Dual Diagnosis
The Alcohol, Drug Abuse, and Mental Health Administration (ADAMA) states that at least 50 percent of the 1.5 to 2 million Americans who have severe mental illnesses also abuse alcohol or illicit drugs, compared to 15 percent of the general population. (Talbot, 1987) The National Institute on Alcohol Abuse and Alcoholism released results of a study done in 1993 where clinicians attempted to make psychiatric diagnoses on suicide victims. After interviewing family members of over 1400 suicide victims they reported a finding that most of the suicide victims had suffered from a mood disorder, and that nearly half, or 48 percent also suffered from alcoholism or drug abuse. Severe depression accompanied by substance abuse has been shown again and again to be one of the most frequent causes of suicide.
Dual Diagnosis is defined as "the simultaneous occurrence of a psychiatric disorder and a substance abuse disorder in the same individual at the time of diagnosis." It is often difficult to determine if an individual turned to substance abuse (especially alcohol) as a means of ending his pain, or if there was an underlying vulnerability that precipitated both the mental illness and the substance abuse. In fact it makes little difference whether the "chicken or the egg" came first...once a person has a mental illness and an addiction he/she is in a very difficult position and in great danger of becoming a statistic.
An individual with unmedicated Bipolar Disorder, or one who has never been diagnosed is at great risk. Even if the mental illness is recognized and is being treated with the appropriate medications and therapies it doesn't necessarily mean that the substance abuse problem will go away. Certainly, in a person whose symptoms of Bipolar Disorder are controlled substance abuse is easier to treat, but BOTH must be addressed. It is essential that anyone with Bipolar Disorder who also has an addiction problem advise his/her doctor or psychiatrist. An active substance abuse problem will make a diagnosis of mental illness more difficult, as well as the treatment of that disorder.
One of the most difficult things the individual with dual diagnosis must do is to admit that the substance abuse is a problem. This happens mostly in terms of alcohol, as those using drugs generally know that they are addicted. An individual can often recognize alcohol addiction or dependence simply by asking himself a few questions.
Do I drink more or for a longer period than I intended?
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