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In our last post, we started to identify the many challenges associated with “dual diagnosis.” Today we go deeper into symptoms and identify different communities that may be susceptible.

We reported that the National Alliance on Mental Illness (NAMI) says that dual diagnosis is “a term for when someone experiences a mental illness and a substance use disorder simultaneously.” The two diagnoses share a close relationship across a number of areas. NAMI states: “Either disorder—substance use or mental illness—can develop first. People experiencing a mental health condition may turn to alcohol or other drugs as a form of self-medication to improve the mental health symptoms they experience. However, research shows that alcohol and other drugs worsen the symptoms of mental illnesses.”

NAMI further states: “According to a 2014 National Survey on Drug Use and Health, 7.9 million people in the U.S. experience both a mental disorder and substance use disorder simultaneously. More than half of those people—4.1 million to be exact—are men.”

So what are the symptoms and what populations might be at risk?

NAMI notes that the symptoms can vary widely. This is because “many combinations of dual diagnosis can occur,” As a result, “mental health clinics are starting to use alcohol and drug screening tools to help identify people at risk for drug and alcohol abuse.”

According to NAMI, substance use disorder symptoms may include:

  • Withdrawal from friends and family
  • Sudden changes in behavior
  • Using substances under dangerous conditions
  • Engaging in risky behaviors
  • Loss of control over use of substances
  • Developing a high tolerance and withdrawal symptoms
  • Feeling like you need a drug to be able to function

Symptoms of a mental health condition can also vary greatly. Warnings signs, such as extreme mood changes, confused thinking or problems concentrating, avoiding friends and social activities and thoughts of suicide, may be reason to seek help.

One population where dual disorders can occur is with military veterans. The Substance Abuse and Mental Health Services Administration (SAMHSA), part of the U.S. Department of Health and Human Services, notes that “co-occurring disorders, such as post-traumatic stress disorder (PTSD) and substance use, is prevalent among veterans and the military community. According to the Veterans Affairs Department (VA), approximately one-third of veterans seeking treatment for substance use disorders also met the criteria for PTSD.”

It continues: “Veterans and service members benefit from integrated care for mental and substance use disorders. However, some veterans may not seek medical treatment for one of many reasons, including a fear of being treated differently.”

Another area to watch: Primary Care. SAMHSA notes: “People who receive primary care often may have multiple health issues, including co-occurring disorders. Integrating behavioral and primary care is especially important to meeting their needs.”

“People with co-occurring disorders may seek primary care services first before seeking behavioral health services. As a result, primary care practitioners have unique opportunities to identify people with co-occurring disorders through screening. Screening for co-occurring disorders in primary care settings can assist practitioners in recognizing and addressing conditions early. Screening also can serve as a baseline to measure clinical progress.”

How is dual diagnosis treated? That’s our next post.