Dual Diagnosis

Dual Diagnosis Treatment

Dual Diagnosis treatment is a relatively novel innovation in the field of addiction recovery.  Until the early 1990’s, people who were exhibiting symptoms of a mental health disorder were treated separately from those who sought help for substance abuse.  When these conditions overlapped, clients were frequently denied treatment for their mental illness until they could demonstrate abstinence from all substances.  For instance, a depressed person with active alcoholism might not be able to receive therapy for depression until she had successfully completed detox and rehab.

In recent years, as the inextricable link between mental disorders and substance use became more apparent, practitioners began to internalize the necessity of treating both illnesses simultaneously.  This type of treatment became known as dual diagnosis treatment, in which the comorbid disorders were treated concurrently in an effort to achieve full recovery.  This was vastly different from the sequential approach of years past, where Dual Diagnosis clients were excluded from one area of treatment until they were considered stable in the other.

Receiving a Dual Diagnosis

To receive a Dual Diagnosis, you must meet the criteria for a mental health disorder and a substance use disorder as defined by The Diagnostic and Statistical Manual of Mental Disorders.  Here at Column Health, we often see the dual diagnosis of addiction coupled with other mental disorders such as depression and anxiety.  Receiving a dual diagnosis can be unnerving, but like all diagnoses, it is simply a tool that your treatment team will utilize in order to craft the most appropriate treatment plan in order to ensure full recovery.  It is also important to understand that you are not alone should you receive a dual diagnosis.  NAMI (National Alliance on Mental Illness) estimates that 1 in 6 adults have some for of mental illness, and NIDA (National Institute on Drug Abuse) estimates that approximately 10% of the American population had used illicit substances in the previous month.

Treatment Options

There is strong evidence to support that with help, people with a dual diagnosis can stabilize and recover.  A large portion of treatment for dual diagnosis is rooted in behavioral interventions.

Types of behavioral therapy commonly used in dual diagnosis treatment include:

• Dialectic behavioral therapy, which has the goal of reducing self-harming behaviors that often accompany mental health conditions and substance use disorders.
• Integrated group therapy, which seeks to treat the symptoms of both substance use disorders and mental health illnesses all at once.
• Cognitive behavioral therapy, which works to minimize problematic beliefs and behaviors and develop healthier thinking and behavioral patterns to sustain sobriety.
• Individual psychotherapy, which treats behaviors related to substance abuse and/or particular behavioral or mental health problems.

Dual diagnosis treatment programs sometimes utilize behavioral therapies in combination with medication. Medicines will vary according to the individual and the diagnosis. Some of the more commonly used medications include lithium and anticonvulsants, which are often prescribed as mood stabilizers, selective serotonin reuptake inhibitors (SSRIs) and other antidepressants and anti-anxiety drugs.  At Column Health we offer a comprehensive psychopharmacology evaluation to determine if medication in conjunction with behavioral therapy would be the appropriate course of action.

Treatment Types

Inpatient Dual Diagnosis Treatment

Depending on the severity of the illness, a person with a dual diagnosis may require or benefit from inpatient care.  A common form of inpatient treatment is “residential” treatment, in which the participants live and receive treatment at the rehab center.  Co-occuring disorders are exceedingly complex, and often times individuals who receive a dual diagnosis initially require the intensity of an inpatient treatment facility in order to achieve some semblance of stability.

Participants in an inpatient dual diagnosis program:

• Receive regular education about mental health issues as well as substance abuse and addiction.
• Receive daily therapy.
• Have the opportunity to attend support groups every day.
• Are immersed in a community of people who are learning to live without drugs or alcohol.

Outpatient Dual Diagnosis Treatment

Outpatient treatment for dual diagnosis is more flexible than inpatient treatment.  Outpatient programs can vary in intensity and time commitment, and are often the next step that an individual might take after graduating from an inpatient program.  Participants in Outpatient programs may receive a variety of services, including

• Medication Management
• Involvement in peer support groups or 12-step programs.
• Individual and family therapy.
• Support in living independently.

Regardless of the treatment modality, successful recovery from a dual diagnosis is largely contingent on whether or not the two disorders are treated concurrently.  In selecting a treatment option, it is critical to seek out facilities like Column Health whose programs recognize the undeniable link between substance use and mental health disorders.   It is only through integrated treatment of the co-occuring disorders that one can hope to achieve full remission from the symptomology of these disorders.  If you or a loved one is struggling with addiction, please don’t hesitate to reach out to the professionals at Column Health to initiate treatment.