or SUD. These terms are still commonly used, often interchangeably, but substance abuse, addiction, and dependence are not the same things.
Substance abuse is the use of drugs or alcohol in a problematic way. Drug and alcohol abuse can cause problems related to your relationships, health, finances, or the law, and substance abuse often leads to high-risk situations. Binge drinking is the most common form of substance abuse and occurs when you drink enough alcohol over the course of two hours to bring your blood alcohol content up to .08 percent. One in six Americans binge-drink around once a week, according to the Centers for Disease Control.
Substance abuse is not addiction, although it can lead to addiction, which is characterized by compulsive drug or alcohol abuse despite the negative consequences it causes. People who are addicted will continue to abuse drugs or alcohol even though it’s causing serious problems in their life. They may want or try to quit but find that they can’t.
Addiction is the result of changes in the brain’s structures and chemical functions related to reward, memory, learning, and motivation. Brain regions begin to communicate in a way that leads the brain to equate liking drugs or alcohol with wanting them, and the result is intense cravings and compulsive drug-seeking behaviors. Addiction leads to dysfunctional thought and behavior patterns that further perpetuate the addiction and cause even more problems.
Dependence is a physical reliance on drugs or alcohol. It’s characterized by withdrawal symptoms that occur when you quit using. Dependence develops as the brain attempts to adjust its chemical function to compensate for the presence of drugs or alcohol. This leads to tolerance, which means you need increasingly larger doses of drugs or alcohol to get the same effects a smaller dose once produced. However, the more you use, the more the brain changes as it tries to maintain normal function.
At some point, brain function may shift so that the brain now operates more comfortably when the substance is present. Then, when you suddenly stop using, the normal chemical function of the brain rebounds, and this swift shift in neurotransmitter activity causes physical withdrawal symptoms, which can be excruciating.