Medically Reviewed by Dr. Mohammed Saeed, MD.
Dual diagnosis. Sounds a bit ominous, doesn’t it?
It’s not as scary as it sounds. In fact, dual diagnosis is common and simply a medical way of saying you’re experiencing something like depression, anxiety, or PTSD in addition to drug or alcohol addiction. The National Alliance on Mental Illness reported approximately 9.2 million adults also experienced a dual diagnosis, sometimes called a co-occurring disorder, in 2018.
This doesn’t mean you should treat dual diagnosis lightly. While this combination of challenges is common, it’s still important to have a proper support team around you when fighting addiction and emotional/mental challenges in tandem. Treating one without the other isn’t effective. The medical professionals you choose must have expertise in both addiction recovery and mental health.
Treatment centers like Into Action Recovery, for instance, customize treatment programs so individuals have addiction recovery support, along with the medical and emotional support they need to heal from other conditions.
As is often the case, awareness is a good starting point. Chances are if you’ve been assessed and diagnosed recently, you’ve heard some daunting medical terms thrown around. Into Action will help clarify the medical jargon, so you get a better handle on your own recovery. Here’s a good place to start with a brief glossary of terms:
Assessment and Diagnosis
Any substance use disorder (addiction) diagnosis begins with an assessment. Regardless of whether you visit a treatment center or individual addiction recovery specialist, a proper assessment will include a series of health screenings, both mental and physical. Based upon these screenings, your provider will give you a diagnosis related to your substance use and maybe co-existing conditions like depression, anxiety, or PTSD.
DSM-5
The Diagnostic and Statistical Manual of Mental Disorders: Fifth Edition (DSM-5) is used by most mental health and addiction recovery professionals to diagnose addiction and related conditions. First, patients receive different screenings that provide the information needed to diagnose conditions in terms of the descriptions outlined in the DSM-5. For information on the DSM-5, visit the American Psychiatric Association, which offers further details and a history of the manual.
Addiction and Substance Use Disorder
The DSM-5 defines addiction as a complex brain disease marked by compulsive behaviors. An addictive disorder is severe when the intense focus and compulsion around a substance becomes the central focus of an individual’s life. Those with addictive disorders continue to use substances even when they’ve experienced negative consequences related to substance use.
The DSM-5 breaks down substance use disorders into four categories, including:
- Impaired control
- Social problems
- Risky use
- Drug effects
Each category requires a trained addiction recovery professional to evaluate and provide a formal diagnosis. This is not something to self-diagnose using an Internet screening. The assessment process can be complex, requiring a thorough examination of many different areas of an individual’s life.
For example:
- “impaired control” could mean you tried at different times to control the use of the substance in question but failed.
- “Social problems” could mean you came in late or missed work because of a hangover.
- “risky use” could mean putting yourself or someone else in harm’s way due to substance use, such as using substances when you’re in charge of watching children.
- “Drug effects” generally means any physical consequences to substance use. Maybe you find it takes more of the substance to give you the same feeling you had when you first started using/drinking. In this way, your body has developed a tolerance for the substance, an indication of a disorder.
Co-Occurring Conditions
Let’s say you’ve been given the diagnosis of substance use disorder. Welcome to a very large crowd!
If you have shown other symptoms of a mental health disorder, a good diagnostician will either screen you for dual diagnosis or refer you to someone else who can conduct that diagnosis.
For example:
- If you use substances in binges where you stay up for days at a time followed by a period of depression, a professional may recommend a screening for bipolar disorder.
- If you drink more during the gloomy days of winter, you may have mild seasonal depression in addition to a substance use disorder.
- Alternatively, if social anxiety leads to your substance use, you might be referred to a psychiatrist for an anxiety evaluation.
- If you started using substances immediately after a traumatic experience, a professional will likely recommend a PTSD screening.
Treatment and Beyond
Initially, most addiction treatment professionals will create a treatment plan to tackle substance use first, typically through detoxification. But treating other conditions like depression aren’t far behind.
Your treatment may include traditional addiction recovery along with psychotherapy. Or your doctor may prescribe an anti-depressant as a means of lifting depression during early sobriety.
Yes, dual diagnosis sounds ominous. It isn’t. The good news is you have an idea of what’s wrong and how to treat the problem.
Ask questions. If you feel confused or uncertain of the lingo used, ask. It’s okay to get more than one opinion. It’s okay to ask to see the DSM-5 for clarification on your diagnosis. Be your own advocate.
You are human, dual diagnosis is complex and participating in your recovery is key to healing.
