Rehabilitation for Mental Illness and Substance Abuse

The concept of Dual Diagnosis treatment is a relatively new idea in the field of drug and alcohol rehabilitation. Dual Diagnosis occurs when an individual simultaneously has an addiction and a mental illness.

In the past, people dealing with both a mental illness and substance abuse faced a frustrating conundrum when seeking treatment. On one hand, psychiatrists would say they could not provide treatment until an individual was clean and sober. On the other hand, drug and alcohol rehab providers would say they could not help until their mental illness was totally stabilized. Now it is understood it is completely ineffective to treat these problems separately, and concurrent treatment in the form of Dual Diagnosis rehabilitation has the best hope for a sustained sobriety.

Challenges for Dual Diagnosis Rehabilitation of Mental Illness and Substance Abuse

The staff of a Dual Diagnosis rehabilitation center face many difficulties that staff at a standard treatment program does not due to the compounding issues of multiple diagnoses. With numerous issues clouding the mind and a plethora of potential behavioral symptoms, it is no wonder that individuals with a Dual Diagnosis have the following additional concerns:

  • Patients are at an increased danger of suicide
  • Self-medicating is a big issue with mental illness and can undermine addiction rehab attempts
  • The symptoms of substance abuse and mental illness overlap, creating problems in rehab
  • Violent outbursts are more common in Dual Diagnosis individuals
  • Their touch with reality is shaky, inhibiting the honesty they need to overcome addiction
  • Medicating the mental illness may be problematic due to tendency towards addiction

Facts About Dual Diagnosis Rehab

Here are facts about individuals with a Dual Diagnosis and the most effective aspects of rehabilitation:

  • Mental illness creates a greater vulnerability for developing a substance abuse problem
  • Standard drug treatment centers are not equipped to help someone with a Dual Diagnosis
  • Psychiatric professional are essential for effective Dual Diagnosis treatment
  • Dual Diagnosis treatment usually takes longer than standard rehab
  • Quality Dual Diagnosis rehab will go at a speed that is comfortable for the patient
  • The most effective Dual Diagnosis rehab is integrated all under the same roof

Mental Illnesses that Coexist with Substance Abuse

Bipolar Disorder and Drug Addiction+

Recent studies have estimated that as many as 60 percent of people with bipolar disorder struggle with at least one type of substance abuse issue during their lifetime. This number is so alarmingly high because of the tendency for those diagnosed with bipolar disorder to attempt to self-medicate by abusing legal substances and/or illegal narcotics.

In addition to the drive to self-medicate, another reason large numbers of bipolar individuals turn to drug addiction is because of the extreme emotional highs and lows of the disorder. Those in the high of a manic phase may believe they can do or try anything without any negative consequences due to a feeling of invincibility. The indestructible mindset that comes with mania can easily lead to experimentation with addictive drugs. Once someone with bipolar disorder tries a certain substance in a manic phase, they are more likely to try it again in the future, leaving them vulnerable to developing a drug addiction.

Reasons Bipolar Individuals Self-Medicate with Drugs

When someone with a disease tries to relieve their symptoms using either more medication than prescribed by their doctor or abusing alcohol or drugs, this is known as self-medicating. People struggling with bipolar disorder may be driven to self-medicate for some of the following rationales:

  • Relieve symptoms of mania or depression while in an acute episode
  • Feel they can’t afford the medications prescribed by their doctor
  • Frustrated with the periodic prescription adjustments that are often necessary with bipolar medication

Dangers of Self-Medicating Bipolar Disorder with Drugs

Self-medicating bipolar disorder feels good at first, to help even out the intensely positive and negative moods associated with the disorder. However, as this behavior continues, there are many harmful consequences with some potentially lethal effects, such as:

