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Can you tell us more about dual diagnosis?

Yes, indeed. This is an important issue, as these mental health and chemical abuse and/or dependency issues frequently go hand in hand. Sometimes this is called “double trouble” because the conditions can work to keep the person destabilized. Dual diagnosis can be complicated by the fact that a diagnosis of depression or anxiety should not be made if it is a direct result of drug use. For someone involved in significant drinking of alcohol there will be some euphoria when the alcohol level is increasing, based on brain neurobiology. There may be symptoms of depression with anxiety present as the person is coming around following a hangover. This isn’t a good or healthy pattern, but it shouldn’t be used as the basis for a diagnosis of depression or anxiety. Indeed, the best research and the American Society of Addiction Medicine indicate that two to four weeks should elapse between the patient stopping alcohol use and a new or reviewed diagnosis of depression or anxiety. Why? To allow time for the brain chemistry to start to normalize and heal, because it takes time for the multiple transmitters to regulate, or approximate normal.

Psychotropic medications and psychotherapy are very important options to consider. The professionals involved with these need to know about the chemical abuse/dependency issues and treatment, and vice versa. Some people obtain a mental health diagnosis, when really the symptoms being diagnosed are due to chemical abuse or dependence. The best outcomes are seen when both conditions are treated. Why? The most direct answer is that use of drugs or alcohol would be very tempting if there is a return of depression, anxiety or other mental health conditions. The prescribers need to know this personal history to help determine which medications to use or not to use. Many times people are afraid of taking medications, and angry about having either a mental health or chemical dependency condition and diagnosis, much less both! However, success is found in accepting and treating both as fully as needed, so the whole person is restored to functioning. Different therapy approaches are needed with certain types of mental health diagnoses. Watch WYNK flash videos pertaining to your issues and interests, and be honest with all of your providers of care.

by: Lois Cochrane Schlutter, Ph.D. L.P.

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