Mental Health and Addictions (dual diagnosis)

The National Institute for Health and Care Excellence (NICE) estimate that up to 15% of those seeking treatment for addiction in rehab also have a mental health condition. Sadly, another 20% don’t seek treatment and are shunted around community services with no positive avenue for recovery. The combination of addiction and mental health conditions is known as dual diagnosis.

Our clinicians have a background in mental health, either as psychiatrists or special interest GP’s. They can help you with free 24-hour addiction advice as well as a free rehab referral service to anyone seeking alcohol and drug treatment. We also offer free rehab advice online.

There are several factors to consider, amongst others: 

• Traumatic experiences
• Environmental features
• Genetic predisposition

It is not uncommon for those who have a significant family history of mental illness to develop an addiction. Traumatic experiences can lead people to try and seek an escape while others can become wholly reliant on medication prescribed for a mental health condition even when their clinician no longer feels it is appropriate to take it.  Sometimes drug and alcohol use can bring enjoyment to someone but it’s use can lead to a mental health condition.

When someone has a mental health condition and an addiction, the two are intertwined and cannot be separated. If one is treated and the other not, the person is not going to get into recovery. However, this realisation doesn’t have to be a negative realisation: By recognising, and understanding, that there is more than one element to treat, a better outcome can be achieved.

Dual diagnosis is not, a condition but an acknowledgement that there is a combination of both addiction and mental health condition.

The symptoms of a mental health condition and a dependency can be difficult to differentiate but each will have their own. As there are many different types of mental health condition, so there are various types of addiction.

For mental health conditions it is not uncommon to see the following:

• Withdrawal from social activities
• Loss of a job, removal from an educational course
• Poor concentration
• Appearing confused
• Very severe mood swings
• Thoughts of deliberate self-harm and suicide

Symptoms of addiction:

• A very high tolerance for alcohol/drugs and adverse reactions to withdrawal
• Putting themselves at unnecessary risks (sex parties, debt)
• Unable to finish tasks due to lacking focus
• Being reclusive and avoiding social situations
• Thinking they can only carry out daily activities if able to access the substance

Not all people who use drugs/alcohol will develop a mental health condition, just as not everyone with a mental health condition has a dependency on drugs/alcohol but it is very clear that a substance addiction will adversely affect someone with a mental health condition.

• Addiction and anxiety
• Gambling and suicidal thinking/serious self-harm
• Addiction and personality disorder
• Neurodiversity/ADHD and addiction
• Addiction and anxiety
• Bi-polar affective disorder (manic depression) and addiction
• Post Traumatic Stress disorder/Complex PTSD and addiction
• Obsessive Compulsive Disorder and addiction
• Major mental illness (schizoaffective disorder/schizophrenia) and addiction
• Addiction and managing grief
• Toxic relationships/co-dependency and addiction
• Addiction and personality disorder
• Anxiety, insomnia, anger, stress and addiction

All rehab centres provide evidence based effective treatment for addiction: That is their core function. Where a client, for example, develops anxiety and stress through alcohol, the group therapy process (and individual therapy where appropriate) can often resolve both issues. For others, until the addiction is treated, it is not possible to address a mental health condition.

Helping clients in a rehab centre who have a dual diagnosis requires a combination of different therapeutic approaches and a multi-disciplinary approach. The aim of treatment is to address the addiction while helping the person to manage their mental health condition. There is bespoke treatment available, for treatment of addiction and mental health outside of the normal rehab centre programme, at additional cost.

Here at Find me a Rehab we offer free rehab advice online. If you need 24-hour addiction advice: call or email. Our free rehab referral service is available to anyone: even if you just want to ask a question on someone else’s behalf.

This is the cornerstone and mainstay of all rehab centres. While everyone, caught up in addiction, as different experiences, there are many similarities and sharing experiences can help the individual to face up to their challenges. Most of the staff at rehab centres are in recovery themselves and take an active part in groups.

Groups help to engender a sense of acceptance, where ideas can be challenged in a supportive environment which is essential for recovery.

Away from bespoke treatment packages, nearly all rehab centres offer a session of individual therapy, weekly, to clients. The therapist may, themselves, be in recovery. Specific issues relating to a client’s dual diagnosis can be explored in these sessions and strategies to manage conditions discussed.

This therapeutic approach can be used, not only to achieve abstinence and recovery from addiction but can also be used to treat mental health conditions. For those with a dual diagnosis this is a very valuable part of the treatment process.

It is a talking therapy that is based around the concept that addiction/mental health conditions are based (wholly or in part) due to the way the client is thinking and that the resulting problems are based in unhelpful patterns of behaviour. The aim of CBT is to help the client revisit their thinking patterns and to alter them. It helps someone to see how their thoughts may be distorted which is exacerbating their problems and how to re-assess them. CBT also helps someone to re-evaluate the actions and behaviours of others and their motivations. Other aspects of CBT are to challenge, and then to change, the clients’ behavioural patterns which may include having the client face the anxiety that is causing problems, often through role play. Relaxation and self-calming strategies are also part of CBT.

Dialectical means exploring how two things, that appear at total odds with each other, can both be true: at the same time. For example, a client accepting that they are caught up in addiction may find it contradictory to then think that it is possible to recover from addiction. The aim is to help someone accept what is going on in their addiction/mental health diagnosis and how to make positive changes, to move away from behaviours that perpetuate addiction and exacerbate mental illness. One of the core elements is to help someone with new skills.

No one starts off in life wanting to be an addict or experience mental illness. Experiencing trauma is not an excuse for addiction but is usually responsible for it. Similarly, mental illness can be rooted in traumatic experiences.  It is not long-term psychotherapy as this is an extended period of treatment which could not be completed during a stay in a rehab centre. The aim of trauma-based therapy is to help a client develop more positive coping mechanisms rather than drugs, alcohol, gambling, etc.

How does it work?

A trauma-based approach looks at how the trauma is impacting on an individual. It is rooted around helping the client to understand how the trauma is connected to the present addiction and mental health condition. The second aim is to help the client by offering new skills and different strategies to assist the client to better understand their responses to the trauma and develop different coping strategies.

Regardless of the nature of the addiction, the type of dual diagnosis, aftercare is one of the strongest links in the recovery chain. All rehab centres provide aftercare with access to a weekly support group (in person or virtually) as well as telephone support. Some clients, for an additional fee, continue to use individual therapy and family therapy services based at the centre.

If you need 24-hour addiction advice, we provide a free rehab referral service for anyone seeking drug and alcohol treatment. Our clinicians work in the field of addictions, either as consultant psychiatrist addiction specialists or as special interest GPs with additional training and experience. We also offer free rehab advice online.