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Dual Diagnosis

Clinically Reviewed By Dan Schimmel, LCSW, CAP
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Dual diagnosis refers to people who abuse substances like alcohol while having underlying mental health issues.

Dual Diagnosis & Self-Medicating

“Self-medicating” has moved from a clinical mental health term to slang.

You might half-jokingly refer to the friend who has only left his apartment in months to visit the liquor store because he is “self-medicating” from the bad vibes of the Coronavirus lockdown. Did your girlfriend get dumped by a dude currently dating his PlayStation Pro? She is “self-medicating” with some White Claw.

“Self-medicating,” for some, may be tongue-in-cheek. For others with a dual diagnosis of a mental health disorder and substance abuse, the act of using alcohol to relieve the “blues” of, say, depression can eventually spiral the person into a destructive abyss.

Dual diagnosis means a person who has co-occuring mental health disorder and an addiction to a substance like alcohol.  According to the National Alliance on Mental Health, roughly one third of individuals struggling with alcohol abuse suffer from mental illness.

Not all people who are manic depressive or swing from states of manic euphoria to bleak depressive states are alcoholics. Not all alcoholics are OCD (Obsessive Compulsive Disorder) and have uncontrollable obsessions that lead to compulsive behavior.

The two, however, are often linked and can feed off one another. A person with depression will drink to self-medicate. He or she will have a few drinks and get a “buzz” with a release from the depressive feelings only to “come down” from the alcohol rush and collapse further into despair.

Symptoms of Dual Diagnosis

Symptoms of co-occuring mental illness and alcohol addiction depend on the specific mental illness and how long the person has been a problem drinker. There is a widespread social stigma to both conditions often leading individuals to deny they have a problem with either. Some common symptoms of dual diagnosis include:

Rationalizing excessive drinking

Isolation from friends and family

Change in appetite whether eating more or less than usual

Trouble concentrating and completing tasks

Neglecting personal and professional responsibilities

Increased irritability, anger and anxiety

Treatment for Dual Diagnosis

Like any 12 Step program promises, there is a solution for co-existing alcoholism and mental illness. Three common treatments include:

Detoxification

Detoxification is the first step of treatment and involves purging the alcohol from your body. Abrupt alcohol cessation can cause potentially dangerous withdrawal symptoms like delirium tremors. For such drinkers, entering detoxification at a treatment facility is the best course. In detox, medical professionals often substitute drugs that have similar effects to that of alcohol to prevent uncomfortable withdrawal symptoms. Following detox, a facility will often have other forms of inpatient or outpatient treatment and therapy to guide the recovering alcoholic further along the road of sobriety while tending to underlying mental disorders.

Inpatient Rehab

Inpatient rehab is where a dual diagnosed patient resides overnight in a treatment facility anywhere from 30-90 days if not longer in a structured program with around-the-clock care from specialists trained in alcohol rehabilitation and mental health issues. A facility would offer a regiment including therapy sessions, support groups and medication-based therapies to treat both the alcoholism and mental health issues.

Outpatient Rehab

Outpatient rehab refers to a patient receiving treatment for alcoholism and mental illness at a facility during the day where he or she receives, similar to inpatient care, a battery of therapy, counseling and other care to stop drinking, maintain sobriety and treat the mental health disorder that can be fueling their addiction issues. At night, the patient returns to their home.

Contact Us

Co-medicating a mental health disorder with alcohol is widespread and potentially deadly. If you feel you have a dual diagnosis problem, please contact us and we can provide advice on a professional treatment facility where you can receive help and hope.


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