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Rehab for Mentally Ill Patients

Mental Health And Substance Abuse

Many persons attempting recovery from addiction have pre-existing mental health issues. Patients with an addiction and who have a mental health condition have co-occurring disorders and fall into a treatment protocol known as dual diagnosis.

Scientists have come to realize the powerful correlation between mental health and addiction. In order to treat the addict who has a mental health disorder like depression, bipolar disorder or anxiety, physicians have found that both conditions should be treated simultaneously.

The relationship between substance abuse and mental health can create a vicious cycle. When the individual's mental health worsens, he or she invariably turns to substance abuse to ease the symptoms of the mental disorder. Conversely, when the addict does not resupply, the mental condition worsens. Co-occurring disorders feed off each other. If untreated, the mental health condition worsens and the substance abuse increases concurrently. Successful addiction treatment must coincide with treatment of the underlying mental health condition.

Addiction is common in persons with mental health challenges. Recovering addicts with untreated mental health conditions are likely to relapse quickly.

Statistics Regarding Dual Diagnosis

The existence of co-occurring disorders is changing the way treatment centers address recovery. There have been debates about what condition to treat first, but the general consensus is that because addiction poses many health risks, detoxification should happen immediately. Treatment for the mental disorder occurs while the recovery is underway.

The Journal of American Medical Association reports the following statistics regarding dual diagnosis

  • Approximately 50 percent of people with severe mental disorders are affected by substance abuse.
  • 37 percent of alcohol abusers suffer one or more serious mental disorders.
  • 53 percent of drug abusers suffer from one or more serious mental illnesses.
  • Of all people diagnosed as mentally ill in the US, 29 percent are alcohol or drug abusers.

Drugs and alcohol only serve to worsen the mental health of an individual who has a mental health condition. The sufferer often turns to substance abuse for a temporary release from the underlying mental issue. If the substance abuser is taking medicines like anti-depressants, anti-anxiety medication or mood stabilizers, the effect of the substance abuse negates the medication and compounds the brain's sense of reward.

Diagnosing Co-Occurring Disorders

Dual diagnosis can be a challenging diagnosis for several reasons including the addict's steadfast state of denial. The addict refuses to admit their dependence on the abused substance and is likely to deny any mental health conditions as well.

In order to arrive at a dual diagnosis, the physician will use the tools that are available. Invariably, the physician will follow these steps to determine the existence of an underlying mental health condition:

Family History - The patient's family history will be scrutinized to see if such conditions as depression, or alcohol abuse or drug abuse have been part of the patient's upbringing.

Physical examination – Patients will be given a complete physical examination to uncover any undetected physical conditions and ensure they are capable of entering the recovery program.

Psychological Evaluation – The patient will undergo a psychological evaluation by a licensed professional. The purpose of the evaluation will be to uncover any undisclosed mental health conditions that could complicate the recovery.

Treatment Protocol – After the physical and psychological evaluations are complete, the patient will have a profile and a treatment protocol will be charted. If co-occurring disorders are identified, the patient will begin treatment for the metal health issue immediately but concurrently with addiction therapies.

Not all addiction treatment centers offer dual diagnosis care. In these cases, the patent would attend clinics or counseling outside the facility. However, in cases where a dual diagnosis exists, both conditions must be treated simultaneously in order to increase the opportunity for a life of abstinence.

The Most Common Mental Health Conditions Accompanying Addiction

Anxiety, depression and bipolar disorder are the three most common mental health conditions that accompany addiction. Web MD identifies the following symptoms for these three conditions.

Common signs and symptoms of depression

  • Feelings of helplessness and hopelessness
  • Loss of interest in daily activities
  • Inability to experience pleasure
  • Appetite or weight changes
  • Sleep changes
  • Loss of energy
  • Strong feelings of worthlessness or guilt
  • Concentration problems
  • Anger, physical pain, and reckless behavior (especially in men)

Common signs and symptoms of mania in bipolar disorder

  • Feelings of euphoria or extreme irritability
  • Unrealistic, grandiose beliefs
  • Decreased need for sleep
  • Increased energy
  • Rapid speech and racing thoughts
  • Impaired judgment and impulsivity
  • Hyperactivity
  • Anger or rage

Common signs and symptoms of anxiety

  • Excessive tension and worry
  • Feeling restless or jumpy
  • Irritability or feeling "on edge"
  • Racing heart or shortness of breath
  • Nausea, trembling, or dizziness
  • Muscle tension, headaches
  • Trouble concentrating
  • Insomnia

Treatment for Dual Diagnosis

Every addiction recovery protocol is different. People with co-occurring disorders face a greater challenge than patients without dual diagnosis. Treatment programs use different approaches in treating co-occurring disorders but there are certain standards that are shared by most centers.

  • Treatment will address the addiction and the mental health issue.
  • The patient is actively involved in the recovery, setting goals, making decisions and developing strategies that affect the disorders.
  • Treatment will include education about both disorders.
  • Patients will learn to develop strong coping skills.
  • The patient will be taught better relationship skills.
  • Dual diagnosis patients will receive special counseling in single sessions or group therapy.

Tips For Dual Diagnosis Recovery

The following tips for patients with addiction and a co-occurring mental health disorder are important to a successful rehabilitation experience.

Learn to recognize and manage stress and emotions – Identifying the triggers and developing coping skills to better manage the effects of triggers is an important step in the recovery process. Patients should develop action plans to counter the effects of triggering situations.

Engage Support – Patients should develop support networks and stay active in these groups. No other person understands your challenges better than someone who is experiencing the same challenges. Alcoholics Anonymous and Narcotics Anonymous are the largest two support networks in the US.

Make Healthy Lifestyle Choices – Turn the page on your old lifestyle, set aside your relationships that encouraged substance abuse and look to the future. Exercise regularly, eat healthy foods, get enough sleep and have a positive outlook. Recovering addicts will face many potential obstacles but if they are committed and have support, a life of abstinence is possible.

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