How Do I Know If I Have Dual Disorders?
“Dual diagnosis” and “dual disorders” are terms used to describe when a person has both a substance use disorder (SUD) and a mental health disorder like an anxiety disorder, clinical depression, post-traumatic stress disorder (PTSD), obsessive-compulsive disorder (OCD), bipolar disorder, etc.
SUD, more commonly known as drug or alcohol addiction, and other mental health disorders are often linked for a wide variety of potential reasons, and when someone develops one of these disorders, they are at much higher risk of developing the other. In fact, according to the National Institute on Drug Abuse (NIDA), over 7.7 million adults in America have co-occurring mental and substance use disorders, which translates to 37.9% of those with an SUD also having a mental illness.
Addiction and co-occurring disorders are often underdiagnosed, and failure to provide treatment for both aspects of a client’s overall condition makes recovery more difficult. This is why it is important for people to understand the basics of what a dual diagnosis is and have the knowledge to identify these issues in their own life and reach out and get help if they believe they may be affected.
Signs You May Have A Dual Diagnosis
There are a number of signs and symptoms that may suggest that you or someone in your life is experiencing both a particular mental health disorder and/or substance use disorder. However, only a medical professional has the training and expertise to properly diagnose these conditions and to develop an effective treatment plan.
If you suspect you may have some form of mental illness, a substance use disorder, or other difficult emotional, mental, or behavioral symptoms, please reach out to a healthcare professional you trust as soon as possible.
Potential warning signs that you are experiencing dual disorders include the following.
You Have A More Severe Form Of Substance Use Disorder
SUDs come in mild, moderate, and severe forms depending on the specific symptoms a person experiences.
These symptoms are summarized below from 11 criteria set forth in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5):
- using more of a substance than you meant to or using it for longer than you meant to
- trying to cut down or stop using a substance but not being able to
- experiencing intense cravings or urges to use a substance
- needing more of the substance to get the desired effect (drug tolerance)
- developing withdrawal symptoms when you do not use the substance
- spending more time getting, using, and recovering from a substance
- neglecting responsibilities at home, work, or school because of substance use
- continuing to use a substance even when it causes relationship problems
- giving up important or desirable social and recreational activities due to substance use
- using substances in risky settings or ways
- continuing to use despite the substance causing problems with your physical and mental health
According to the DSM-5, people who have just one symptom from this list are at risk of developing an SUD, those who experience two or three have a mild SUD, those with four or five have a moderate SUD, and those with six or more can be considered to have a severe SUD, i.e., full-blown addiction.
While people with mild, moderate, or severe SUDs may or may not have co-occurring disorders, depending on their unique situation, people with more severe forms of SUD are more likely to face significant psychological factors that greatly increase their risk of developing a serious mental illness or experiencing other mental instability.
You Have Experienced Past Trauma
Part of the strong connection between SUDs and mental illness relates to common risk factors including exposure to trauma, and childhood trauma in particular.
These experiences, often indicated by adverse childhood experiences (ACEs), are known to have a profound long-term impact on a person’s physical and mental health and overall well-being.
Examples include:
- violence
- abuse
- neglect
- discrimination
- loss of a caregiver or loved one
- attempted or completed suicide of a family member
- caregiver substance use
- family member with serious mental illness
- incarceration of a family member
- financial instability / lack of food or other essentials
These situations may have occurred as a single event, a series of events, or as a long-term situation that a child was exposed to. While ACEs are common, with about 64% of American adults reporting having experienced at least one, according to the Centers for Disease Control and Prevention (CDC), those who experience severe ACEs are known to experience significant long-term mental, emotional, and behavioral issues including increased rates of serious mental illnesses, substance abuse, domestic violence, criminal activity, and incarceration.
Fortunately, treatment is available to help people of any age address past trauma and build positive coping strategies to manage its echoes.
You Use Drugs Or Alcohol To Avoid Other Negative Feelings
Many people develop an unhealthy relationship with drugs or alcohol after experimenting and associating these substances with their pleasurable effects, or “getting high.”
