Reviewed by Richard Turrell, Specialist Addiction Therapist
Dual-diagnosis treatment addresses addiction and mental health simultaneously without prioritising one condition over the other.
Many people who struggle with substance misuse also experience a co-occurring mental health disorder. Leaving a mental health condition untreated can lead to worse treatment outcomes and a higher risk of relapse.
Dual-diagnosis treatment solves this problem by first carefully assessing clients who enter treatment and determining whether they are living with a co-occurring disorder. From there, dual-diagnosis treatment specialists can treat co-occurring disorders in a way that understands the interplay between mental health and addiction.
Rates of Co-Occurring Disorders
Co-occurring disorders are exceptionally common in people seeking treatment for substance use. Often, people are unaware that they have a co-occurring mental health condition when they first enter treatment, as addictive substances can often mask the symptoms of mental illness. Similarly, addictive substances can create or exacerbate symptoms of mental illness.
In the United Kingdom, the overall rate of people entering addiction treatment with a mental health need is estimated at 63%.
Despite this majority, many people don’t get the mental health treatment they need. Dual-diagnosis treatment can help people with mental health challenges and set the stage for lasting recovery from substance use disorders.
The Link Between Addiction and Mental Health Disorders
Substance issues and mental health both fall under the same umbrella of behavioural health, along with life stressors and crises, trauma, and stress-related physical symptoms. But these challenges have more in common than just their categorisation; there isn’t one singular mechanism that ties mental health and addiction issues together.
Instead, a complex web of circumstances and risk factors links addiction and mental health. We’re outlining two of the main mechanisms in detail below.
Substance-Induced Mental Health Disorders
The first link is a pathway known as substance-induced mental illness. In some instances, depression or anxiety symptoms can stem from a substance use disorder or even frequent substance use.
For example, a person who develops an addiction to alcohol may find themselves with low energy, a loss of motivation and hope, and difficulty focusing on cognitive tasks. This person may be diagnosed with substance-induced depression, which can often persist even if the person achieves recovery from alcohol use disorder. Another example could be a person with a cocaine use disorder who then experiences cocaine-induced psychosis, which can closely mimic the symptoms of schizophrenia.
The Royal College of Psychiatrists acknowledges that regularly drinking too much can affect the brain chemistry of the brain and increase the risk of depression. The RCP also acknowledges that hangovers can create a cycle of waking up feeling ill, anxious, jittery and guilty, further compromising mental health. Individuals who rely on other substances (aside from alcohol) may experience similar physical symptoms.
Self-Medication for Pre-Existing Mental Health Disorders
The second pathway is known as the self-medication hypothesis. In this scenario, people with a mental health disorder use drugs and alcohol to treat the symptoms of their disorder – this can happen even when people are unaware of their condition.
For example, a person with an anxiety disorder may use substances to calm their symptoms, and while self-medicating with substances may provide some temporary relief, it can also worsen anxiety symptoms over time. Alcohol withdrawal can affect the nervous system and neurobiology in a manner which can significantly increase anxiety symptoms.
Eventually, the same dose will no longer achieve the desired outcome; the individual will build a tolerance to the initial dose and require a higher amount to find relief. This cycle can spiral out of control, possibly leading to a substance use disorder.
How Dual-Diagnosis Treatment Can Help
Proper dual-diagnosis treatment provides targeted assessments and therapies to help people simultaneously address addiction and mental health. Depending on a person’s unique circumstances, this may entail specialised therapy, medication management with a psychiatrist, or adjunctive services that can help reduce or eliminate the symptoms of mental health disorders.
Dual-diagnosis treatment is the most effective treatment for people with co-occurring disorders. Let’s take a look at some of the benefits below.
Better Long-Term Recovery Outcomes
Substantial evidence shows that dual-diagnosis treatment programmes produce better long-term outcomes for people seeking recovery from substance use disorders. When people seek addiction treatment without treating their co-occurring mental health concerns, they may experience a number of troubling symptoms that can increase the risk of relapse.
The scientific consensus is that mental health symptoms are significant risk factors for returning to active addiction. Only by treating these problems with evidence-based therapies and techniques can people overcome these symptoms and live healthier and more fulfilling lives in recovery.
Treatment for Both Conditions Simultaneously
Another key benefit of a dual-diagnosis treatment programme is the ability to treat multiple disorders simultaneously. Dual-diagnosis treatment involves more than just a mental health programme offered alongside a substance use programme – it is an integrated approach, considering both problems and how to treat them at the same time.
This distinction between siloed treatment approaches and dual-diagnosis programmes is of critical importance. While the symptoms of mental illness and the effects of substance use disorders significantly overlap, the treatment options differ drastically depending on an individual’s needs.
