(Part 1) Shedding Light on Dual Diagnosis: Compassion.
A Personal Story of Dual Diagnosis
Meet John. John is a 35-year-old veteran who served in Iraq for two tours. He witnessed horrific scenes of violence and death, and lost some of his closest friends in combat. When he returned home, he suffered from nightmares, flashbacks, and guilt. He felt detached from his family and friends, and had trouble adjusting to civilian life. He started drinking heavily to cope with his pain and numb his emotions. He soon developed an alcohol use disorder, which worsened his PTSD symptoms. He felt hopeless and suicidal.
John is one of the millions of people who struggle with dual diagnosis, a term that refers to the co-occurrence of a mental health disorder and a substance use disorder.
What is Dual Diagnosis?
According to the Substance Abuse and Mental Health Services Administration (SAMHSA), about 9.5 million adults in the U.S. had both a mental illness and a substance use disorder in 2019. This means that nearly one in four people with a mental illness also has a substance use disorder, and vice versa.
Why is Dual Diagnosis so Common?
There are several possible explanations. One is that some people may use drugs or alcohol to cope with the symptoms of their mental illness, such as depression, anxiety, or trauma. This is known as self-medication, and it can provide temporary relief but also worsen the underlying condition over time. Another explanation is that some substances can trigger or exacerbate mental health problems, especially if used excessively or during adolescence, when the brain is still developing. For example, marijuana can increase the risk of psychosis, and alcohol can increase the risk of depression. A third explanation is that some people may have a genetic or biological vulnerability to both mental illness and substance use disorder, or they may share some common risk factors, such as stress, trauma, or poverty.
What are the Challenges of Dual Diagnosis?
Regardless of the cause, dual diagnosis can pose significant challenges for both individuals and treatment providers. People with dual diagnosis often experience more severe and chronic symptoms, more functional impairment, and more medical complications than those with either condition alone. They also face higher rates of homelessness, incarceration, suicide, and violence. Moreover, they may encounter barriers to accessing appropriate and integrated care, such as stigma, discrimination, lack of coordination, or lack of resources.
What are the Treatment Options for Dual Diagnosis?
Therefore, it is crucial to raise awareness and understanding of dual diagnosis among both professionals and the public. People with dual diagnosis need comprehensive and holistic treatment that addresses both their mental health and substance use needs in a coordinated and compassionate manner. They also need support from their families, friends, communities, and peers who can offer them hope, encouragement, and acceptance.
Fortunately, John sought help from a dual diagnosis treatment center that offered integrated treatment for his alcohol use disorder and PTSD. He received medication to help him manage his withdrawal symptoms and stabilize his mood. He also participated in cognitive-behavioral therapy (CBT), which helped him identify and challenge his negative thoughts and beliefs, and develop coping skills to deal with his trauma and triggers. He also joined a support group for veterans with dual diagnosis, where he found peer support and encouragement from others who understood his situation.
If you or someone you love has a dual diagnosis, you are not alone. There are many treatment options and resources available to help you overcome your challenges and achieve recovery. You can start by contacting your primary care provider, a mental health professional, or a substance use disorder treatment program. You can also call the SAMHSA National Helpline at 1-800-662-HELP (4357) or visit their website at https://www.samhsa.gov/find-help for more information and referrals.
What are some Tips for Recovery from Dual Diagnosis?
Recovery from dual diagnosis is possible. With proper treatment and support, you can overcome your mental health and substance use problems and live a fulfilling and productive life. Here are some tips to help you on your journey:
● Seek professional help as soon as possible. The sooner you get treatment, the better your chances of recovery.
● Follow your treatment plan and stick to your medication regimen. Be honest with your providers about your symptoms and progress.
● Avoid substances that can worsen your mental health or interfere with your medication. This includes alcohol, drugs, nicotine, caffeine, and some over-the-counter or herbal remedies.
● Engage in healthy activities that can boost your mood and well-being. This includes exercise, meditation, hobbies, volunteering, or spending time with supportive people.
● Join a support group or a recovery community that can offer you peer support and guidance. You can find online or in-person groups through SAMHSA's website or other organizations such as Alcoholics Anonymous (AA), Narcotics Anonymous (NA), Dual Recovery Anonymous (DRA), or NAMI (National Alliance on Mental Illness).
● Be patient and compassionate with yourself. Recovery is a process that takes time and effort. You may face setbacks or challenges along the way, but don't give up. Celebrate your achievements and learn from your mistakes.
What are some Success Stories of Dual Diagnosis?
Here are some stories of people who have recovered from dual diagnosis:
● Lisa was diagnosed with bipolar disorder and cocaine addiction when she was 19 years old. She struggled with mood swings, impulsivity, paranoia, and suicidal thoughts. She used cocaine to feel energized and euphoric, but it also made her manic and psychotic. She dropped out of college, lost her job, and alienated her family and friends. She tried several treatment programs but relapsed repeatedly.
● After hitting rock bottom, she decided to give recovery another chance. She enrolled in an intensive outpatient program that offered integrated treatment for her dual diagnosis. She received medication to stabilize her mood and prevent relapse. She also attended individual and group therapy sessions, where she learned about her conditions, developed coping skills, and addressed her underlying issues. She also joined a DRA group, where she found peer support and accountability.
● Today, Lisa is 25 years old and has been sober and stable for three years. She has resumed her studies, works part-time as a peer counselor, and has reconnected with her family and friends. She says that recovery has given her a new purpose and direction in life.
● James was diagnosed with major depression and heroin addiction when he was 23 years old. He suffered from low self-esteem, hopelessness, and chronic pain. He started using heroin to escape his misery and dull his pain. He became addicted and dependent on the drug, which consumed his life. He lost his job, his girlfriend, and his home. He overdosed several times and nearly died.
● After his last overdose, he was admitted to a hospital, where he was referred to a dual diagnosis treatment center. He received medication-assisted treatment (MAT) to help him detox from heroin and reduce his cravings. He also received antidepressants to treat his depression. He participated in dialectical behavior therapy (DBT), which helped him regulate his emotions, tolerate distress, and improve his relationships. He also joined an NA group, where he found fellowship and inspiration.
● Today, James is 27 years old and has been clean and happy for two years. He has a stable job, a loving girlfriend, and a comfortable apartment. He says that recovery has given him a new lease on life.
According to SAMHSA, people who receive integrated treatment for dual diagnosis have better outcomes than those who receive separate or sequential treatment. Integrated treatment can help reduce substance use, improve mental health symptoms, increase social functioning, decrease hospitalization rates, and enhance quality of life.
By shedding light on dual diagnosis, we can help reduce the suffering and improve the quality of life of millions of people who struggle with these complex and interrelated conditions.
