Dual diagnosis is a condition that involves the co-existence of a substance use disorder and a mental health disorder. Dual diagnosis is an envelope term used to describe a wide range of situations, including specific connections between conditions and broad relationships.
While co-occurring disorders can be treated at some drug rehabilitation clinics, there are often problems associated with correct diagnosis. Dual diagnosis can be a challenging condition to live with, with mental health problems and substance use disorders often interacting to make each diagnosis worse.
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People with mental illness largely use drugs and alcohol for the same reasons as other people: for recreational purposes. But another reason mentally ill patients use drugs is to self-medicate. The perceived benefits of drug use may provide temporary relief from the symptoms of mental illness, such as depression, anxiety or paranoia.
While the connections between mental health problems and substance abuse have been documented multiple times, causality theories are complex and unclear. When evaluating patients with co-occurring disorders, doctors will first try to differentiate between pre-existing conditions and substance-induced disorders, with the relationship between disorders an important part of both analysis and drug and alcohol treatment.
People with co-occurring disorders often have problems following through with treatment regimes. There are a range of institutional and systematic reasons why this is the case, with the existence of multiple disorders difficult to diagnose and treat at a single facility. For example, most mental health clinics are not designed to treat substance abuse disorders, so patients are unable to receive treatment for both of their conditions at the same time.
A similar situation exists for rehab centers, many of which are not set up to accommodate patients with a mental illness. In addition to this widespread institutional problem, society may also be intolerant of common behaviors associated with co-occurring disorders.
With more research being added every day, this is slowly beginning to change.
Treatment for co-occurring disorders depends on the individual and institution in question, with common examples including primary treatment, sequential treatment, parallel treatment, and integrated treatment. Primary treatment is perhaps the most widespread way to approach co-occurring disorders, with treatment centers evaluating patients and then treating what they consider to be the primary condition.
While this seems like a common sense way to approach co-occurring disorders, there is a danger than patients will not receive an adequate level of treatment for both conditions. Sequential treatment starts the same as primary treatment, with clinicians then treating the secondary disorder once the primary disorder has been evaluated and stabilized. This kind of treatment can be difficult to arrange, with separate facilities often needed to treat both conditions.
Parallel treatment is the third method of treatment, with patients receiving treatment for both conditions at the same time. There are a number of advantages to this approach, with doctors able to analyze the complex relationship between conditions and provide the appropriate level of support. Parallel treatment may take place at a single facility or across multiple facilities.
Integrated treatment is perhaps the most advanced way to approach co-occurring disorders, with therapists attempting to get to the bottom of both conditions through a coherent treatment package. Both disorders are considered primary with this kind of treatment, with a consistent philosophy and approach used to tackle the underlying cause of the co-occurring disorders.