Mental Health and Substance Abuse - Dealing with a Dual Diagnosis

Very often, not all the time, but very often substance abuse and mental health illness overlap and create a storm that has the potential to elevate the risk of drug use while increasing the symptoms of mental illness joining forces that can lead to a Maelstrom for both the patient and the family. In the mental health and substance abuse communities individuals who use drugs to self medicate their mental illness are referred to as a patients with a dual diagnosis. Some professionals are still arguing that drug use can lead to mental health issues. However the majority of professionals who work with these clients believe that the mental illness comes first and that individuals turn to street drugs to try and control their mental illness and that by the time professionals get involved the patient mental illness has become firmly rooted into their psyches and the drug and alcohol abuse have become physical dependencies.

When a patient reaches the level where the mental illness and the drug and alcohol addiction have both taken hold it is extremely important for the patient to be seen by a professional who has the skill to deal with patients struggling with a dual diagnosis. Often times a patient will first have to deal with the drug issues and this can be very difficult as often street drugs can be the things that are holding the mental health issues at bay. Some examples include a manic depressive using alcohol to help control a manic stage as alcohol is a depressive agent. When a person is in a depressive stage of a manic expressive cycle they may turn to cocaine to jump start the mania which tends to be a much more pleasant experience for the manic depressive then the depressive state and cocaine can kick start the mania. The problem explodes when the patient using the alcohol or cocaine crashes and runs out of money and their mind spins out of control causing the voices and the insanity and the illness takes over often leading to the patient being picked up by the police of the community services board which leads to placement in a mental house facility and this placement can be limited to three days or it may last up to months.

The positive side of this commitment is that the patient is now able to have 24 hour supervision and can begin the detox process and can begin to work with the doctors and professionals to get to the bottom of the issues that have lead to the use of drugs and alcohols. This can be an extremely difficult process as along with the physical dependency that the patient may experience they are also emotionally connected to the drugs and this can be as hard to deal with as the physical side effects. However until a persons mind is clean from substances they do not really have the ability to answer questions and be examined and tested for mental health issues. The tests used to determine mental health diagnoses require a "clear"mind - it may be a mind that is hearing voices or it may be a mind that does not feel safe but the only way to get a true diagnoses is to have the patients brain acting as it would without the input of alcohol and street drugs.

The next steps seems to be counterproductive but it is to find a prescription drug that will help the patient manage his or her illness. The main difference between street drugs and ones dispensed by doctors are that street drugs are not doled out in controlled quantities and they are often not free from "added extras" also they are not time released. Pharmaceutical drugs can be very helpful in dealing with depression and bi-polar and we are even seeing some success with schizophrenia. However it often takes time to find a drug or a combo of drugs that that will deal with the symptoms and also make the side effects tolerable.

One of the biggest challenges of a dual diagnosis of mental health illness and substance abuse is that often patients will go off of their prescribed medications. This can happen for many reasons including but not limited to the following 1. the medicines makes the patients feel better so they decide they no longer need to be on the meds b. patients can lose their insurance and with loss of insurance can come loss of access to drugs c. it is hard to except that you have an illness especially one that cannot be seen by others and one that is misunderstood and the emotional cost of taking the drugs outweighs the benefits d. even on the drugs patients can have a psychotic break causes their brains to tell them to stop the medicines e. the side effects of the drugs can be very unpleasant, weight gain, loss of sex drive, dry mouth, feeling as if you are moving under water.

When you are dealing with a dual diagnosis or you have a friend or family with a dual diagnosis you must vigilant and educate yourself. Here is a list of some books that can help you if you would like to obtain additional information

Madness, Prozac Nation, The Quiet Room, The Bell Jar, Bi-Polar and Manic

Peace