What is Dual Diagnosis?
Mental disorders such as depression, anxiety, bipolar disorder, dementia, and schizophrenia are relatively common. Yet what many people don’t know is that these mental health conditions often co-occur with substance use disorders—also known as a dual diagnosis. In order to effectively treat both conditions during rehab, an integrated treatment approach should be taken, which may involve an interdisciplinary team of counselors, case managers, psychiatrists, and therapists. However, the complexity of both disorders can pose some challenges in effectively treating each disorder.
What Are Co-Occurring Disorders?
Though concurrently having both a mental disorder and a substance use disorder is not unusual, the causality behind the onset of each condition isn’t always clear. For example, in some cases, the mental health disorder may be present before a person becomes addicted to substances, and in others, the addiction may trigger the onset of a mental health disorder or further exacerbate its presentation.
As a matter of a quick review, a substance use disorder is a complex disease that is characterized by the ongoing, compulsive use of drugs or alcohol despite harmful personal, social, or medical consequences. People who struggle with addiction are thought to experience several neurochemical changes within their brains that make it more difficult for them to stop using the drug, even though they know it causes problems in their life.
And mental health disorders are usually “characterized by a combination of abnormal thoughts, perceptions, emotions, behavior, and relationships with others.”2
Grappling with both simultaneously takes a toll not only on the person primarily experiencing the issues, but their family and community as well. According to the World Health Organization (WHO), dual diagnoses are the leading cause of disability worldwide, with roughly 23% of all years lost due to disability caused by them.1
Mental health conditions that most commonly co-occur with substance use disorders are:2,3
What Are the Symptoms of Co-Occurring Disorders?
Some common issues that may affect people in need of dual diagnosis treatment include:11
- Their performance at work is going down.
- They have trouble communicating in a meaningful way.
- They have financial difficulties.
- They have trouble with the law.
- Their emotions are heightened or unstable.
However, the symptoms of co-occurring disorders vary based on the patient’s exact condition, including the substance they use and the mental health issues they’re experiencing.11 These disorders can produce a wide range of symptoms that may be difficult for the sufferer’s family and friends to detect. 11
The symptoms of intoxication or withdrawal can sometimes be mistaken for the signs of a mental disorder, so it’s strongly recommended for individuals to undergo a clinical assessment by a trained professional. Once they establish a correct diagnosis, they create a personalized treatment plan for the patient.11
If you suspect that a loved one is battling drug or alcohol addiction and a coexisting disorder, you can seek evidence-based treatment at many rehab facilities across the county. According to the 2018 National Survey of Substance Abuse Treatment Services, 7,808 (52.7%) centers conducted in-depth mental health evaluation and diagnostics while 7,437 (50.2%) offered tailored assistance to clients with co-occurring disorders.12
What are the Challenges During Dual Diagnosis (Co-occurring Disorder) Treatment?
People who struggle with co-occurring disorders have higher relapse rates, which is, in part, due to the fact that mental health and substance abuse treatment systems are not always integrated. This makes it difficult for a person to navigate being treated for and recovering from both conditions. In recent years, more dual diagnosis services have been created to help bridge this gap and better serve people with both disorders. A successful recovery means that a person learns to manage both of their illnesses so that they can pursue a meaningful life.4
Comprehensive treatment for both co-occurring disorders must take into consideration the following challenges:4
Challenge: People who have dual diagnoses present at varying stages of their mental disorder or addiction.
Challenge: People with dual diagnoses may experience problems connecting with services or may resist entering treatment and remaining there.
Challenge: People who struggle with mental health and substance abuse disorders may lack motivation to move through treatment and maintain their recovery progress.
Challenge: To achieve long-term sobriety, treatment providers need to address the underlying issues that fuel addiction and exacerbate mental health issues.
Challenge: Treatment providers don’t always comprehensively address both addiction and mental health issues over the long-term.
What Are the Signs That Someone Needs a Dual Diagnosis Treatment?
While symptoms of co-occurring disorders vary from person to person, there are some signs that may help loved ones recognize that a person needs dual diagnosis treatment:22
- Their behavior has dramatically changed.
- They don’t maintain social connection.
- They’re confused or lack concentration.
- They engage in behaviors that are potentially dangerous to themselves or others.
- They have developed a tolerance to the substance and they experience withdrawal symptoms when they stop using it.
- They feel like they can’t function normally without the substance.
Getting access to the right type of dual diagnosis treatment may be even more urgent if the person suffers from a serious mental illness, which is defined as:10
- Having a diagnosis of a severe mental disorder.
- Being unable to take care of oneself or function independently.
- The difficulties have persisted for two years or more.
Not all people will exhibit the same signs but it’s important to address your concerns over a loved one as soon as possible. Starting treatment sooner offers better chances of successful recovery.19 Even if the person isn’t willing to enter specialized treatment for dual diagnosis disorders or isn’t able to make the call themselves, the program can still be effective.23
Does Insurance Cover Dual Diagnosis Treatment?
Yes, both private and public health insurance will cover your dual diagnosis treatment either fully or partially. According to the Affordable Care Act, insurance coverage has to fund the treatment of mental health and substance use disorders to the same extent as other medical expenses.18
However, the degree to which your insurance will cover your treatment depends on the exact coverage you have. You can contact your insurance carrier to check. You’ll also need to verify that your preferred treatment facility is in your carrier’s network. You can usually call a toll-free number to get in touch with the facility and confirm this.19
If you don’t have private health insurance, you can check your eligibility for publicly funded programs. There are also government grants and scholarships, sliding scale fees, and loan opportunities that could help you fund your stay in rehab and receive the appropriate treatment for your dual diagnosis.20
Even low-income individuals who can’t access programs at for-profit rehab facilities can get evidence-based assistance for their co-occurring disorders. Some non-profit and religious organizations run free rehab centers and there are also many available no-cost, state-funded treatment centers. While there are eligibility restrictions and long waiting lists for most of these, they’re an effective option for people who couldn’t otherwise finance treatment expenses.21
How to Find Dual Diagnosis Treatment Centers Near Me?
Despite the increased awareness that people with dual diagnoses benefit from integrated treatment, research studies show that only 18% of addiction treatment and 9% of mental health programs meet criteria for offering capable dual diagnosis services.6 Establishing guidelines for effectively treating co-occurring disorders is important for serving this population. American Addiction Centers (AAC) a leading provider of drug and alcohol addiction and dual diagnosis treatment nationwide. AAC is in network with many of the top insurance providers in the U.S.