What are Concurrent Disorders (Dual Diagnosis)?
The term concurrent disorders – or dual diagnosis – refers to the combination of mental health and substance misuse issues. Examples of concurrent disorders include PTSD or clinical depression and alcohol addiction, ADHD and cocaine addiction, or Generalised Anxiety Disorder and Benzodiazepine dependency. It is often impossible to separate mental health and addiction because so many doctors misdiagnose addiction and confuse the symptoms. We know this because so many clients regain mental stability and normality once they address their addiction. Substance use is often regarded as “self-medicating” the symptoms of the emotional and mental disorders listed below:
Please Note: Hope successfully treats many clients with common mental health issues such as depression and anxiety, usually together with addiction. However Hope Rehab is not a substitute for a psychiatric unit and do not have a psychiatrist onsite. We know our program is ideal for clients suffering with many types of mental health issues. We work closely with the Doctors/Psychiatrists at the hospital opposite who provide all our detox and medication needs. All clients must undergo a formal psychological assessment with our team and need to be able to function safely in our community. The reason we are selective is to protect all clients from unnecessary disappointment and disruption. If you are in any doubt please double check with our admissions department.
It is common for people with Mental Health issues to turn to using addictive and illicit substances to improve coping abilities, feel better, or decrease and numb feelings. Some call it “putting out fires with gasoline”. The problem is that self-medicating may work at first, providing the person with relief from their restless brains. However, the pain and the problems are now burning out of control and the gasoline ultimately makes the problems worse.
How Frequently do Mental Health Issues Coexist with Substance Misuse?
While there are variations as to the degree that substance abuse and mental health disorders coexist depending on the mental health diagnosis or type of substance abuse someone is struggling with, the general rule is that it is more likely than not that both are present at the same time.
What is the Link between Mental Health and Substance Use Problems?
The link between mental health and substance use problems is manifold:
NOTE: Hope is not a substitute for a psychiatric unit, we do treat depression, anxiety and most personality disorders together with addiction. However, we do not treat patients with enduring paranoid schizophrenia, self-harm or TBI. Also Hope is not a specialist eating disorder clinic although our program is appropriate. For further clarification please speak to our admissions team.
It is therefore important to understand that Mental Health and substance problems interact with one another in multiple and complex ways, and these interactions changes both the course and the outcome of the problems individuals experience. In short, it’s complicated!
Why is it Important to Know about Concurrent Disorders?
Compared to an individual suffering from either an addiction OR a mental illness alone, individuals suffering from concurrent disorders are more likely to:
How are Concurrent Disorders assessed?
Given the complexity and multiple ways in which mental health and substance use problems interact, an assessment of such problems requires skill and time, and it is rarely complete or accurate if completed in one short session. Not surprisingly, individuals are often misdiagnosed and therefore at risk for receiving inadequate, unnecessary or insufficient treatment for their problems. A comprehensive assessment by a skilled clinician trained in the areas of mental health and substance use is therefore highly recommended. At Hope Rehab Center, we provide skilled care through our multidisciplinary team, and we often work in collaboration with clients’ physicians to guarantee best possible treatment outcomes for our residents.
A Word about Medication
Many individuals suffering from anxiety or depression enter rehab with prescribed medications, such as antidepressants for depression or anti-anxiety medication. All too often, residents are eager to stop taking such medication in an attempt to be completely ‘drug-free’. It is, however, very important to distinguish between medications prescribed by a medical professional for the treatment of a diagnosed mental health problem on the one hand, and illegal substances often taken excessively on the other hand. While the former often brings about mood stabilisation and increase levels of day to day functioning, illegal substances tend to have the opposite effect: they destabilise, make for unpredictable moods and behaviours, and interfere with individuals’ functioning in all areas of life.
While a desire to rely on non-pharmacological tools such as mindfulness and thought challenging to manage one’s moods is very much desirable, making changes to established medication regimes typically results in at least temporary instability and should, therefore, be carefully timed, planned and monitored. At Hope Rehab, we work in careful collaboration with residents’ prescribing physicians prior to considering making any changes to established medication regimes. Naturally, there are exceptions to this rule considering the potential for misuse or abuse of some prescription medications, most notably benzodiazepines, opiate medication and ADHD medications.
While these types of medications may alleviate suffering if taken as prescribed and for the general population, they are potentially dangerous in the hands of an addict. For these reasons, we at Hope Rehab suggest a planned gradual cessation of these types of medications, ideally prior to entry into treatment, or as part of early recovery.
Tim Hamilton & Pat Samples – The Twelve Steps and Concurrent Disorders
The most common types of mental health problems that people tend to experience with addiction would include:
How Concurrent Disorders are treated at Hope Rehab
As mentioned before: Misdiagnosis happens in some cases, as substance abuse and mental health conditions can be confused due to similar symptoms and consequences. This usually means that when the addiction is treated successfully the client stabilises.
At Hope Rehab, firstly we take away the drugs or alcohol and only allow safely prescribed medications. We provide individualised care – this means the treatment path you follow will be based on an assessment of your exact needs. Our team is experienced at working with clients who have a concurerent disorders.
The addiction treatmen program here at Hope Rehab Thailand includes a number of approaches that have a good track record for helping people with dual diagnosis:
Cognitive-Behavioural Therapy (CBT) is concerned with identifying and eliminating patterns of thinking that are holding you back in life. It can be effective in the treatment of a number of conditions such as depression, anxiety disorder, obsessive thoughts, and self-esteem issues. It is also a clinically proven way of dealing with addiction. Our CBT program will provide you with tools to help you set goals and achieve them.
Mindfulness is a type of meditation practice that teaches you how to live in the present moment and experience your thoughts and feelings in a more objective way. It can be effective for managing depression, anxiety, and obsessive thinking, and it is an excellent tool for relapse prevention.
Learning to live in the present moment also helps you develop emotional sobriety, and it can eventually lead to serenity. We use the Minnesota Model here at Hope Rehab because we’ve seen how effective the 12-step program can be to help our clients build a solid sobriety. This path can also work if you are dealing with a dual diagnosis. The way you experience your dual diagnosis is going to be unique to you, but our individualised approach to treatment means we almost certainly have a path that is going to work for you. Contact us now to find out more.
After a successful treatment of the concurrent disorders and a recovery program to follow up, many sufferers find their symptoms subside, and life takes on a healthy direction.