Addiction is a mental health condition characterized by the intensive use of substances or performing a certain activity. It rarely operates in isolation and is usually tangled with mental health disorders. The combination of these ailments has an adverse effect on the individual’s health. The identification and treatment of these conditions are complex and require an integrated treatment approach. Treatment aims to unmask the hidden psychological drivers and provide individuals with the best chance of attaining lasting recovery.
The connection between addiction and mental health illness is clinically referred to as co-occuring and dual diagnosis. Nearly 50% of people with a substance use disorder are more likely to develop a mental illness. This underlines the critical importance of a comprehensive diagnostic process, which goes beyond simply tackling addiction.
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Multi-faceted Assessment Process for Co-Occurring Disorders Diagnosis
The diagnosis involves a thorough assessment that examines biological, psychological, and social factors. Let’s look into the process in detail below.
First Screening and Comprehensive Interview
The diagnostic treatment begins with a thorough initial assessment when the client seeks help. The individual may report their addictive behaviors or problematic patterns. However, skilled psychologists dig deeper and try to understand the addiction in detail. They ask open-ended questions and actively listen to the clients. If they find any cues of substance use causing mental problems or vice versa, they’ll dive deeper to uncover the co-occuring problems.
In the comprehensive interview, they’ll dig deeper and ask for a detailed history of the condition. It may include the onset of the addiction, its symptoms, family history, and past trauma. During this time, a psychologist will assess the client’s mood and thought process to evaluate their psychological functioning.
Usage of Diagnostic Criteria
Psychologists use the criteria mentioned in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR) to diagnose the co-occuring conditions. This will allow them to differentiate symptoms caused by substance addiction or withdrawal from mental problems. For example, severe anxiety is expected during alcohol withdrawal. However, if anxiety continues for a long period after withdrawal, then it is an independent disorder.
Psychological Testing and Tools
Psychologists rely on a suite of diagnostic tools and structured assessments. These tools help them screen different mental health conditions and establish a treatment plan. The tools include:
- Questionnaires and Self-Report Inventories: Psychologists use self-reports and clinician-rated measures to find specific symptoms of mental disorders. Examples include:
- Patient Health Questionnaire (PHQ-9): Screens for depression.
- Generalized Anxiety Disorder 7-item (GAD-7): Screens for generalized anxiety disorder.
- Drug Abuse Screening Test (DAST-20): Screens for drug use disorders.
- Alcohol Use Disorders Identification Test (AUDIT): Screens for alcohol use disorders.
- Trauma Screening Questionnaire (TSQ): Screens for post-traumatic stress disorder (PTSD).
- Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI): Provide more detailed measures of depression and anxiety symptom severity.
- Collecting Collateral Information
Psychologists seek information from the family, close friends, and past health care providers about the person’s condition. This is done strictly with the client’s explicit consent. The information can help providers get crucial insights into the client’s history, behavioral patterns, and the impact of other issues.
- Observational Data
Psychologists pay close attention to the client’s behavior during sessions. This involves their mood, appearance, thought process, speech patterns, and overall behavior. For example, if a client speaks rapidly or shifts topics during therapy, it may be a sign of severe anxiety or mania. Similarly, someone with slow speech or poor eye contact may indicate depression. This will help them detect mental health problems if they were not detected earlier in the initial assessments.
All these assessments allow psychologists to identify whether the client is suffering from co-occuring disorders.
Common Underlying Mental Health Issues Linked to Addiction
The mental health issues that frequently co-occur with addiction are:
- Depression
- Anxiety Disorders
- Post-Traumatic Stress Disorder (PTSD)
- Bipolar Disorder
- Schizophrenia and Psychotic Disorders
- Personality Disorders
- Attention-Deficit/Hyperactivity Disorder (ADHD)
Why is Accurate Diagnosis Critical?
The accurate diagnosis of mental health issues linked to addiction is fundamental for effective treatment.
- Tailored Treatment Plans: A dual diagnosis treatment requires an integrated treatment approach to address both conditions simultaneously. Treating one condition and ignoring the other usually results in relapse as the untreated condition worsens. Alpha Healing Center has some of the best psychologists who provide customized treatment plans to fight against co-occuring conditions. Our rehab center in Mumbai offers state-of-the-art facilities and has an excellent track record of dual-diagnosis treatments.
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- Medication Management: If a condition is treated singularly, then medications may not be effective. For example, substance abuse, medications like naltrexone, and acamprosate may provide relief, while mental disorders require antidepressants. A combination of these medications can support overall recovery.
- Therapeutic Modalities: Evidence-based therapies are very effective for treating both addiction and mental disorders. However, some therapies are more beneficial than others. Cognitive Behavioral Therapy (CBT) is effective for both addiction and many anxiety and depressive disorders. Trauma-focused therapies are better for those with PTSD. Similarly, Dialectical Behavior Therapy (DBT) is particularly beneficial for individuals with Borderline Personality Disorder and co-occurring addiction.
- Relapse Prevention: Understanding the condition helps psychologists anticipate challenges during recovery and develop relapse prevention strategies. Addressing core psychological vulnerabilities strengthens resilience and improves the prognosis for recovery.
- Reduced Stigma and Self-Blame: Identifying both the issues is incredibly helpful for clients. It allows them to understand their struggles and not worry about it as a moral failing, but rather a complex, treatable condition. This helps individuals have a greater sense of hope and get motivation for recovery.
Frequently Asked Questions
Yes, it is possible, especially in the initial stages of treatment when the client is experiencing severe withdrawal. This may mask or mimic symptoms of underlying disorders. Long-term evaluation is essential to refine the initial diagnosis and achieve stability and abstinence.
Yes, individuals usually lean towards substances to cope with their ailments. The initial relief may soon turn into addiction and cause severe problems.
Dual diagnosis treatment is complex, but not impossible. The major problem is that one condition often triggers the other condition. The treatment process has to be integrated to address both conditions and is usually led by the same clinical team.
