Dual diagnosis means someone is living with a mental health disorder and a substance use disorder at the same time. There are a wide array of possible interactions between mental illness and addiction, with some disorders affecting others in a linear fashion and others creating bi-directional links.
Dual diagnosis treatment addresses scenarios such as depression and alcoholism, panic disorder and prescription drug abuse, psychosis and methamphetamine abuse, and anxiety disorders and benzodiazepine dependence. Dual diagnosis conditions range from broad links through to specific causal relationships, with controversy surrounding the use of this single term to define a large and heterogeneous group of individuals.
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The terms "dual diagnosis" and "co-occurring disorders" are often used interchangeably, despite a fundamental difference between these two classifications. According to the Association for Addiction Professionals (NAADAC), the primary disorder has to be related to substance abuse for someone to be diagnosed with co-occurring disorders. The same restriction does not apply for dual diagnosis, where the primary condition can be related to either substance use or mental health.
Before treating people with co-existing conditions, doctors and clinicians will attempt to differentiate between mental disorders induced by psychoactive substances and those that existed prior to substance abuse. A primary disorder is often defined by making this distinction, with common dual diagnosis treatment plans including primary treatment, sequential treatment, parallel treatment and integrated treatment.
Obsessive Compulsive Disorder (OCD) and Addiction
OCD is a serious mental disorder involving the experience of irrational fears and anxiety. People living with OCD often engage in repeated and compulsive rituals, with the performance of these rituals providing temporary relief from their condition. OCD has been associated with a range of substance use disorders, with the Journal of Anxiety Disorders estimating that 25 percent of people seeking treatment for OCD are also living with substance abuse and addiction.
OCD is an anxiety disorder, with the Anxiety and Depression Association of America (ADAA) estimating that 20 percent of people with an anxiety disorder also have a substance use disorder. Professional treatment is often required to address people with OCD and addiction issues, with medication sometimes applied along with behavioral therapy and relapse prevention measures.
Anxiety Disorders and Benzodiazepine Abuse
Benzodiazepines are a type of central nervous system (CNS) depressant commonly prescribed for anxiety and sleep disorders. Benzodiazepines include Valium, Serax, Xanax and many more, with these drugs often taken for a long period of time. While the short-term use of benzodiazepine drugs is generally believed to be safe, long-term use is controversial due to the possibility of developing tolerance and dependence.
Benzodiazepine addiction can creep up on people over time, with detox and psychotherapy often required to help break the bonds of addiction. Benzodiazepine dependence can be noted by the continued use of drugs despite negative consequences, with dependent people neglecting responsibilities because of drug use and finding it impossible to stay sober.
A range of psychotherapy options are available for people with a dual diagnosis, with common dual diagnosis treatment models including cognitive behavioral therapy, motivational incentives, motivational interviewing, family therapy, 12-step facilitation, client-centered counseling and many more.
Most psychotherapy programs are based on either cognitive, behavioral or motivational principles, with many programs combining methods in order to provide comprehensive treatment. Relapse prevention techniques and programs also play an important role during dual diagnosis treatment, both during residential regimes and in an aftercare environment.