Battling substance abuse disorders (SUDs) like alcoholism isn’t easy, but those who meet the criteria for “dual diagnosis” face a unique challenge. Dealing with a mental health condition at the same time as alcohol dependence becomes complicated quickly, and helping a client reach full recovery from both conditions is more difficult than if they’re contending with only one or the other.

At The River Source, we’re proud to offer treatment to clients with co-occurring disorders.

What Is a Dual Diagnosis?

A dual diagnosis, or co-occurring disorder, is when a person faces both a substance use disorder (SUD) and any mental illness. It’s a common problem: The National Survey on Drug Use and Health (NSDUH) found that roughly 9.2 million American adults suffer from a dual diagnosis — nearly half (45%) [1] of all those nations who are struggling with a SUD.

A dual diagnosis can be difficult to manage, diagnose, and treat. Those with a co-occurring disorder must deal with both their addiction and mental illness, two diseases whose symptoms intermingle and feed into each other. One can mask or worsen the other, and the ways they interact vary depending on the person, the mental illnesses, and specific aspects of their addiction.

What Causes Co-Occurring Disorders?

It’s important that we clarify that a dual diagnosis, as with any mental illness or addiction, is not a moral failing, personal weakness, or character flaw. Anyone can suffer from a co-occurring disorder, whatever their background or circumstances.

Sometimes, mental illness leads to substance and alcohol abuse, as with a person who uses alcohol to find an “escape” from stress or anxiety. In other cases, substance abuse may lead to mental illness. It’s also possible that a person develops both addiction and mental illness simultaneously from the same root causes. One of the following can often be the cause of both sides of a dual diagnosis:

• Unhealthy coping mechanisms in response to stress or anxiety
• Genetic predisposition
• Environmental triggers (such as a negative, unhealthy, or stressful living situation)
• Early exposure to substances
• Trauma, often at a young age

 What Mental Illnesses Are Associated with a Dual Diagnosis?

While a dual diagnosis can include any mental illness, some are more common than others:

• Anxiety / Generalized Anxiety Disorder (GAD)
• Attention-Deficit/Hyperactivity Disorder (ADHD)
• Bipolar Disorder
• Borderline Personality Disorder (BPD)
• Depression
• Eating Disorders
• Obsessive-Compulsive Disorder (OCD)
• Post-Traumatic Stress Disorder (PTSD)
• Schizophrenia

Medicating these mental illnesses is often tied to a dual diagnosis: those with serious mental illness symptoms of any kind may self-medicate using alcohol. Some mental illnesses are especially correlated to co-occurring disorders: over 1 in 4 US veterans with PTSD also have a substance abuse disorder [2] and an astonishing 2 in 3 of those with BPD will, at some point, have a dual diagnosis [3].

Common Alcohol Co-Occurring Disorders

With alcoholism in particular, some mental illnesses stand out: anxiety, depression, bipolar disorder, and OCD are positively correlated with alcoholism. It’s unclear whether this is because alcohol is used to self-medicate or alcoholism can lead to these mental illnesses. It also may be that they develop at the same time.

Anxiety

Alcohol is well-known to calm nerves by blocking overactive GABA receptors, similar to anti-anxiety medications. The issue is that these medications are prescribed in limited amounts because the body can become dependent on them, regulations that don’t exist with alcohol. In addition, alcohol dependency can lead to withdrawals that can worsen the symptoms of anxiety.

Depression

While alcohol can superficially treat several symptoms of depression, like providing a temporary high to a person experiencing a low or helping an insomniac fall asleep, it ultimately does more harm than good. Alcohol is a depressant, meaning that it will ultimately bring you lower than you started.

Bipolar Disorder

Bipolar disorder is defined by rapid and often unpredictable mood swings between hyper-stimulated mania and bouts of depressive behavior. Alcohol can “calm” a manic episode and provide temporary relief from a depressive one, hiding the extent of the condition. In addition, mania can lead to compulsive and risky behaviors, such as pushing the limits of safe alcohol consumption.

Obsessive-Compulsive Disorder (OCD)

OCD is a specific type of anxiety where a sufferer has unwanted, intrusive thoughts (obsessions) that often lead to ritualistic or repetitive behaviors (compulsions). Alcohol can distract someone with OCD from those thoughts, or reduce focus so that they can’t hyper fixate on their obsessions. However, alcohol actually makes these symptoms worse over time and can foster an unhealthy dependence as a crutch to the underlying causes of OCD.

What Are the Symptoms of a Co-Occurring Disorder?

Before we continue, we’d like to make one thing clear: only a specialized addiction treatment center is qualified to accurately diagnose and treat a co-occurring disorder.

That said, if you or a loved one are experiencing certain symptoms, it may be time to seek a professional diagnosis. Some of the most common signs of a dual diagnosis include:

• Anxiety
• Difficulty functioning
• Difficulty keeping employment
• Difficulty maintaining relationships
• Delusional thinking
• Denial of issues
• Dependent alcohol use
• Depression
• Erratic or impulsive behavior
• Extreme, uncontrollable mood swings
• Financial problems
• Heightened tolerance to substances
• Legal problems
• Neglected hygiene
• No longer enjoying or doing things they used to enjoy
• Panic attacks
• Risky behaviors
• Uncontrollable substance use
• Withdrawal symptoms

Because dual disorders vary depending on the person and conditions involved, they aren’t easy to identify. If you or a loved one is experiencing several of the above, however, call The River Source at (866) 294-9331 to learn more about seeking professional, compassionate help.

Suffering from a Dual Diagnosis? Here’s How We Can Help

At The River Source, we work with clients suffering from a dual diagnosis every day. Most commonly, we see co-occurring mood, anxiety, and personality disorders alongside alcoholism or other substance abuse. Although both halves of a dual diagnosis can have similar symptoms, we treat them as separate diseases, even as their treatment overlaps.

We utilize medical and psychotherapeutic intervention, as well as popular alternative treatments, including acupuncture, massage therapy, neurofeedback, nutritional education, and more. We understand that medicated treatment must be performed extremely cautiously, so we learn about you and your substance abuse issues before exploring this path. Psychotherapeutic intervention can be extremely helpful to help you process not only your mental illness but the physical reality of your substance abuse.

At The River Source, we’re here to help our clients heal, restore balance, and recover their lives from addiction and mental illness. Call us at (866) 294-9331 or schedule a free consultation online to begin your journey towards complete recovery.

[1] https://www.samhsa.gov/data/sites/default/files/cbhsq-reports/NSDUHNationalFindingsReport2018/NSDUHNationalFindingsReport2018.pdf
[2] https://www.ptsd.va.gov/publications/print/sudptsdflyer.pdf
[3] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6145127/