What Does Dual Diagnosis Mean?Dear Dr. Steve:
I’m
concerned about my daughter. She came home from the hospital almost six months to the day
that I’m writing you yet she doesn’t seem to be getting any better. Don’t
get me wrong, I’m grateful for the fact that she is no longer drinking, but she seems
so down, almost depressed. She sleeps more than I’ve ever seen her sleep before.
There are days that she can’t get out of bed to go to work. She appears sullen more
often than not. I have done everything I can to help her feel good about herself but
she’s more negative than ever. When she was in her drug program at the hospital, we
were given reason to believe that it was normal to be depressed or anxious, but I thought
for sure that this would have cleared up by now. What’s got me especially concerned
is that I overheard her talking to a friend and I thought I heard her say that there are
days where she just wishes that she were dead. I feel like I almost lost her once to
alcohol and drugs. Now that we have her back, I don’t want to take a chance of losing
her again. What do I need to do to get my daughter the help she needs?
Although
what you’re daughter is going through is by no means unusual, you have good reason to
be concerned. Oftentimes, an individual who is chemically dependent may be suffering from
a co-existing emotional disorder(s) as well. We often use the phrase dual diagnosis
to describe a condition where an individual may be diagnosed as chemically dependent as
well as suffering from a co-existing emotional disorder. Some examples of co-existing
emotional disorders follow.
Alcohol
and Depressive Disorders
It’s
not uncommon for alcoholic men and women to complain about feeling depressed. Many
symptoms of alcoholism mimic the symptoms of depression. Insomnia, appetite reduction,
hopelessness, feelings of worthlessness, and reduced energy are symptoms of both
alcoholism and depression. As a result, nearly a third of alcoholic men and women meet the
diagnostic criteria for major depressive disorder.
Because
alcohol is a depressant, many people who drink experience the depressive effects of
alcohol on their mood. It has been found that after two or three weeks of good nutrition,
proper rest, and abstinence, the temporary depressive effects of alcohol subside and the
individual’s underlying mood begins to clear up. Sadly for many others, depression
and bipolar depression are more chronic diagnosable conditions that do not clear up with
abstinence and proper nutrition. For those individuals, treatment by a qualified doctor or
psychiatrist is critical to an individual’s long-term well-being. If the depression
is not treated both timely and properly, the newly abstinent individual is much more
vulnerable to relapse.
Alcohol
and Anxiety Disorders
Alcohol
works in a similar fashion to a group of medications called benzodiazepines.
Benzondiazepines are tranquilizers that are often used as anti-anxiety agents. As such,
many people who abuse and are dependent on alcohol have learned to medicate their anxiety
by drinking. For those individuals who may have a diagnosable anxiety disorder such as
generalized anxiety disorder, social phobia, or panic disorder, alcohol may be what they
have used to provide temporary relief from their anxious feelings. Tragically, in so
doing, they have developed a dependency on alcohol as well as continue to struggle with
their co-existing anxiety disorder. For these individuals, their anxiety disorder
must be treated by a qualified doctor or psychiatrist with appropriate medications and/or
behavioral therapy.
Alcohol
and Suicide
Among
people who attempt suicide, alcoholism is a common diagnosis. For those people who commit
suicide, major depression and alcoholism are the most commonly diagnosed psychiatric
disorders. Alcoholism and drug addiction are the second most important risk factors in
people who commit suicide.
Alcoholics
are vulnerable to committing suicide because the depressive effects of alcohol can
exaggerate a co-existing depression disorder and thus increase the likelihood of an
impulsive act like suicide. For those individuals who are at risk for suicide, they need
to be treated by a qualified psychiatrist and/or psychologist.
Alcohol
and Dependence on Other Drugs
Alcohol
abuse and dependence often times co-occur with the abuse of and dependence on other mood
altering substances such as marijuana, cocaine, heroin, hallucinogens, and/or a wide range
of prescription medications. Because of this, the newly abstinent individual should be
abstinent from all mood-altering substances.
Your
daughter should be seen by a psychiatrist who specializes in the treatment of
alcoholism and drug addiction. It’s critical that the treating psychiatrist
understand the potential difficulties with prescribing certain medications to an
individual who has a co-existing addiction and emotional disorder. The psychiatrist will
do an evaluation of your daughter’s presenting problems, assess the seriousness of
her suicidal ideation, and make the appropriate treatment recommendations based on the
findings of your daughter’s evaluation.
Recover
from chemical dependency and its toxic impact on family members. Raise your children to
choose to be alcohol and other drugs free. Learn how to in Dr. Frisch’s, Psy.D.
Recovery book series—From Insanity to Serenity.
Pathfinder’s Checklist
1.) Often times a chemically dependent individual suffers from a co-existing emotional
disorder as well.
2.) If you suspect that either you or a loved one is suffering from a co-existing
emotional disorder, you or your loved one should see a qualified psychiatrist who is an
expert in addictions to evaluate and treat the co-existing mood disorder.
3.) If you suspect that either you or a loved one is at risk for committing suicide, you
or your loved one should see a qualified psychologist or psychiatrist for an evaluation.
4.) Co-existing emotional disorders can be successfully treated along with successfully
treating one’s chemical dependency.
G.B.U.
Steve
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