  • Not seeking proper medical diagnosis and treatment
  • Unmonitored manic and/or depressive phases can be lethal due to risky behavior during these periods
  • Alcohol or drug addiction
  • Wild spending sprees that can cause bankruptcy
  • Erratic behavior that can cause loss of job, spouse and friends, and cause permanent damage to one’s relationship with their children
  • Increases the already extremely high suicide rate for people with bipolar disorder

Dual Diagnosis Rehab Is the Best Option to Treat a Combination of Bipolar Disorder and Drug Addiction

Dual Diagnosis rehabs are equipped to treat both mental illness, such as bipolar disorder, and drug addiction simultaneously. If the needs of both an individual’s bipolar disorder and substance abuse are not addressed during rehab, they will almost assuredly be headed for relapse in the near future.

Dual Diagnosis rehabs are staffed with psychiatry staff members that standard treatment programs generally do not provide. This additional help from professionals experienced in the treatment and medication of individuals with bipolar disorder is indispensable to the chance of a long-term recovery.

Dissociative Disorders and Drug Abuse+

Many people in the general public may not be familiar with the term dissociative disorder. This is a relatively new label that describes periodic interruptions in an individual’s typical psychological functioning. This can come in the form of personality changes or the blocking of memories from the past. Dissociative Identity Disorder (DID) is the most well-known of this group of mental illnesses and is what used to be known as multiple personality disorder.

Dissociative disorders develop in some individuals as their brain’s way of managing events that are too difficult to emotionally handle while they are happening or as a method of side-stepping painful past memories. Dissociative disorders can occur as a consequence of trauma, abuse or from damage caused by drug addiction.

A limited amount of research has been completed analyzing the dual diagnosis of dissociative disorders and drug abuse. It does seem that dissociative disorders can develop as a result of drug addiction for about 30 percent of cases whereas for the other nearly 70 percent, dissociative experiences occurred before the drug abuse started. Studies have found estimates ranging from 15 to 39 percent of individuals in drug rehab have at least one type of dissociative disorder, and individuals with dissociative disorders tend to abuse multiple substances at a higher rate than the average population.

The Importance of Dual Diagnosis Rehab for Dissociative Disorders and Drug Abuse

During drug abuse rehab, an individual with a dissociative disorder may recover previously blocked memories from past traumatic experiences. Childhood emotional and physical abuses are some of the biggest predictive factors for developing a dissociative disorder. If these memories surface without the proper support then devastating consequences may occur.

People dissociate to protect themselves from overwhelmingly painful past memories. When these memories are recovered and the individual is no longer shielded from the pain, they can become suicidal. Dual Diagnosis rehab offers all the components someone with addiction compounded by mental illness needs to make a safe and successful recovery. Unlike standard treatment facilities, Dual Diagnosis rehab has a full time psychiatry team to support the treatment of mental disorders.

Vital Features of Dual Diagnosis Rehab for Dissociative Disorders and Drug Abuse

Dual Diagnosis treatment offers the following features:

  • Phases: Treatment is tackled in parts. Trust is developed between staff and patients in the beginning to support the progression of the majority of treatment.
  • Inspirational Treatment Options: Evidence-based interventions such as counseling, education and alternative therapies are provided to empower change in deeply discouraged individuals.
  • Holistic: Addresses all levels of an individual – mental, physical, emotional and spiritual.
  • Social Support: Developing trustworthy relationships with others can help buffer someone in recovery from future relapse.
  • Recovery Stance: Teaches patients that a sustained sobriety is a long-term, day-to-day commitment.

Personality Disorders and Addiction+

Current statistics in the United States today estimate that as many as 60 percent of individuals with an addiction to drugs or alcohol have at least one of the personality disorders. A diagnosis of personality disorder predisposes an individual to struggling with addiction sometime during their life. In addition, it is believed almost a quarter of people in our society have a personality disorder.

There are currently 10 recognized branches of personality disorder and each causes severe impairments in social function. People with a personality disorder often have major issues managing daily stresses and more often than not have extremely stormy relationships in their life.

