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Dual Diagnosis: What Comes First, Mental Illness or Substance Abuse?

Turning Point

A common phenomenon is co-occurring drug addiction and mental illness, also called a dual diagnosis. Either of these can develop first, as a mentally ill individual may turn to drugs to self-medicate, or a drug addict may develop mental illness as a result of their drug addiction.

The compound problem of dual diagnosis is that it is difficult to address in a one-size-fits-all manner. The group of people who suffer from dual diagnosis is quite varied, not only because they have different drugs of choice, but because their mental illnesses require specific treatment, as well. Dual diagnosis patients suffer from a range of mental illnesses, from mood to personality disorders, and some even have more than one mental illness, to further complicate the problem.

How Drug Abuse and Mental Illness Coincide

The reason mentally ill individuals turn to drugs or alcohol is often to self-medicate from the symptoms they experience. Drugs and/or alcohol can provide a pleasant escape from the rigors of daily life, and it can even temporarily improve their mood. However, constantly picking up that next drink or seeking that next high taps out the “pleasure center” of the brain, and they can no longer produce dopamine (the neurotransmitter the brain releases that is associated with pleasure). Eventually, they simply feel numb, but cannot give up drugs or alcohol, because they have become physically and/or psychologically addicted.

The Journal of the American Medical Association reported alarming statistics about dual diagnoses:

  • Nearly 50% of those who have a serious mental illness are substance abusers.
  • 37% of alcoholics and 53% of drug addicts have at least one serious mental illness.
  • 29% of those who are diagnosed with a mental illness abuse alcohol or drugs.

On the flipside, drug abuse can increase the risk of developing a mental disorder. As a substance abuser becomes more secretive about their drug use, they can also begin to exhibit disturbing symptoms. Among them, they may feel like they need their drug of choice to be able to function, and they will engage in risky behavior as they chase the high.

Why Dual Diagnoses Require Drug Addiction & Mental Health Treatment

An integrated intervention is necessary to treat a patient with dual diagnosis. The notion that a person must control their drug abuse before they can be treated for a mental illness is outdated and dangerous to the mental and physical health of the individual with co-occurring mental illness and substance abuse. The key component of dual diagnosis treatment is to help the patient detoxify to get the drug out of their system. This does not mean the individual is clean and sober yet. They must also undergo intensive drug rehabilitation, have a supportive medical team to help them get well, and individual and group psychotherapy is also beneficial. Any dual diagnosis treatment plan must include a psychotherapy component (cognitive behavioral therapy is particularly useful) to help addicts learn how to cope with the symptoms of their mental illness and change their ineffective thought patterns.

It isn’t easy to overcome drug addiction for those who are also mentally ill, but it can be done. With the guidance of a dedicated, compassionate drug addiction treatment team, you, too, can get sober and start on a path to lasting wellness.

Contact us at Turning Point for help getting sober and mentally healthy by dialing (973) 380-0905 today.

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