DUAL DIAGNOSIS: ADDICTION AND MENTAL ILLNESS

A dual diagnosis is applied when a person is engaging in addictive behaviors of alcohol or drug abuse while at the same time exhibiting signs and symptoms of mental illness. The presence of mental health issues commonly occurs alongside substance abuse and dependence. An individual will “self-medicate” as a means of coping with feelings of depression or anxiety, or the effects of very serious disorders such as schizophrenia, bi-polar or other debilitating conditions.

We will first assess a person who is both substance-dependent while also showing signs of a mood or thought disorder. We will create a treatment plan and where appropriate, invite the spouse, partner, or family members of the individual to participate. Once a diagnosis is established, treatment begins with education regarding substance use and related mental health issues.

We work with the client to set realistic goals and to establish a positive healthy daily schedule which incorporates regular supportive follow up. We seek to help an individual gain insight into the issues being faced, and to adopt a sense of openness, honesty, and acceptance of the reality of challenges as they are undertaken.

When necessary we will address medication issues and work with the primary physician or psychiatrist to monitor a medication regime.

We work to help the individual start and maintain abstinence from substances and assist in identifying, confronting, and managing the triggers and warning signs that can lead to relapse.

We have provided simple screening tools to assess whether an adult or spouse may be showing signs of addiction and mental illness.

The National Co-Morbidity Survey (NCS) estimates that 9.9 million Americans, between the ages of 14 and 54, and living in households, have co-occurring substance abuse and mental health disorders. It is estimated this figure would rise if the survey included the homeless and those housed in institutions (Kessler 1994).

It is important to note “red flags” such as threatened suicide with persons who are dully diagnosed and to call the Access and Crisis line if any sign of impending self-harm is observed.

The following are what we term “red flags” that identify that a person is in crisis:

– Suicidal – presence of plan or means, history of past attempts
– Recent loss
– Severe stressors
– Deepening depression
– Lack of social support
– Traits such as impulsivity, rigidity, or becoming isolated
– Poor health or hygiene
– Recent change in depressed symptoms, improvement or deterioration
– Abrupt behavioral change
– Preoccupation with putting affairs in order
– Relapse to alcohol or drug use
– Sleep disturbance
– Feelings of helplessness or hopelessness
– Presence of delusions or hallucinations
– Intelligence – loss of normal verbal skills
– Thought content – bizarre or irrational thoughts
– Non-linear thinking
– Loss of sensory awareness or alert level of consciousness
– Loss of orientation and ability to maintain concentration