The different personality disorders are placed into three distinct groups and their symptoms are as follows:

  • Cluster A
    • Schizoid Personality Disorder: An emotionally withdrawn, isolated and cold personality
    • Schizotypal Personality Disorder: A withdrawn person who displays odd speech and behavior
    • Paranoid Personality Disorder: Exhibits extreme distrust and jealousy of others without cause
  • Cluster B
    • Antisocial Personality Disorder: Dishonest, aggressive and has difficulty following societal laws
    • Borderline Personality Disorder: Poor self-image, fear of abandonment and little impulse control
    • Narcissistic Personality Disorder: Displays an exaggerated sense of self-importance
    • Histrionic Personality Disorder:. Seeks attention and exhibits dramatic behavior for little reason
  • Cluster C
    • Avoidant Personality Disorder: Hypersensitive to criticism and feels they can’t fit in anywhere
    • Obsessive Personality Disorder: Behavior that is consumed with perfectionism and control
    • Dependent Personality Disorder: Low self-esteem with a strong need to be taken care of by others

Why Personality Disorders Have a Dual Diagnosis with Addiction

Personality disorders cause effects that impair the quality and functioning in all arenas of life including:

  • Trouble making and/or maintaining friendships
  • Low self-esteem
  • Issues in family relationships
  • Explosions of anger; inadequate impulse control
  • Distrust of others
  • Drama in interpersonal exchanges
  • Problems in career/school
  • Difficulties in social situations
  • Frequent and extreme mood swings
  • Tendency towards addiction in all forms

These consequences of personality disorder lead to addiction because:

  • The addiction makes them feel more secure temporarily
  • Inability to control impulses drives addiction
  • Coping mechanism for unprocessed emotions

What Addictions Are Common in the Dual Diagnosis with Personality Disorders

Drug and alcohol abuse are not the only addictions individuals with personality disorders may develop. They are at risk for any type of addiction and in many cases multiple addictions may be occurring simultaneously. The addictions that are most commonly found with personality disorders are:

  • Drugs
  • Alcohol
  • Gambling
  • Food
  • Sex

Why Dual Diagnosis Treatment Is Necessary for Personality Disorders and Addiction

When someone is dealing with both a personality disorder and addiction, then Dual Diagnosis treatment is the best route to sobriety. In Dual Diagnosis rehab, both issues are treated together. If both problems are not addressed, the chances of a lasting recovery are extremely slim.

Schizophrenia and Alcoholism+

Over one-third of individuals with schizophrenia also meet the criteria for alcohol abuse. Other than nicotine, alcohol is the most commonly abused substance by people with schizophrenia. Unfortunately, people with a Dual Diagnosis such as this can easily fall through the cracks.

Up until recently, getting treatment for a Dual Diagnosis was like being caught between a rock and a hard place. The drug and alcohol rehab programs would say they could only admit patients whose mental illness was totally stabilized. While on the other hand, many psychiatrists would assert they could not facilitate recovery from mental illness if the patient had a drug or alcohol addiction; this meant countless individuals, if they were being honest, were not able to get treatment for their mental illness or substance abuse problem because they were suffering from both. In essence, the people who needed the most help were denied any assistance at all.

Factors Contributing to the Dual Diagnosis of Schizophrenia and Alcoholism

High rates of alcoholism among schizophrenics are in large part due to the facts that it’s legal, socially acceptable and readily available just about everywhere. In addition, people with schizophrenia abuse alcohol oftentimes for the same reasons as the general population (reduce stress, poor self-image, loneliness, depression, etc).

However, there are a variety of additional reasons specific to schizophrenia that can be a factor in the development of alcoholism including:

  • Self-Medication. Drinking helps temporarily alleviate schizophrenic symptoms, reinforcing the desire to drink again.
  • Changes in Brain Chemistry. Schizophrenics have less availability of the neurotransmitter dopamine and alcohol affects these pathways.
  • Weak Impulse Control. Easily gives in to the desire to drink.
  • Poor Social Judgment. Creates relationships that do not support a healthy and sober life.
  • Development of Identity. Personal identity becomes wrapped up in drinking.
  • Maintain Social Network. Drinking is the only thing in common with friends.
  • Boredom. Often due to limited social and career opportunities.

