A person with a dual diagnosis has been given two separate but interrelated diagnoses: a psychiatric diagnosis and a chemical dependency diagnosis, which might include both alcohol and drugs. The term is interchangeable with the terms co-morbidity, co-occurring illnesses, concurrent disorders, co-morbid disorders, co-occurring disorder, and dual disorder.
Dual diagnosis occurs when someone suffering a wide range of psychological issues, multiple inter-acting illnesses, and mental disorders simultaneously struggles with drug and alcohol dependency and abuse to the point that the illness and the addiction affect each other. Drug abuse usually correlates with mild to severe depression and anxiety in typical substance abusers. More advanced mental diagnoses, such as schizophrenia
and antisocial personality disorder
, may result in more erratic, compulsive and dangerous behaviors, with an equal degree of compulsive drug use to match them.
When mental disorders occur first, a person, especially with a predisposition to substance abuse, is likely to seek comfort in drugs and alcohol for temporary relief. When a drug or alcohol addiction occurs first, the progression of the disease of addiction may either activate latent mental disorders or alter the user's brain chemistry and emotional state to the point where a mental disorder is created.
A variety of problems exist for the dual diagnosed person. For example, psychiatric symptoms may be covered up or hidden by drug and alcohol use, making them harder to identify, diagnose, and treat. Additionally, alcohol and drug use, or the withdrawal from alcohol and drugs, can often simulate or give the appearance of psychiatric illness, such as paranoia, hallucinations, narcolepsy, or tremors. Furthermore, psychiatric symptoms may persist if chemical dependency goes untreated; likewise, untreated mental illnesses can contribute to further drug and alcohol abuse and relapse.
Other problems associated with untreated dual diagnoses include isolation and social withdrawal, problems at school and work, problems within the family or intimate relationships; problems with finances, risky and compulsive behavior (particularly while driving or operating machinery), legal problems and incarceration; declining health, multiple psychiatric assessments, and recurring drug abuse and relapse.
Risk factors may lead to both mental illness and chemical dependency, including social isolation, poverty, boredom; lack of structured daily activity, lack of adult accountability, living in areas with high drug availability, and association with drug users. Traumatic life events, such as near death experiences or sexual abuse, and the corresponding post traumatic stress disorders (PTSD
) may also be associated with the development of psychiatric problems concurrent with substance abuse.
Recovery from drug and alcohol abuse while simultaneously treating mental disorders is possible, but must be approached in a setting, such as a drug rehabilitation facility, where dual diagnoses are specifically addressed. Detoxification from drugs and alcohol, followed by abstinence from compulsive use, is a good place to start in treating drug addiction that coincides with mental disorders.
Rehabilitation, which may include in-patient residences at a drug treatment facility, medicines, support groups, and therapy can also help the person suffering both addiction and mental disorders to address both issues. A person is recovering from substance abuse and mental illness when they are actively following a treatment program that addresses their recovery needs for both their addiction and their psychiatric disorders.