Simple Definition

Very simply, the term dual-diagnosis refers to having both an addictive disorder and another psychiatric/psychological disorder.

Examples:          

• Alcoholism + Depressive Disorder
• Cannabis Abuse + Anxiety Disorder
• Vicodin Addiction + Panic Disorder

Complex Definition 

The term dual diagnosis is typically used to describe a co-morbid occurrence within an individual where they are suffering from a substance abuse problem and mental illness. The concept of dual diagnosis may be used in the broad sense (e.g. alcoholism and depression) or it can be specific to restricted severe mental illness and substance misuse disorder (e.g. psychosis, schizophrenia and cannabis abuse). The terminology associated with “dual diagnosis” can also be used to characterize a co-occurring condition where an individual is concurrently diagnosed with AXIS I and AXIS II psychiatric disorder(s).

This is relevant in that AXIS I conditions are considered more or less treatable with methodologies such as individual therapy and psychotropic drugs (e.g. antipsychotic, anxiolytic and antidepressant medications), while AXIS II conditions are considered more or less resistant and refractory to these aforementioned types of treatments.

The reason AXIS I conditions are considered treatable through drug therapy, individual therapy or individual counseling is because of the nature of the conditions that fall under AXIS I definition(s).

AXIS I conditions amenable to methodologies offered in the specialized dual diagnosis residential drug and alcohol treatment curriculums include, but are not limited to: 

• Major Depressive Disorder
• Generalized Anxiety Disorder
• Obsessive-Compulsive Disorder
• Delusional Disorder
• Schizophrenia

AXIS II conditions are often considered retractable to such treatments found in most traditional dual diagnosis residential drug and alcohol treatment curriculums because of the actual nature of the conditions themselves. Examples of AXIS II conditions include, but are not limited to: 

• Mental Retardation
• Borderline Personality Disorder
• Antisocial Personality Disorder

Note: These conditions were initially separated from AXIS I conditions to highlight the thought at the time that they were somewhat intractable to traditional AXIS I treatment methodologies. However, there is new evidence that shows personality disorders may be managed through long-term individual therapy. 

So what does this mean? 

Essentially this means that there is a spectrum to the term dual diagnosis. This spectrum could be thought of like a measuring tool where on one side you have sub-severe dual diagnosis – on the other – severe dual diagnosis.  

Is it Unusual to have a Dual-Diagnosis? 

It is highly usual for individuals suffering from addiction to have co-occurring mental illnesses such as depression, anxiety, panic or trauma disorders. These particular types of dual diagnosis are treatable in the right residential setting.  The conditions that are more complicated to treat are the conditions that arise out of substantiated diagnoses related to the AXIS II spectrum. These conditions often require specialized treatments that do not come standard in the average dual diagnosis residential drug and alcohol treatment setting.  

Why don’t Traditionally-Based Drug Treatment Centers Treat Dual-Diagnosis Effectively? 

The problem in treating dual-diagnosis in traditional drug treatment centers is that these programs usually focus more on group-based, 12-step components. This is problematic only in the effective treatment of dual-diagnosis because group-based, 12-step methodologies are traditionally effective in the specific treatment of alcoholism, addiction and substance abuse.

However, if the program participant is experiencing a dual-diagnosis these modalities are not the most effective in treating these conditions – because psychologically based conditions really require individually therapy as a format for successful treatment. 

The goal in individually treating dual-diagnosis is to provide a forum for evaluation and assessment of what dual-issues are present. Once the nature of a dual-issue is specified, individual treatment usually focuses on the intricacies of that particular diagnosis. It is not expected that during this treatment that these issues will be completely eliminated or that the issues will disappear. The nature of the treatment is usually on creating a foundation for coping with the condition in a more productive, less self-destructive way…as well as understanding that issues impact on the addiction recovery process. 

This can really only be effectively accomplished with individualized treatment that includes individual therapy.  

How Does the Authentic Recovery Center Effectively Treat Individuals with Dual-Diagnosis? 

The ability for a drug rehab or alcohol addiction treatment program to effectively treat dual-diagnosis is derived from the programs focus on individual therapy. With the Authentic Recovery Centers focus on individual therapy as a primary component of the ARC treatment philosophy – the program is well positioned to deliver dual-diagnosis services in the most effective format possible.

The Authentic Recovery Center is a drug rehab program that focuses on offering treatment services that are more individualized than traditionally-based drug treatment centers. To see how ARC is different click here.

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