Addictions and mental illnesses on their own are enough to deal with, but when coupled together, they share an intertwining, dangerous, and lethal relationship that can easily go unchecked. In fact, it’s estimated that only 12% of those struggling with a dual diagnosis actually receive treatment for both their substance abuse disorder and their mental illness. That’s an important note to make: treating both the mental illness and the substance abuse is key to actually recovering. Unfortunately, many only receive treatment for one or the other, and thus the feedback loop continues indefinitely. Treating both simultaneously, however, can stop a dual diagnosis in its tracks.
The first step in many treatment programs is figuring out which of the disorders is the primary disorder, meaning the disorder that in part caused the other disorder. For example, if one began to drink because they were depressed, depression obviously played a major role in their alcohol abuse. If the depression is treated, so too can the alcohol abuse be treated. If only the alcohol abuse was treated, the patient might go back to drinking because they’d still be depressed. However, removing the depression and treating the alcohol abuse will remove the reason for drinking all together. The same goes for the opposite. If prolonged alcohol abuse brought about depression, then treating the alcohol abuse disorder can help minimize depression. However, many believe the best treatment course is one that involves treating both disorders as primary.
In this form of treatment, both disorders are viewed as feeding into each other, and as such must both be treated simultaneously for the best chance of recovery taking hold. This approach often blends both treatment programs into one single rehabilitation. Studies have shown that treating both simultaneously with the knowledge that they are a part of a dual diagnosis usually produces better overall outcomes. Usually these treatment programs are over longer periods of time and can couple both inpatient and outpatient rehabs and treatment options. Integrated treatment like this incorporates the best part of primary disorder treatment and simultaneous treatment. It understands that both disorders function with each other in a feedback loop, and removing one does not automatically end the comorbidity. Instead, the loop continues, and the other disorder may resurface.
As much as anyone would love to say we’ve figured out dual diagnoses, we haven’t. Every dual diagnosis is a little different, and each one requires different treatment and different attention. We now know how to treat dual diagnoses, but the world still has plenty to learn about how substance abuse and mental illness interact. Figuring out more about how the brain works when influenced by two different contributing disorders is paramount to preventing future dual diagnoses and improving awareness and treatment all at the same time. Every day we learn more, and every day the future looks that much brighter.