Why is Dual Diagnosis Important for Alcoholism?

Alcoholism is a complex brain disorder and mental illness, according to the National Institute on Drug Abuse. Many people who suffer from alcoholism have a dual diagnosis and require treatment for their addiction and mental health condition.

Understanding why dual diagnosis is vital for long-term alcoholism treatment can empower you to find a recovery center that offers therapy for these common conditions.

What is a Dual Diagnosis?

A person with a dual diagnosis has both a substance use disorder and a mental illness. Also known as co-occurring disorders, a dual diagnosis affects roughly half of all people in the United States with a substance use disorder and half of all people with a mental illness, say the National Institutes of Health (NIH).

Because these health disorders often coincide, it can be challenging to determine what the substance use disorder or the mental illness causes. Additionally, substance use disorders and mental illnesses share many risk factors, including stress, trauma, and genetics.

Can Alcohol Abuse Trigger a Mental Health Disorder?

When consumed in moderation, alcohol produces sedative effects that slow down your heart rate and make you feel more relaxed. It also interacts with certain brain chemicals to trigger euphoria or extreme happiness. However, if you drink alcohol regularly in high amounts, it can eventually change the structure and functioning of your brain to increase the risk of mental health disorders.

According to a 2014 study published in the Indian Journal of Human Genetics, alcohol interferes with the brain chemicals dopamine, serotonin, glutamate, and gamma-Aminobutyric acid (GABA). These brain chemicals play an essential role in specific bodily processes, including mood regulation. For example, dopamine plays a role in feelings of pleasure, motivation, and satisfaction.

Over time, heavy alcohol use can prevent your brain from producing these chemicals in normal amounts. Low dopamine levels can make you experience less pleasure when doing activities you typically love, increasing your risk for a mental health condition like depression. Low levels of GABA can increase your risk for an anxiety disorder, considering how GABA induces feelings of calm and relaxation during times of stress.

Can Mental Health Issues Cause Alcohol Abuse?

Symptoms of mental health disorders can often be so unpleasant and difficult to deal with that some people turn to alcohol or drugs to self-medicate their symptoms. For example, those who suffer from anxiety may take a few shots of hard liquor to relax and calm their nerves. Or, a person with bipolar disorder may drink during cycles of depression to feel more lively and outgoing in social situations.

According to Mental Health America (MHA), over half of adults in the United States with a mental illness do not receive treatment, which equates to more than 27 million adults. MHA adds that the percentage of adults with an untreated mental illness has increased every year since 2011. In 2019, nearly 25% of adults with a mental illness did not receive any form of treatment.

Untreated mental health issues can increase the risk for alcohol misuse and addiction, especially if people turn to alcohol regularly to relieve their symptoms. Unfortunately, alcohol can worsen the severity of a mental health condition since it further alters brain chemistry. That is partly why dual diagnosis is so vital for alcoholism because treating both mental illness and addiction at the same time can help people experience relief and achieve greater well-being.

What are the Warning Signs of a Dual Diagnosis?

To determine whether you or a loved one may have a dual diagnosis, it helps to know the warning signs of substance use disorders and mental health disorders.

Here are diagnostic criteria for alcohol use disorder, with examples of situations that may indicate a possible co-occurring disorder.

• You drink alcohol in larger amounts or over a longer period than intended. For example, you used to drink three beers a night to reduce depression, but you now drink at least six beers a night.
• You’ve been trying to reduce your alcohol intake but cannot control your alcohol use or stop drinking.
• You devote a great deal of time to obtaining alcohol, drinking alcohol, and recovering from its effects, such as a hangover.
• You experience intense cravings, desires, urges to use alcohol. For example, you may feel an overwhelming urge to drink alcohol when you feel incredibly nervous or have an anxiety attack.
• Your drinking behaviors have led to severe work, school, or home problems.
• You keep drinking alcohol even though it is causing persistent or recurring problems in your social life or personal relationships.
• You have given up several vital activities in your life, so you can spend that time drinking alcohol instead.
• You continue to drink alcohol in situations where it is physically hazardous. For example, you keep drinking alcohol at a bar far away from home, knowing you must drive yourself home afterward.
• You keep drinking alcohol despite knowing it is causing or worsening a physical or mental health problem. For example, your drinking behaviors are causing you to have more severe cycles of mania or depression if you have bipolar disorder.
• Your tolerance for alcohol is higher than it ever was before, meaning you may need higher amounts of alcohol to feel its effects, or the usual amounts fail to produce effects.
• You experience alcohol withdrawal symptoms when not drinking alcohol, or you drink alcohol mainly for the sake of avoiding or relieving withdrawal symptoms.

