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A person may have an addiction to drugs or she may have a mental disorder—or she may have them both at the same time. When this happens, special care must be taken so that this person will receive help for both conditions at the same time,
It is often not clear which came first—substance use or mental disorder. Whether that LGBT person first had the mental disorder and began drinking more alcohol to mask the symptoms of that, or whether she was abusing drugs and that caused severe depression, it doesn’t matter nearly as much as that they are both addressed in treatment. When more than one issue is present, they all must be treated with the other one in mind.
What Is a Dual Diagnosis?
When a person in the LGBT community has a mental disorder at the same time as a substance use problem, the two situations can each blur the other. Especially as the person seeks treatment for one issue, it is important that every part is identified and therefore dealt with together. For instance, working only toward fixing a mental health problem, such as bipolar disorder, without also addressing that person’s alcoholism, will not result in complete recovery. If more than one thing is going on, it all needs to be addressed together.
When a person is diagnosed with both a mental health disorder and a substance use disorder it is called a Dual Diagnosis or co-occurring disorder. This diagnosis is made when “at least one disorder of each type can be established independent of the other and is not simply a cluster of symptoms resulting from the one disorder.”
According to the Substance Abuse and Mental Health Services Administration (SAMHSA), about 8.9 million adults have co-occurring disorders. Of those, only 7.4 percent receive treatment for both conditions, with 55.8 percent receiving no treatment at all. People with dual disorders are at high risk for many additional problems including the following:
- Symptomatic relapses
- Financial problems
- Social isolation
- Family problems
- Sexual and physical victimization
- Serious medical illnesses such as HIV and hepatitis B and C
- Early death
By dealing with both disorders together in an integrated treatment, the outcomes are more likely to be positive. Other benefits of the proper, integrated treatment may include the following:
- Reduced substance use
- Improved psychiatric symptoms and functioning
- Decreased hospitalization
- Increased housing stability
- Fewer arrests
- Improved quality of life
If you are physically dependent on a substance, even if you show no other signs of addiction, that still is considered an addiction. If the dependence is on a medication prescribed for you in relation to a mental disorder, it can still turn into an addiction and therefore be considered to be co-occurring with the original problem.
Psychiatric disorders most prevalent among dually diagnosed patients in the LGBT community include mood disorders, anxiety disorders, personality disorders and psychotic disorders. Common examples of co-occurring disorders include the following:
- Major depression with cocaine addiction
- Alcohol addiction with panic disorder
- Alcoholism and polydrug addiction with schizophrenia
- Borderline personality disorder with episodic polydrug abuse
It is possible for a person to have more than two disorders. The principles that apply to dual disorders generally apply also to multiple disorders.
Why Is Treatment for Patients with Dual Diagnoses So Complex?
An LGBT person who has dual disorders often also has more severe and chronic medical, social and emotional problems. It makes sense that because there are more issues that need help there are more pieces to the puzzle that can come undone.
They are vulnerable to relapse from the substance use and also may experience a worsening of the psychiatric disorder. It can be a vicious cycle, since once a person has an addiction relapse, this “can lead to psychiatric decompensation, and worsening of psychiatric problems often leads to addiction relapse,” according to Psychology Today. “Relapse prevention must be specially designed for patients with dual disorders. Compared with patients who have a single disorder, patients with dual disorders often require longer treatment, have more crises and progress more gradually in treatment.”
Learn More About Co-Occurring Disorders
If you or someone you love in the LGBT community need to seek treatment for either a substance use disorder or a mental disorder, consider that there may be more than one issue that needs to be addressed. Dual Diagnoses are extremely complex and require special attention when it comes to treatment options. To learn more about the intricacies and possibilities of what treatment for a Dual Diagnosis entails, contact our admissions coordinators any time 24 hours a day, seven days a week at our toll-free helpline. They will be happy to discuss options and give you more information as you begin to make decisions. Please call today.
 “Co-occurring Disorders,” Psychology Today, last reviewed Dec. 27, 2015, www.psychologytoday.com/conditions/co-occurring-disorders