Dual diagnosis or a co-occurring disorder is when a drug addict or alcoholic simultaneously suffers from a mood disorder or other mental illness. The National Alliance on Mental Illness notes that according to a national survey conducted in 2014, 7.9 million people in the U.S. cope with a dual diagnosis. Many people who suffer from co-occurring disorders report self-medicating with alcohol and drugs in order to quiet the uncomfortable thoughts and feelings they’re experiencing. This self-medication leads to addiction and compulsive behavior, which further exacerbates any pre-existing mental health issues. Alcohol and drugs have negative interactions with most psych meds, creating additional dangerous physical and mental symptoms, which lead to the patient wanting to use more and more substances in order to self-medicate. This vicious cycle makes co-occurring disorders one of the most dangerous and hard to treat phenomena in addiction recovery.
The difficulty in dealing with a co-occurring disorder comes with trying to define and quantify exactly what is causing a particular symptom. Let’s say a patient is diagnosed with depression and suffers from alcoholism, and that patient experiences frequent anxiety attacks, is it a symptom of the depression or a side effect of alcohol withdrawal? It is extremely difficult for the sufferer because he will continuously medicate what they believe to be symptoms of their illness, but may be medicating symptoms of their drug addictions.
Common addictions are gambling, sex, shopping, and alcohol and drug dependency. While their counterparts are often bipolar disorder, depression, anxiety disorders, PTSD, ADHD, OCD and in rare cases, schizophrenia. While it may seem like a long journey to combat both problems at once, total abstinence is necessary for the treatment of the underlying disorder to become effective. Here are some steps you can take to get your dual-diagnosis under control:
Stop drinking and using drugs
The number 1 most important step in battling addiction and co-occurring disorders is to seek help from professionals and stop your current alcohol and drug abuse. Depending on your substance of choice, quitting “cold turkey” may be dangerous, may require hospitalization or a stay in a safe, medically operated detox facility. During the detox process, the physicians and medical personnel will set up an appointment with a mental health professional to diagnose and treat other disorders like bipolar, depression, and anxiety.
After detox and medication adjustment, many people suffering from co-occurring disorders spend time in a 30- 60- or 90-day inpatient rehab program to help you stay sober while you attain clarity. While this is the most difficult step in recovering from a dual diagnosis it is vital in order for you to get much needed treatment for your disorders.
Ongoing treatment, therapy, and recovery fellowships
Once past the crisis phase of detox, diagnosis, and early treatment, it’s important to engage in ongoing treatments for your co-occurring disorders and dual diagnosis. This may mean regular visits with a psychiatrist and/or therapist, as well as participation in a 12-step program or other recovery fellowship.
The conventional wisdom is that no one can get sober alone. Getting sober requires help from people who have recovered from their own addictions, and are actively treating their own co-occurring disorders. Explore the world of addiction recovery, and find a program that works for you. Use the tools of whatever program you choose to stay focused and on track.
Remember that feelings aren’t facts
In the haze of mood disorders and addiction, it can be very difficult to sort out our thoughts and feelings and recognize what’s real, and what is simply perceived. We often believe what our own negative thoughts, and those negative thoughts and feelings can be harmful and sometimes deadly. Realize that not everything that goes on in your head is real. It is often a symptom of depression that we have negative self talk, and often the antithesis of our real centered healthy selves. It is a cycle of telling yourself you are bad, so it won't matter if you pick up a drink or drug.
If your negative thoughts and feelings turn to suicidal ideations or thoughts of harming yourself, seek professional help immediately. Call 911, or the National Suicide Prevention Lifeline at 1-800-273-8255.
Find a professional specialist that you trust
To effectively treat co-occurring disorders, help from an experienced professional is crucial. Find an expert in the field of dual diagnosis, whether it’s a psychiatrist that specializes in addiction medicine, or a doctor that specializes in the medical treatment of alcohol and drug addiction with co-occurring disorders.
Take medication as prescribed by your doctor
Alcohol and drugs are not the same as medication prescribed by a licensed professional. Your APRN or doctor will be able to give you medication that will work over a period of time. You should continue to take medication as prescribed and discuss any changes with your doctor. You may find that a doctor will prescribe habit forming or controlled substances, even though you are in recovery. Talk to your doctor and express your concerns, get a second opinion if you need to, but ultimately, do what your doctor tells you to do. Take your meds AS PRESCRIBED, and do not mix them with any other chemicals which may cause interactions.
You may find certain people in recovery fellowships that look down upon people who use medication in sobriety. Forget those people. Don’t listen to anyone who makes you feel bad for taking medications that are prescribed to you by a responsible doctor. Your medications are none of their business.
By attacking the demons of addiction and mental illness simultaneously, we are sometimes able to experience miraculous change! We come from the depths of despair, stuck in an endless cycle of depression and self medication, never knowing when the pain will end and come out the other side realizing we needed help! Yes, we all need a little help sometimes and with the right support in recovery and in illness we can achieve a healthier way of life. I know this to be true because I lived through it.
In 1997 I was diagnosed with Bipolar depression and by the age of 13 began self medicating. I always thought I was just going crazy, I couldn't tell if alcohol was the solution to all my problems or the inevitable cause of my demise. It wasn't until 2014 when I began my recovery from alcohol and drug addiction did I seek real honest help from a therapist. I had crippling anxiety which has since been treated. I am able to live my life to the fullest without constantly searching for my next release. With help it is possible!
-- Emily Ash for Life Assurance Recovery, 2018