Imagine struggling through a verified alcohol dependence problem only to find yourself plunging more deeply into despair even in the midst of ongoing treatment. Also, imagine pleading for answers that are not forthcoming. Unfortunately, untold numbers of alcohol and drug addicts experience these kinds of scenarios due to unidentified co-occurring conditions.
When co-occurring conditions such as alcoholism and clinical depression are presented in the same patient simultaneously, it is known as a dual diagnosis scenario. The dual diagnosis gets its name from the fact that an experienced doctor or therapist is able to identify the co-occurring conditions for what they are, diagnosing them accordingly, rather than simply assuming that only one condition exists that might be manifesting itself in other ways.
There are plenty of challenges that come with dual diagnosis. As such, properly treating someone with co-occurring conditions requires specialists with experience in the field. Unique treatment programmes tailored to the two conditions must be applied if the patient is to experience eventual success in overcoming.
Challenges in Diagnosis
The first challenge in dual diagnosis is the actual diagnoses themselves. The example of co-occurring alcoholism and depression provides the perfect illustration.
As a drug, alcohol is considered a central nervous system depressant. That means when alcohol reaches the brain it reduces the effectiveness of the brain in controlling and responding to central nervous system stimulation. In layman’s terms, this is what causes the pleasurable effects associated with drinking. What many people fail to realise is that the depressant effect of alcohol can also play a role in emotional stability.
Therapists without extensive experience in dual diagnosis may assume that the symptoms of depression presenting in the alcoholic do not constitute a separate mental illness but are, rather, simply the effect of alcohol consumption. In many cases, that is true. Alcohol can cause feelings of depression over time. But there are some people in whom the feelings of depression are symptomatic of a separate, co-occurring condition. It can be challenging for the therapist or doctor to distinguish a single condition from co-occurring conditions.
Without a correct diagnosis, it can be difficult to know how to treat a person suffering from a dual diagnosis. A treatment focused only on alcohol could involve medications and counselling that would make depression worse. The same is true on the other side. Therefore, it is critical that a correct diagnosis is made as often as possible.
Challenges in Treatment
Once a dual diagnosis of co-occurring conditions is made, the next challenge is one of finding a way to treat both conditions simultaneously. While treatment may sound simple enough, it is often terribly complicated. Doctors and therapists must first try to determine whether one condition produced the other. In such cases, treating the condition considered to be the cause often relieves the secondary condition, either partially or fully. In cases where cause-and-effect cannot be determined, doctors must proceed as though both occur separately from one another.
Treating the conditions separately is much more challenging. As previously mentioned, medications that might be used to treat alcoholism could make the depression worse. Likewise, depression medications could make it more difficult for the individual to stop drinking. The right balance must be found in order to treat both conditions without negatively impacting the patient.
Treating dual diagnosis conditions starts with some basic principles:
Detox – Regardless of any existence of cause-and-effect, the need for detox is always present with drug and alcohol addiction. The challenge arises when using medications to help control withdrawal symptoms. Given that medically supervised detox is the norm today, doctors have to be very careful about the medications they choose.
Counselling – Both addiction and mental illness utilise counselling as an important part of treatment. In both cases, patients have to be retrained in new ways of thinking in order to avoid falling back into the same pitfalls that led to the problems being treated.
Individual Ownership – Finally, both addiction and mental illness require a certain degree of personal ownership if patients are to overcome their problems. It is easy for someone caught in a dual diagnosis situation to blame one condition on another and expect, incorrectly so, that solving one problem will mean permanent recovery. Rarely does this work. Therapists must help patients take ownership of their lives moving forward.
Suffice to say that treating co-occurring conditions is not easy. But doing so successfully significantly increases the chances that a patient will ultimately overcome both. It is with that hope that UKAT offers dual diagnosis treatment to patients all over the UK.
Professional Evaluation Is Necessary
UKAT counsellors who provide initial consultations to those in need are trained according to medical standards. They can give clients a basic understanding of addiction issues to the extent that they can help determine whether residential or outpatient care is most appropriate. But in order to receive an accurate dual diagnosis, clients really need a professional evaluation from an experienced doctor or therapist.
Fortunately, such evaluations are a normal part of addiction treatment. Where the rehab clinics of the past assumed every drug or alcohol addict could get by with the same kind of treatment, clinics in the modern era understand the need for custom, bespoke treatments for each client. Implementing a bespoke treatment requires every client undergo an individual evaluation at the start of a treatment programme.
In the event a dual diagnosis is made, clients are offered choices. Here at UKAT, we typically recommend residential treatment as the best course of action for these kinds of cases. Remember that dual diagnosis involves co-occurring conditions that are more challenging to treat. While it is possible to handle a dual diagnosis scenario using outpatient treatment, residential treatment is preferred because it offers more concentrated care in an environment that is more conducive to getting well.
UKAT is the leading provider of bespoke addiction treatment in the UK. We are here to help you if you need assistance dealing with a dual diagnosis situation or any other form of drug or alcohol abuse.
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