For example, mental health treatment for an anxiety disorder may involve pharmaceutical interventions. Prescribing a controlled substance to someone with a history of substance misuse could put a client at risk for future misuse, even under the supervision of a psychiatrist.
A dual-diagnosis team can determine whether these medications are clinically necessary or an unnecessary risk and develop customised treatment plans that align with a holistic consideration of each client’s needs. Medication adherence protocols can also be used to monitor if a client is using their medications correctly, greatly lowering the risk of misuse.
Treating the Whole Person
At the core of any effective dual-diagnosis treatment programme is the understanding that addiction does not occur in a vacuum. People seeking recovery from a substance use disorder need their treatment to focus on more than substance use alone, and that’s what a dual-diagnosis programme sets out to do.
Addressing a mental health condition or a substance use disorder without a cohesive strategy can be exhausting, and communicating treatment plans across specialists can increase the burden. By acknowledging that addiction is about more than substances, a dual-diagnosis treatment team treats the whole person rather than a single issue in isolation.
What to Expect in a Dual-Diagnosis Treatment Programme
A dual-diagnosis treatment programme extends across several different levels of care with various therapies and interventions. Typically, you’ll have a team of multidisciplinary providers working together with you to ensure you’re making meaningful progress in your recovery.
We individualise each treatment programme for every client. Below, we’re sharing some of the pillars of dual-diagnosis treatment at APN London.
Detailed Assessment and Diagnosis
The first step in a dual-diagnosis programme is a detailed mental health assessment and a formal diagnosis procedure. This step allows our team to determine your main mental health challenges and the severity of your substance use disorder. Our comprehensive assessment creates a roadmap for your treatment plan so we can plot the most effective route to recovery.
Using evidence-based assessments, a detailed interview process, and precise history-taking measures, our team can identify patterns and problems to make an accurate diagnosis.
Customised Treatment Plans
From there, we’ll work with you to design your treatment plan to your specific needs and preferences. At APN London, you don’t have to choose to prioritise one issue over the other or struggle to figure out the next step: we’ll provide a treatment plan designed to help reduce mental health and addiction symptoms while treating the root cause of dysfunction.
Therapies Offered in Dual-Diagnosis Treatment
As a dual-diagnosis treatment centre, we’re prepared to treat a wide variety of behavioural health conditions with various targeted therapies and modalities. The style of therapy you receive depends on your preference and the specific mental health disorder you’re struggling with. We’ve outlined some of the options offered at APN London below.
Cognitive Behavioural Therapy (CBT)
Cognitive behavioural therapy is one of the most well-studied and evidence-based forms of talk therapy available today. It can help people overcome and cope with a vast number of mental health challenges, including:
- Substance use disorders
- Anxiety disorders
- Bipolar disorder
This style of therapy emphasises the connection between our thoughts, moods, and behaviours – and how all three influence each other. By learning to change how you think, you can change how you feel and behave.
Dialectical Behaviour Therapy (DBT)
Dialectical behaviour therapy builds upon the foundation of CBT but incorporates elements of mindfulness and acceptance. DBT techniques can be remarkably helpful, especially for treating substance use disorders, as invasive thoughts and cravings are often outside of your direct control.
Similar to CBT, DBT has proven itself effective for a vast number of mental health challenges, including:
- Borderline personality disorder
- Substance use disorders
- Anxiety disorders
- Bipolar disorder
As such, DBT has quickly become a leading form of treatment offered within dual-diagnosis treatment programmes.
Eye Movement Desensitisation and Reprocessing (EMDR)
Eye movement desensitisation and reprocessing, or EMDR, is a specialised form of trauma therapy. EMDR builds upon the principles of prolonged exposure therapy with specialised tools and techniques that can help people process traumatic situations and overcome trauma-related symptoms.
This approach is particularly beneficial in the treatment of substance use and co-occurring post-traumatic stress disorder (PTSD), which are frequently linked. EMDR is an evidence-based approach designed to heal trauma symptoms and emotional distress using bilateral stimulation; EMDR techniques can teach your brain how to process traumatic memories.
Recover With Dual-Diagnosis Treatment
Living with two behavioural health challenges can make it feel as though recovery is an impossible task. Professional help in the form of a dual-diagnosis treatment programme can help you find your way forward with an evidence-based strategy and the support you need to thrive.
To learn more about how APN London treats people with co-occurring disorders, reach out to our team by calling 0203 984 7699 or complete our confidential online contact form. You are worthy of healing, and we can help you take the first step toward recovery.