Many people suffering from a mental health disorder, such as depression or bipolar disorder, choose to self-medicate with alcohol. Combatting the symptoms of a mental health disorder by drinking may help individuals feel emotionally stable and better for a short period of time. However, this self-medicating behavior can quickly become a problem.
People that drink excessively build up a tolerance that requires them to drink more to achieve the same effect. After a while, it becomes a vicious cycle. Without drinking, they feel the pain from both their illness and withdrawal from alcohol.
With an estimated 140 million alcoholics in the world, according to the World Health Organization, it is safe to say a certain percentage drink to feel better, and that is where dual diagnosis treatment centers come into play.
What Is A Dual Diagnosis?
A 2011 study conducted by the USA National Survey on Drug Use and Health showed that approximately 17.5 percent of adults diagnosed with a mental health disorder also had an addiction. This adds up to almost eight million people just in the United States. A person who has both a mental illness and a substance abuse problem has a co-occurring disorder, or a dual diagnosis.
Co-occurring disorders are extremely common. Those suffering from an alcohol use disorder are much more likely to also have a mental health disorder when compared to individuals with no alcohol problem. Individuals with a mental health disorder are also much more likely to develop an addiction to alcohol than those with no mental health condition.
There is a definite link between alcohol use disorders and mental health disorders, and this link can oftentimes be complex. Mental health conditions such as depression or anxiety can often lead people to use alcohol as a coping mechanism to deal with their emotions and feelings. This can increase the risk of alcoholism, as the more someone drinks, the more his or her body becomes dependent upon alcohol.
Common Dual Diagnosis With Alcohol Use Disorder
Mental health and alcohol use disorders frequently share some of the same characteristics, and can have biological, psychological, and social components. Sometimes distinguishing which symptoms or behaviors result from which disorder may be difficult.
Some of the most common mental disorders that occur with an alcohol use disorder are:
- Bipolar disorder
- Obsessive-compulsive disorder
- Borderline personality disorder
- Antisocial personality disorder
Depression And Alcohol Use Disorders
People who suffer from depression may turn to alcohol to cope with their symptoms, such as loneliness, sadness, hopelessness, or suicidal thoughts. Alcohol is a depressant, so using a large amount of it can actually worsen a person’s feelings of hopelessness and sadness.
Most people with severe depression are prescribed antidepressants, which balance the chemicals in their brain, called neurotransmitters. Antidepressants can affect moods and emotion, help people sleep better, increase appetite, and improve concentration. Drinking alcohol while on antidepressants can counter the effects of the drugs, or make a person’s symptoms worse and more difficult to treat.
Generalized Anxiety And Alcohol Use Disorder
An anxiety disorder is marked by severe and often disproportionate anxiety in several areas of a person’s life, including work, social relationships, and financial matters. Anxiety is one of the largest mental health disorders in the country. According to the National Institute of Mental Health (NIMH), anxiety affects over 18 percent of the adult population.
Drinking alcohol can change the level of serotonin in the brain, which can intensify anxiety through a process known as the rebound effect. Drinking alcohol to lessen anxiety during social gatherings is common, yet this can also cause people to become dependent on alcohol to cope with social situations all the time. With prolonged alcohol abuse, anxiety symptoms may worsen and risk of alcoholism may increase.
One of the most effective ways to treat an anxiety disorder is with sedative medications and talk therapy (psychotherapy) that can help patients change for the better.
Bipolar And Alcohol Use Disorders
Bipolar disorder is a mental illness identifiable by a person’s drastic shifts in mood. People with bipolar disorder frequently shift from a very happy “high” to a melancholy and hopeless-feeling “low.” Many people with bipolar disorder will experience normal moods between their mania and extreme depression.
Alcohol intensifies bipolar mood changes. During an alcohol-induced manic episode, a person’s behavior may become hostile, reckless, and careless. The relationship between alcohol and bipolar disorder is no different when the person is experiencing a “low” mood. A person with bipolar disorder may become suicidal or completely isolated when they drink.
Bipolar disorder is often treated with an antipsychotic medication, as well as counseling and support to help patients get better.
Obsessive-Compulsive And Alcohol Use Disorders
Obsessive-compulsive disorder (OCD) is a chronic disorder which causes a person to have uncontrollable, recurring thoughts and/or behaviors that they feel the need to repeat over and over. A person with OCD may not have control over these obsessions and compulsions. Sometimes OCD goes away, or eases over time, but it may also worsen over time.
Some people with OCD may practice avoidance and purposely stay away from places that might make them tick. Others may try to calm themselves with drugs or alcohol, a habit which can present a lot of problems.
Using alcohol to self-medicate any mental disorder only masks the problem, instead of treating it. With time, a person who drinks to cope with OCD may become dependent on alcohol to manage their obsessive thoughts and compulsive behaviors—creating an alcohol addiction.