There are many types of conditions regarding mental health disorders, each of which produces its own set of symptoms.

Therapists recognize and diagnose specific mental health disorders after spending time with you and talking to you about your symptoms.

Here are common mental health disorders, along with a few of their most common symptoms:

• Anxiety disorders: Restlessness, rapid heart rate, shortness of breath, nervousness, and racing thoughts.
• Depression: Sadness, guilt, hopelessness, loss of interest in favorite activities, changes in eating and sleeping habits, and suicidal thoughts.
• Bipolar disorder: Cyclic periods of mania (euphoria, high energy, reduced appetite, fast-talking, and risky behavior) and depression.
• Eating disorders: Eating alone (or secretly), overeating, frequent dieting without weight loss, purging, rigorous exercise, and binge eating.
• Post-traumatic stress disorder (PTSD): Flashbacks and nightmares of the traumatic event, paranoia, insomnia, angry outburst, and avoiding places that remind you of the event.
• Schizophrenia: Delusions, hallucinations, strange movements, difficulty making decisions, and problems with concentration.

What are Mental Health Issues Linked To Alcoholism?

Alcohol addiction can trigger a wide range of mental health issues. However, some mental health disorders are more common than others. According to the NIH, the most common psychiatric disorders associated with alcoholism include:

• Major depression. Depression affects an estimated 80% of alcoholics at some point in their lives.
• Bipolar disorder. Between 50% and 60% of people who experience mania with bipolar disorder become dependent on alcohol or drugs at some point during their illness.
• Antisocial personality disorder (ASPD). This anxiety disorder affects 15% to 20% of men with alcoholism and 10% of women with alcoholism.
• Social anxiety disorder. This anxiety disorder affects an estimated one-fifth of people who suffer from alcohol addiction.
• Panic disorder. This anxiety disorder affects as many as 20% to 28% of people with alcohol use disorder.
• PTSD. People with PTSD are between two and 2.5 times more likely to develop alcohol use disorder than people without PTSD.
• Schizophrenia. This anxiety disorder affects between 40% and 70% of people who suffer from alcohol use disorder.

What are Treatments for Dual Diagnosis?

Dual diagnosis therapy focuses on treating both the substance use disorder and the mental health condition. Many addiction treatment facilities offer this dual diagnosis therapy through drug and alcohol rehab programs, including alcohol detox, behavioral therapies, and support groups.

Alcohol detox is the first stage of treatment for patients with an alcohol-related dual diagnosis. Alcohol detox helps you recover from physical alcohol dependence, as it manages the physical symptoms of withdrawal. This treatment usually involves using medications that can help you feel more comfortable during withdrawal and reduce the risk of potential complications.

After detox, many patients transition into an alcohol rehab program to receive a variety of behavioral therapies and attend one or more support groups related to the dual diagnosis. For example, if you started drinking to cope with PTSD, you may attend Alcoholics Anonymous meetings and support groups that address trauma and PTSD.

With dual diagnosis therapy, you will learn how to cope with your mental illness in ways that don’t involve alcohol or drugs. You’ll learn how to manage stress using healthier methods like exercise or deep breathing and may even be prescribed medications that reduce your mental health disorder symptoms. All treatment programs get tailored to each patient based on the unique circumstances of their dual diagnosis.

Contact The Recovery Team for Dual Diagnosis Therapy

The Recovery Team believes anyone can find freedom from alcoholism or drug addiction. We are devoted to helping you or your loved one recover from a dual diagnosis using alcohol detox, behavioral therapies, support groups, and many other evidence-based interventions.