Similarly, people may use substances to avoid experiencing negative thoughts and emotions, including those that may be produced due to an untreated mental health disorder and the distressing symptoms it is causing in a person’s life and relationships. This is known as self-medication, and it is a very strong potential warning sign suggesting that one’s substance use is a symptom of another issue.
If you find yourself dealing with intense mood swings or getting high or drunk to avoid feelings of anger, emptiness, frustration, inadequacy, fear, guilt, sadness, resentment, or confusion, treatment may be able to help you deal with these feelings directly, without a harmful and habit-forming reliance on drugs or alcohol to get by.
You Have A Family History Of Both Substance Abuse And Mental Illness
A large part of every person’s susceptibility to mental and behavioral disorders involves genetics. In fact, genetic factors are thought to amount to between 40% and 60% of a person’s risk for developing both substance use disorders and serious mental illnesses.
If you come from a family that has a long history with different forms of drug abuse/alcohol abuse and mental instability on one or both sides, there is a much greater risk that you may also experience these issues yourself.
Fortunately, genetics don’t have the final say in what your life experience turns out to be. By taking proactive steps as soon as possible, you can deal with any issues that exist while also developing strategies to avoid further problems you may be predisposed toward in the future.
You’ve Received Treatment In The Past, Unsuccessfully
If you’ve begun a treatment program in the past but didn’t complete it, or if you completed treatment but relapsed, this may suggest that you have some form of co-occurring disorder that requires additional treatment and support.
Oftentimes, even mild untreated mental health conditions can create ripple effects that impact every area of a person’s life, making it difficult to achieve long-term recovery from a drug or alcohol use disorder. Examples include:
- anxiety disorders including panic disorder (panic attacks), phobias, social anxiety disorder, and others
- mood disorders, including bipolar disorder, major depression, persistent depressive disorder, and others
- attention-deficit/hyperactivity disorder (ADHD), which can impact concentration, focus, organization, and overall mental clarity in both adults and children
- post-traumatic stress disorder (PTSD), producing intrusive memories, emotional distress, and avoidance behavior following some form of traumatic event
- personality disorders, in which a person’s view of themselves and the world around them develops abnormally, leading to strange patterns of thinking and behavior
- schizophrenia, a psychotic disorder involving periods of delusions, hallucinations, disorganized speech, and more
- schizoaffective disorder, which blends the symptoms of schizophrenia with those of a mood disorder
- self-harm, eating disorders (anorexia nervosa, bulimia nervosa, binge eating), and suicidal ideation
If left unmanaged, these conditions have the potential to derail a person’s recovery from drug or alcohol addiction. However, through dual diagnosis treatment, many people with addiction and co-occurring disorders go on to celebrate successful and long-lasting recoveries.
Treatment For Addiction And Co-Occurring Disorders
Co-occurring substance use and mental health disorders are as unique as the people who experience them. It is imperative that dual diagnosis treatment programs provide individualized care and support for each and every person they serve.
Dual diagnosis care can be provided in a variety of different healthcare environments, including inpatient treatment centers/stabilization programs, residential treatment programs, and outpatient treatment programs. In each case, trained healthcare providers will work closely with clients to understand what they are going through before developing a personalized treatment plan to address both issues simultaneously.
This allows the client to work toward a greater degree of stability both during the treatment program and long after. Treatment usually includes a combination of both medication and therapy, as well long-term aftercare coordination to ensure that the client can go forth with the care and support they need to continue managing their condition long-term.
Seek Dual Diagnosis Care At Ark Behavioral Health
Getting the right care to deal with addiction and co-occurring disorders may have a lifelong impact. If you or someone close to you may be struggling with a substance abuse problem, a mental illness, or both conditions simultaneously, consider reaching out to Ark Behavioral Health.
Working in private, scenic treatment settings, our compassionate and experienced staff have the training, experience, and resources to help steer you onto the road of recovery. To learn more about your options, please reach out to us today.
Written by Ark Behavioral Health Editorial Team
©2024 Ark National Holdings, LLC. | All Rights Reserved.
This page does not provide medical advice.
Columbia University - Substance Use Disorder and Mental Illness Often Go Hand in Hand. Both Must Be Addressed
Johns Hopkins Medicine - Recognizing and Coping with Negative Emotions
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