Borderline Personality And Alcohol Use Disorders
A borderline personality disorder (BPD) is characterized by suicidal thoughts, unstable moods, behaviors, and relationships. Drinking alcohol may cause each of these symptoms to escalate.
The National Library of Medicine estimated that 57 percent of people who suffer from BPD also have an alcohol-related disorder. Research also shows that people suffering from alcoholism were over three times more likely to be diagnosed with borderline personality disorder.
Those struggling with comorbid BPD and AUD may be less receptive to treatment, which means they may need to work a little harder to succeed in recovery. Alcohol addiction treatment is still very effective for those who adhere to treatment principles and work to build a sober life.
Antisocial Personality And Alcohol Use Disorders
Chronic antisocial personality disorder (ASPD) is characterized by a person’s heightened disregard for other people. A person with this disorder might lie, break laws, become aggressive, act impulsively, and lack regard for themselves or the safety of others.
Someone struggling with a co-occurring disorder of alcohol abuse and antisocial personality may be more prone to alcohol-related aggression than someone without these disorders. Some research indicates that up to 90 percent of people with an antisocial personality disorder have a comorbid substance use disorder as well.
ASPD is a chronic mental disorder, which means that there is no cure, and it can last throughout a person’s lifetime. ASPD typically starts affecting people between 14 and 18 years old. Talk therapy, remaining abstinent from alcohol, and aftercare support are among the best ways to treat a person with ASPD. Support groups for family members who have been affected by mental disorders and addiction are also helpful.
Challenges In Treating A Dual Diagnosis
One of the biggest challenges that people face with attending an inpatient drug or alcohol rehab program is paying for treatment. Some people find that their loved ones are willing to help them pay for rehab. Insurance companies can help pay for alcohol treatment as well.
Other challenges may start at home. With a dual diagnosis, symptoms may seem like they stem from either the substance use or the mental disorder. The symptoms of dual diagnosis can vary widely, according to each type of disorder.
Some of the indications of a comorbid alcohol use disorder are:
- withdrawal from friends and family
- obsession with alcohol
- giving up family functions to go drink
- becoming depressed or anxious when not drinking
- frequent changes in behavior
- using alcohol under dangerous conditions
- engaging in risky behaviors while drinking
- loss of control over alcohol intake
- needing alcohol to function or feel normal
- developing tolerance and withdrawal symptoms when not drinking
“Co-occurring disorders can be difficult to diagnose due to the complexity of symptoms, as both may vary in severity. In many cases, people receive treatment for one disorder while the other disorder remains untreated… undertreated co-occurring disorders can lead to a higher likelihood of experiencing homelessness, incarceration, medical illnesses, suicide, or even early death,” (Substance Abuse and Mental Health Services Administration).
Dual Diagnosis Alcohol Treatment Programs
A dual diagnosis with alcohol may be one of the hardest experiences in a person’s life. Choosing the best treatment is important, and the safest place to start may be a medical detoxification.
In medically-supervised detox programs, people can rid their bodies of harmful toxins gained during alcohol abuse while remaining safe under the care of treatment professionals. After, in an inpatient rehab program, recovering individuals can find accountability, comprehensive care, and safety.
Inpatient treatment centers that offer specialized treatment for dual diagnosis will often center their programs around a specific form of treatment and integrate other types of therapy for a complete program of recovery. These therapies may include:
- Cognitive behavioral therapy — This type of therapy helps individuals identify thoughts and feelings that are negative to overcome addiction.
- Dialectical behavioral therapy — This therapy form works to boost an individual’s self-esteem and will help the patient seek out positive environments and relationships that will promote recovery.
- Biofeedback therapy — A form of therapy that tracks the body’s involuntary functions to show individuals how they are reacting internally. They are taught things like mindfulness meditation to help combat stress, withdrawal symptoms, anxiety, and more.
Cost of Dual Diagnosis Treatment
The cost will vary by both treatment requirements and facility. Residential, or inpatient, treatment is more costly, but also more effective. Out of pocket expense for inpatient care can range anywhere from several thousand dollars to tens of thousands depending on the care plan and insurance coverage. For those with a lower level of addiction, outpatient care is possible and less expensive.
An integrated approach offers the best chance of successful recovery for those with facing both mental illness and addiction. An insurance provider may or may not cover treatment specifically for co-occurring disorders. They may ask for proof of a dual diagnosis to verify the advanced treatment is necessary. Treatment centers will sometimes require the patient or family to pay upfront or apply for financing then get reimbursement from the insurance company.
Regardless of the cost, getting the right care is worth the money. An integrated approach offers the best chance of successful recovery for those with facing both mental illness and addiction.
To learn more about treatment centers that offer programs to treat a dual diagnosis, contact us today.
- National Library of Medicine — Borderline Personality Disorder and Comorbid Addiction
- Substance Abuse and Mental Health Services Administration — Co-Occurring Disorder