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Dual Diagnosis & Dual Disorders
Recent times have seen the much
awaited merging of Substance Abuse
Professionals with Mental Health
Professionals. Because one issue has
the potential, and many times does,
of perpetuating the other issue,
both substance abuse issues and
mental health issues need to be
addressed simultaneously.
These Conditions include:
- Bipolar Disorder
- Clinical Depression
- Eating Disorder
- Attention Deficit Disorder
- Clinical Mood Disorders
Bipolar Disorder:
Bipolar disorder is a major
affective disorder between states of
deep depression and extreme elation.
Symptoms are: sleeping more than
usual, then needing very little
sleep yet never feeling tired,
becoming uninterested in things you
once enjoyed, becoming unable to
make simple decisions, wanting to
die, experiencing hallucinations or
delusions, indulging in risky sexual
behavior, feeling hopeless or
worthless for a sustained period of
time, paying no attention to daily
responsibilities, and having bouts
of uncontrollable crying.
Clinical Depression:
Not everyone experiences clinical
depression in the same way. Symptoms
are: A persistent sad, anxious or
“empty” mood. Sleeping too little or
sleeping too much, Reduced appetite
and weight loss, or increased
appetite and weight gain,
restlessness or irritability,
fatigue or loss of energy, feeling
guilty, hopeless or worthwhile, or
thoughts of death or suicide.
Anxiety Disorder:
Anxiety disorder fills people's
lives with overwhelming anxiety and
fear. They are chronic, relentless
and can grow progressively worse if
not treated. Symptoms include:
trembling, profuse sweating, nausea,
difficult talking, fatigue, muscle
tension, twitching, irritability,
easily startled, rapid heart beat,
unable to relax, and hot flashes.
Eating Disorder:
The term eating disorders have come
to mean anorexia nervosa, bulimia
nervosa, and binge eating. Anorexia
nervosa is defined as the relentless
pursuit of thinness. The symptoms
are: Person is terrified of becoming
fat, he/she reports being fat when
very thin, weighs 85% or less than
what is expected for age or height,
he/she has compulsive rituals,
strange eating habits, division of
food, low tolerance for change and
new situations, and may fear growing
up. Bulimia is defined as the
diet-binge-purge disorder. The
symptoms are: Person binge eats,
feels out of control while eating,
vomits, misuses laxatives,
excessively exercises, or fasts to
get rid of calories. Bulimics are
often depressed, lonely, ashamed,
and empty inside. Binge eating
disorder is when a person binge eats
frequently and repeatedly. Symptoms
are: depression and obesity, eats
rapidly and secretly, may snack and
nibble all day long. Binge disorder
is not a process of vomiting like
bulimia, it is a process of eating
for emotional reasons to comfort
themselves, avoid threatening
situations and numb emotional pain.
Eating disorders can fall within the
range of the above stated
conditions. Obsessive thought of
food, caloric intake, types of food,
etc. can be warning signs for eating
disorders. Eating disorders affect
men and women. Approximately 70% of
women seeking treatment for drugs or
alcohol have a co-occurring eating
disorder.
Attention Deficit Disorder/Attention
Deficit Hyperactive Disorder (Adult
ADD/ADHD):
Attention deficit disorder/
Attention Deficit Hyperactive
Disorder is described as
inattention, hyperactivity, and
impulsivity. Symptoms include: lack
of focus, depression, impulsive
and/or compulsive behaviors,
disorganization, restlessness,
difficulty finishing projects, and
losing things. These symptoms
interfere with success at work and
get in the way at home or with
friends.
Clinical Mood Disorders: Mood
disorders range from depression,
bipolar disorder and mania. Symptoms
include: low self-esteem, less
control over emotions, lowered
capacity to feel pleasure, less
tolerable to feel pain, not
motivated and low energy levels.
Treatment centers across the country
began treating a new classification
of chemical abuse. Clients with a
behavioral disorder coupled to
compulsive/obsessive symptoms are
classified as dual diagnostics. Many
of these disorders in the past were
seen only by mental health
personnel; and the symptoms were
more often than not treated
erroneously because chemical
addiction was not considered!
In other words, a patient describing
low energy, low self esteem, sadness
and despair, was expressing all the
feelings of depression. And he was
labeled as such. He was a victim of
depression. But if drinking and
using were not discussed, if the
therapist failed to discover the
extent of the chemical habit, the
direction of treatment took the
wrong path.
For years, health professionals
thought to treat addiction, they had
to find the underlying reason for
the addiction. They would treat the
"underlying reason" and figured the
addiction would go away. Sadly, that
is not at all the case. A person
suffering from an
obsessive/compulsive disorder, such
as drinking and using, will surely
return to that behavior after only
brief success. Thus, relapse.
Probably the best way to understand
the futility of psychotherapy is to
use an example that is very fitting:
Say, a person goes into treatment
for fire setting. The therapist
would have little success treating
the underlying disorder if the
patient were allowed to continue to
set fires. Common sense can go a
long ways-first, the fires have to
go! Stop setting fires and now we
have a chance to treat whatever else
is wrong.
So is the case with many addicts.
Learn to stay sober and clean, and
if any severe underlying disorders
still exist we have the benefit of
time and experience to solve those
problems also.
Chemical Imbalance:
Some disorders will simply not go
away with counseling, group therapy,
12 step programs alone. This is yet
another type of dual diagnosis. It
is more bothersome to the client,
and in severe forms can distract
from chemical dependency treatment.
However, these types of disorders
can be treated very successfully.
These people suffer many times from
certain chemical imbalances, and
need additional help to overcome
their challenge. A responsible
treatment program should
professionally diagnose all of it
clients upon intake.
At Surf City Drug Rehab Treatment
Center we treat this kind of
disorder in three phases:
- Psychosocial evaluation
- Proper medication to restore
chemical balance
- One-on-one counseling (evaluating
and treatment planning)
- Introduce client into the primary
phase of chemical abuse treatment
When chemical balance is achieved,
clients respond well to the general
concept of standardized treatment:
- Group process
- Relating to others and gaining
social skills
- Incorporating a treatment plan
into their lifestyle that they can
live a satisfying life
- Identifying and acceptance of
their own personal challenges
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