Dual Findings

There are cases where circumstances in an individual’s life can make their behaviors problematic that it greatly affects the life they live. There are instances where a certain drug addiction can be a resulting factor of a certain psychiatric disorder. An individual afflicted with an anxiety disorder could also become addicted to oxycontin, which can give anyone the feeling of relaxation. Make sense?

Dual diagnosis is a term which means the co-occurrence of an illness in the mind and problems with substance abused. Individuals who experience a dual diagnosis often face a wide range of psychosocial issues and may experience multiple interacting illnesses. With dual diagnosis, both illnesses may affect the person physically, psychologically, socially, and spiritually. Not only is the individual affected by two separate illnesses, both illnesses interact with one another. The illnesses may intensify each other and each disorder predisposes to relapse in the other disease. At times the symptoms can go beyond and even mask each other making diagnosis and treatment more difficult.

Several theories have been formulated to explain the relationship between psychiatric disorders and substance abuse problems. For one, the causality theory suggests that certain types of substance abuse can causally lead to mental illness. Upon studying the causes of schizophrenia, it has been found that cannabis usage could causally develop schizophrenia. Self-medication theory adds that individuals with severe mental illness misuse substances in order to ease a certain set of symptoms and counter the side-effects of antipsychotic medication. Certain studies demonstrate that nicotine could be useful for decreasing motor side-effects of antipsychotics. Similarly, the alleviation of dysphoria theory suggests that individuals with severe mental illness commonly feels bad about themselves and that this makes them vulnerable to using psychoactive substances to alleviate these feelings.

Dual diagnosis presents a major problem because most of the time it is only one of the two interacting illnesses is identified. Moreove, the patient tends to be in denial with one of the illnesses. A person diagnosed with a mental disorder may be in denial about the drinking or substance abuse. The other way around could happen. The clear substance abuse could hide the mental disorder. Therapists, psychiatrists, and professional counselors are having a hard time identifying both illnesses due to psychiatric symptoms may be masked by alcohol or drug use. In addition, alcohol or drug use, or withdrawal from alcohol or other drugs can mimic or give the manifestation of some psychiatric illnesses. Also, untreated chemical dependency could contribute to a reoccurrence of psychiatric symptoms, and untreated psychiatric illness could contribute to an alcohol or drug relapse.

According to one alcoholic, specifically in America, the problem is that society- including the medical community and criminal justice system- do not accept and treat alcoholism as a real illness. Moreover, it looks like that they do not understand how ineffective it is to treat one illness but not the other. The tendency is that doctors may prescribe antidepressants to their patients without screening them for substance abuse. The addict/alcoholic whose depression is not treated will keep on to self-medicate with drugs and alcohol. Those with depression whose substance abuse is not detected will get sicker because alcohol is a depressant and with every sip they are throwing gasoline on their simmering bipolar. Consequently, it is very hard for these people to find appropriate treatment. Most substance-abuse centers do not accept people with serious psychiatric disorders and many psychiatric centers do not have the expertise with substance abuse.

Treatment of the two disorders should be integrated, not separate, and should be a collaborative decision-making process between the treatment team and the patient.

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