Rehab for Dual Diagnosis
Why Residential Treatment Program is essential
What is dual diagnosis?
The link between
mental health & addiction
Substances are used as a way of escaping reality – and once the high wears off, the user finds that the symptoms of their mental illness return. This kind of self-medicating may provide temporary relief, but it does nothing to solve the problem. Moreover, it will almost inevitably lead to a worsening of the mental health condition and, over time, the development of a substance addiction. Self-medicating can also delay the proper diagnosis and treatment of underlying mental health disorders.
People with co-occurring disorders often have multiple combinations of the various mental disorders, such as the following:
Pathological gambling drives people to make risky wagers in order to fulfill their inner needs. A certain class of gamblers, called “action” gamblers, are in it for the excitement; another type (so-called “escape” gamblers) seek to escape from stress or negative emotions. As a result, gambling can function for many people as a stimulant similar to cocaine or amphetamines – and for others a tranquilizer or sedative. Some pathological gamblers use drugs as a means of reaching a similar psychological state.
What is dual diagnosis rehab?
- People with active mental health issues, such as unresolved trauma, anxiety, depression or psychotic symptoms
- People who use drugs or alcohol to cope with unpleasant feelings
- People with a history of childhood trauma and/or abuse
- People who require “as needed” medication and overnight support e.g. those with post-traumatic stress disorder (PTSD) symptoms such as nightmares and sleep problems
- People with poor management of emotion, memory, and cognitive functions
- People with a history of failed attempts at an inpatient or outpatient rehabilitation, for either addiction or mental health disorder
- People with a family history of substance abuse and/or mental illness
Treatment models for dual diagnosis programs
- Serial treatment: Treatment is given sequentially, in separate modules with no communication between the treatment providers
- Simultaneous/parallel: The rehab addresses all co-occurring conditions, using complementary but otherwise uncoordinated methods
- Coordinated/parallel: Using connected and coordinated but nevertheless separate systems, all conditions are treated at the same time with a formal agreement from all parties involved
- Integrated care: Treatment is given by an assigned team of clinicians within the same program to treat all underlying conditions, for the added benefit of integrated medical services
What to look for in a dual diagnosis treatment program
- Therapists and doctors with experience in co-occurring disorders, to avoid misdiagnosis
- Qualified health professionals to prescribe, dispense, and monitor medications
- The ability to design a smoothly integrated treatment plan that takes into consideration the balance between cause and effect
- Provision of mental (and medical) health support while you are going through the physical difficulties of detox
- Complementary treatment systems to address substance use disorders and other mental illnesses together
How long is rehab for dual diagnosis?
At most inpatient dual diagnosis treatment centers, you will have the opportunity to extend your stay in order to treat your substance abuse and mental health issues concurrently. Longer rehab stays have been proven to be more effective when it comes to preventing relapse once you return home from treatment.
Most common dual diagnosis
As a depressant, alcohol has long been known to slow down certain types of brain activity. However, research by the Anxiety and Depression Association of America has found that nearly 20% of Americans with depression or anxiety disorder also battle with drug dependency. This link between substance use and mental health issues underscores the need to address both situations simultaneously through professional rehab for dual diagnosis.
Several studies have shown consistent prevalence of depression among people with alcohol use disorders. Due to the effects of alcohol on the body, it can be difficult to determine whether depression is a result, or a cause, of alcohol addiction. Alcohol can alter the brain’s neural pathways, changing the balance of dopamine and serotonin. Differing levels of these two chemicals can cause highs and lows, as well as triggering the need to drink, or generating feelings of depression.
How dual diagnosis rehab works
Cognitive behavioural therapy is a form of psychotherapy that is effective for those suffering from mood disorders and anxiety, and is aimed at changing their negative thoughts and habits with more positive ones.
Dialectical behaviour therapy was initially used to treat people with borderline personality disorder (BPD), as it seeks to redirect their thoughts away from the ideas of self-harm, suicide, and drug use. The technique has since been adapted to treat people suffering from addiction, however, as many people with BPD are also involved in patterns of substance abuse. The therapy is now also used to promote abstinence, and to reduce the length and adverse impact of relapses.
Exposure therapy is designed to help those with certain anxiety disorders such as PTSD or phobias. It works by gently exposing the individual to a simulated situation, similar to the kind of stimulus which would potentially trigger an emotional response – but doing so in a controlled and safe environment, as a way of reducing their sensitivity and strengthening their coping mechanisms.
An additional layer of Eastern-influenced holistic care is often added to the luxury rehab experience in Thailand – so that treatment addresses not only the addiction itself, but also your mind, body and spirit. The effect of this east-meets-west approach is far more than merely stylistic; it presents a healthy and satisfying model for living that you can follow after you complete your stay as an inpatient.
Contingency management (or motivational incentives) can be used in addition to other treatment programs, as it introduces a reward system for good behaviour. Each psychological achievement is treated as a step toward recovery, and can be rewarded with vouchers or cash as an incentive for progress.
- Inpatient rehab provides close supervision for substance abuse and acute psychiatric symptoms, offering medical and clinical support 24/7
- Multidisciplinary teams of medical, mental health, and addiction professionals work within one setting, where they can coordinate to provide integrated disorder treatment
- Rapport can be built between rehab staff and clients as they get to know each other
- Clients can receive individualized care, focusing on recovery without distractions or temptations from their usual environment
- Clients can go through their recovery journey at their own pace in a safe and secure environment
- Group work ethos and peer support is stronger in inpatient treatment centers, as clients share their stories, seek advice, and support each other
- Clients can receive tailored detoxification treatment, including medication, to manage withdrawal symptoms and prevent relapse
- Clients can receive a relapse prevention plan along with ongoing support, to ensure a long-lasting recovery
Dual diagnosis treatment programs in Thailand
- Substance Abuse and Mental Health Services Administration. (2019). Key substance use and mental health indicators in the United States: Results from the 2018 National Survey on Drug Use and Health (HHS Publication No. PEP19-5068, NSDUH Series H-54). Rockville, MD: Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration. Retrieved from https://www.samhsa.gov/data/
- NIDA. “Comorbidity: Addiction and Other Mental Illnesses.” National Institute on Drug Abuse, 6 Jan. 2019, https://www.drugabuse.gov/sites/default/files/rrcomorbidity.pdf. Accessed 12 Feb. 2020.
- The Victorian Government. (2018). About Residential Rehabilitation. State of Victoria, Department of Health and Human Services. Retrieved from www2.health.vic.gov.au/alcohol-and-drugs/aod-treatment-services/aod-residential-treatment
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- NIDA. “Principles of Drug Addiction Treatment: A Research-Based Guide (Third Edition).” National Institute on Drug Abuse, 17 Jan. 2018, https://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition. Accessed 24 Feb. 2020.
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- Fletcher, A. M. (2013). Inside rehab: the surprising truth about addiction treatment–and how to get help that works. New York, New York: Viking.
- NIDA. “Common Comorbidities with Substance Use Disorders.” National Institute on Drug Abuse, 27 Feb. 2018, https://www.drugabuse.gov/publications/research-reports/common-comorbidities-substance-use-disorders. Accessed 25 Feb. 2020.