Adolescents with dual diagnoses have problems with substance abuse and another psychiatric disorder. Dealing with drug or alcohol problems is tough on its own. Dealing with a mental disorder in addition to substance abuse compounds the difficulty. Treatment providers must develop long-term plans that account for the possibility of relapse when treating adolescents with dual diagnosis.
Features
When an adolescent has a dual diagnosis, both the substance abuse and the psychiatric disorder have their own symptoms. The two problems often interact as well. When symptoms of one condition increase, the other condition often gets worse as well. Alcohol and drugs may be used to self-medicate the symptoms of a mental disorder like depression or anxiety. Alcohol and drug abuse can also increase risk for developing a mental health problem.
Common Co-Morbid Disorders
The mental disorders that most commonly co-occur with substance abuse are depression, anxiety disorders and bipolar disorder, according to HelpGuide.org. Some symptoms of depression include lack of interest in daily activities, loss of energy, feelings of hopelessness, and sleep and appetite changes. Anxiety symptoms can include excessive tension or worry, restlessness, irritability, nausea, racing heart, headaches and insomnia. Bipolar disorder is a mental health problem characterized by intense mood changes. People with bipolar disorder experience depressive symptoms. Some experience manic symptoms including euphoria, high energy and grandiosity.
Prevalence
A study of adolescents in a residential adolescent substance abuse treatment program found that 63.7 percent had co-morbid psychiatric disorders. The study was published by Bryan K. Wise, MD, MPH, and colleagues in the Journal of Substance Abuse Treatment in 2001.
In a study of adolescents with serious emotional or behavioral disturbances, 26 percent of boys and 37 percent of girls also had substance abuse problems. Those with dual diagnoses were more likely to be at risk of suicide, elopement, crime or delinquency, and discharge to institutional placements. The study was published by Dana A. Weiner, Ph.D., and colleagues in a 2001 issue of Psychiatric Services.
Treatment
Integrated treatment for both substance abuse and the psychiatric condition works best. Successful treatment programs will target both the substance abuse and the psychiatric disorder. They allow the patient to contribute to the problem-solving process. Programs should educate the adolescent about their disorders and teach coping skills to manage them effectively. Before beginning a substance abuse program, make sure it is appropriately accredited and licensed, that the treatment methods are research-based and that there is a program in place to prevent relapse. Peer support groups based on the principle of treating both disorders together are often helpful. Local state substance abuse agencies have information available about finding substance abuse treatment programs.
Goals
Successful treatment programs aim to help the patient discover the role of alcohol and/or drugs in his life. They will educate the patient about his mental health problem, about substance abuse and about how the two interact. They will also help patients identify recovery goals and help them become involved with resources to reach those goals, like supported employment.
References
- HelpGuide.org: Substance Abuse and Mental Health
- "Journal of Substance Abuse Treatment"; Dual diagnosis and successful participation of adolescents in substance abuse treatment, Bryan K. Wise MD, MPH; Oct 2001.
- "Psychiatric Services"; Clinical Characteristics of Youths With Substance Use Problems and Implications for Residential Treatment; Dana A. Weiner, Ph.D, et al; June 2001.