Phases of Dual Diagnosis Treatment for Schizophrenia and Alcoholism

For individuals with a mental illness, such as schizophrenia, and alcoholism, a multidisciplinary treatment approach is critical. Frequently these individuals have been disheartened from past failed attempts at sobriety and need extra encouragement just to begin therapy. Dual Diagnosis treatment for schizophrenia and alcoholism generally involves the following phases:

  • Phase I-Engagement. This beginning step entails the therapy team gaining the trust of the patient.
  • Phase II-Motivation. Therapists attempt to inspire patients to want to pursue sobriety.
  • Phase III-Treatment. This involves processing emotions and developing healthy coping skills.
  • Phase IV-Aftercare. Ongoing support following active treatment to guard against relapse.

PTSD and Drug Abuse+

Approximately 30 percent of individuals with post-traumatic stress disorder (PTSD) also battle drug abuse at one point or another in their life. Recently researchers have noticed this strong link between addiction and PTSD and turned their attention towards the topic. Research on this connection is still in the early phases of understanding.

Theories on Why the Dual Diagnosis of PTSD and Drug Abuse Exist

Studies have uncovered a variety of theories that can explain the apparent connection between PTSD and drug abuse in America today. Each of these theories has found support in scientific studies. Depending on different individual factors such as genetics, sex, personal history and the co-occurrence of other mental illnesses, each hypothesis has validity.

Each of the following theories describes the possible reasons that lead to the simultaneous development of PTSD and drug abuse:

  • Self-Medication Hypothesis: This theory purports that individuals with PTSD experience extreme emotional suffering on a continual basis. The need for relief from this psychological pain causes them to use narcotics to get temporary relief. The occasional use eventually turns into abuse as the chemical and psychological consequences of addiction overtake them.
  • High-Risk Hypothesis: The idea behind this theory is using drugs causes major impairments in judgment, health problems and risky behavior. This is a recipe for experiencing more traumatic events than individuals who live a sober life. The more often trauma occurs, the more chances for PTSD to develop.
  • Drug Abuse Vulnerability Hypothesis: This theory proposes that in the wake of a traumatic event, for some unknown reason substance abuse dramatically escalates an individual’s chance of developing PTSD.
  • Shared Vulnerability Hypothesis: Those who support this concept believe an individual is born with a genetic predisposition for the simultaneous development of both drug abuse and PTSD after the experience of a traumatic event.

Consequences of PTSD and Drug Abuse Without Dual Diagnosis Treatment

The use of drugs, whether before or after the development of PTSD, always causes an individual’s stress level to be reduced in the beginning. Over time, stress in not only no longer relieved, it actually begins to increase from the results of addiction.

In the constant struggle to keep an addiction going, all areas of an individual’s life slowly deteriorate. When the symptoms of PTSD are added on top of the anxiety and tension caused by drug abuse, a massive fallout of negative consequences ensues. The results of simultaneous drug addiction and PTSD when left untreated are:

  • Anxiety
  • Depression
  • Relationship problems
  • Loss of job
  • Health issues
  • Financial bankruptcy
  • Legal ramifications
  • Psychosis
  • Suicidal thoughts/attempts

Successful Rehabilitation for Co-Occurring Issues

Recovery, for someone battling on two fronts with an addiction and a mental illness, will only happen when both issues receive equal attention. If you or someone you care about is struggling with a possible Dual Diagnosis then contact us today. Our trained counselors can provide a confidential assessment to match you with one of our top-rated, evidence-based Dual Diagnosis treatment programs. Let us assist you in finally receiving effective rehab that can help you achieve long-term sobriety.