What is Dual Diagnosis?

What having concurrent mental health & addiction Issues means

Dual diagnosis will be used interchangeably with the terms:

• Co-morbidity
• Concurrent disorders
• Co-morbid disorders
• Co-occurring disorders
• Dual disorders
• Complex needs

We’re going to refer to and use the terms interchangeably. Still, they all mean that someone has some form of mental health problem and addiction issue.

But what we are particularly referring to are people who suffer from some form of complex mental health problem and a concurrent addiction issue.

A dual diagnosis is when someone is experiencing mental illness alongside substance misuse issues.

Some examples of co-occurring disorders are:

• a mental health problem or disorder leading to (or associated with) problematic alcohol &/or other drug use
• a substance-use disorder leading to or associated with a mental diagnosis
• alcohol &/or other drug misuse worsening or altering the course of a person’s mental illness.

There can be a number of problems that may result from having multiple disorders & addiction issues simultaneously.

Dual Diagnosis Symptoms

• Health symptoms may mask or hide alcohol or drug use
• Alcohol or drug use or the withdrawal from alcohol or other drugs can mimic or give the appearance of some psychiatric illness
• Untreated chemical dependency can contribute to a reoccurrence of psychiatric symptoms
• Untreated psychiatric illness can contribute to an addiction relapse.

Other Common Dual Diagnosis Symptoms:

• Family relationships breakdown or intimate relationship problems
• Isolation and social exclusion
• Employment issues or school attendance/behavioural issues
• Risky or reckless behaviours
• Frequent admissions to A&E, emergency mental health services, or addiction services
• Financial difficulties
• Increased need for health services
• Problems involving the Police and possible incarceration
• Homelessness

How common is having some form of co-occurring disorders?

Drug or alcohol use by those with mental health problems is on the rise but has always been a problem.

Academics are starting to realise that as many as 50% of people with bipolar disorder or schizophrenia go on to have an addiction issue, but that’s only two diagnoses out of dozens of possible conditions.

You can use the rough estimate of 1 in 50 people in this country who have a diagnosis of bipolar disorder and 1 in 100 have some form of schizophrenia.

If that statistic is accurate, that means that there might be as many as 600 thousand people struggling with bipolar or schizophrenia & some form of addiction in the UK.

If you include depression in the stats, that number becomes even more significant. One-third of adults who suffer from some form of addiction suffer from major depression.

In 2014, roughly 20% of people in the UK aged 16 and over displayed symptoms of anxiety or depression.

16.5% of people with recurring major depression also have some form of alcohol abuse problem, and 18% have some form of drug use problem.

These statistics mean that a lot of people have co-occurring mental health and addiction issues. People with these problems don’t always experience the easiest of times in either traditional 12 Step Programmes or the mental health system.

(How often have we heard about someone on medications being told that they shouldn’t be on medications in some 12 Step meetings? Or heard about someone with severe mental health problems and addiction issues getting passed between addiction and mental health services?)

The lack of ‘joined up’ dual diagnosis treatment is a huge problem that needs addressing by mental health professionals. It is time for the mental health system and traditional 12 Step Fellowships to start working together to help more with this problem.

It is extremely useful when a treatment programme includes addictions treatment but also provides a support plan around a psychiatric condition or mood disorder.

Service users with serious mental health conditions should be encouraged to use tools like WRAP (Wellness Recovery Action Plan) and crisis plans to help empower them in learning how to manage any unpleasant symptoms.

There is currently limited support for those who have concurrent mental health problems and addiction issues.

However, some help is available in specific dual diagnosis groups such as Dual Diagnosis Anonymous or Dual Recovery Anonymous.

There are treatment centres that can provide a high level of support to people with complex mental illnesses. They usually help create a treatment plan that includes mental health services in discussions about their longer-term care. One example is Broadway Lodge, which is the oldest treatment centre in Europe.