Dual-Diagnosis Treatment Can Create Long Term Success In Fighting Addiction

For those who need to treatment for an addiction and a mental illness at the same time, dual diagnosis treatment provides positive, long-term impact.

Dual diagnosis treatment is effective when a person has a substance abuse issue plus a mental illness. Drinking alcohol as someone with diagnosable depression is caused by, and causes, a unique set of risk factors and symptoms than someone who just drinks, or who just has diagnosable depression.

To best treat this individual who has become an alcoholic suffering from depression, a treatment program needs to identify ways to treat both issues at the same time. Co-occurring disorders, in this case alcohol dependence and depression, need simultaneous treatment plans.

If your doctor says you have a broken foot and asthma, you are not going to treat one and expect the other to get better, or to treat each injury/illness the same way. A good approach to fix these medical issues is to put a cast on the foot, allow it to heal for a certain amount of time, participate in physical therapy if necessary, and eventually, hopefully, use the foot as you did before. The cast, the time to heal, and the physical therapy will not do anything to reduce the symptoms of your asthma, or influence the way your lungs breathe. The asthma needs a separate, but concurrent, approach to treatment. Learning to recognize what triggers an asthma attack, and how to avoid those triggers, plus medication and carrying an inhaler with you at all times, could provide the initial steps in asthma treatment.

Individual Treatment

Again, the treatment for each condition is identified and planned individually. As is true for a broken foot and asthma, so is applicable for alcoholism and depression.

To break down what this can look like, a good treatment team and an assigned addiction counselor create, with input from the dually-diagnosed client, a specific and detailed treatment plan to address the alcohol dependence diagnosis and a separate but equally specific and detailed plan for the depression diagnosis. The two plans will be carried out during the same rehab program.
In the case of alcoholism and depression, the worsening of one disorder generally leads to a worsening of the other. Alcohol is a downer, a central nervous system depressant. Alcohol consumption works as a sedative for your brain; it initially cuts off the effects of stress hormones, but it ultimately lowers neurotransmitters levels like serotonin and norepinephrine, so mood is no longer naturally regulated.

The more a dually-diagnosed person drinks, the worse his or her depression symptoms become. It also works the other way: as a person feels more depressed, he or she will generally turn to alcohol more often, perpetuating a vicious cycle.

Concurent Treatment

When properly executed, the concurrent treatment of each diagnosis alleviates the symptoms and subsequently, lessens the palpable stress that each disorder has been causing the individual to experience every day.

In re-referencing the broken foot and asthma dual diagnosis, gradually the foot will heal and the breathing abnormalities can be monitored and managed. As the foot heals and the person starts exercising again, for example, the breathing treatment techniques are tested, and the effectiveness can be tested. If a run causes an asthmatic attack, then it is clear that the treatment plan for the asthma needs to evolve. If the run does not cause breathing issues, than the asthma treatment plan is on point.

If the run causes no asthma issues, but it does cause pain the foot and ankle area, then the broken foot treatment plan needs revision in some way. If the run causes no pain or breathing issues, than both treatment plans are as effective as they need to be at that point in time.

Alcoholism And Depression

With alcoholism and depression, there is less of a test of each plan. It is not ideal for the dually-diagnosed person to go drink to find out if the depression treatment plan is working or not. Conversely, the person does not want to see if being depressed will lead to a relapse.

Instead, life situations while in treatment, interaction with fellow rehab clients, progress during individual counseling sessions, and the client’s ability to self-assess can be used to determine the effectiveness of each disorder’s treatment plan, and then the overall effectiveness of the dual diagnosis treatment program.

The long-term impact of dual-diagnosis treatment can sustain an addict’s sobriety while reducing the debilitating symptoms of the co-occurring, diagnosed mental illness.

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Jared Friedman is Quality Improvement Manager at Sovere Health a dual diagnosis facility that specializes in treating people for alcohol abuse, mental health, eating disorders and drug addiction.

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