If you are a woman struggling with alcohol or a chemical dependency and also have a simultaneous behavior or mood disorder, you have what is called dual diagnosis addiction. This is not all that uncommon. An estimated 53 percent of women who are chemically dependent have one or more behavioral or mood issues. Since either condition by itself can complicate treatment, the most effective treatment addresses both conditions at the same time in a coordinated treatment program.
Co-occurring Behavioral or Mood Disorders
Women admitted to a treatment program to combat alcohol or chemical dependency often have these behavioral or mood disorders:
• Depression, such as bi-polar disorder
• Attention deficit hyperactivity disorder (ADHD)
• Anxiety disorders, including post traumatic stress disorder (PTSD)
• Panic disorder
• Obsessive-compulsive disorder (OCD)
• Other psychiatric disorders such as schizophrenia and personality disorder
How Treatment is Different
Women with dual diagnosis need a treatment program that works to treat both addition and disorder concurrently. Sometimes a woman will be admitted seeking treatment for addiction to alcohol or drugs, and during the initial screening and assessment, another disorder is discovered. Frequently, as the patient achieves sobriety for a sustained period during which she undergoes counseling, the co-occurring disorder becomes less severe or pronounced.
Specifics on the Admissions Process
Just as in admission to treatment for any other addiction, the first step is an initial pre-screening and assessment. What’s different in the dual diagnosis is that the woman also undergoes an initial psychological assessment. Her medical records, as well as a complete history of substance abuse, are analyzed. The treatment facility staff documents the dual diagnosis and integrates the information into the patient’s treatment program that is personalized to meet her specific needs. This personalized treatment plan is crucial, since each woman responds differently to treatment and medications, and each has a different motivation.
The patient or client, as treatment facilities prefer to refer to the women, meets with psychologists or psychiatrists trained in addiction medicine as part of the admissions process. These psychologists make any necessary adjustments to the treatment program depending on the type of dual diagnosis they identify (anxiety disorder, depressive disorder, ADHS, panic disorder, OCD, phobia, or other disorder). At this time, any required medications are ordered to treat the client and are dispensed by nursing staff during the individual’s treatment stay.
First Step: Detox
Within a short time after admission, the client has an individualized treatment plan and begins the all-important first step of detoxification – clearing her body of alcohol or drugs. Depending on the substance, length of time using, any underlying medical conditions, family history and other factors, this detox period could last 1 to 2 days or as many as 5 days or longer.
Once the body is free of drugs and/or alcohol, the next phase of the treatment can begin. This is where the woman starts to address the kinds of issues that have kept her from being able live a sober life, and to overcome or manage her disorder.
Dual Diagnosis Requires a Variety of Treatment Methods
During the client’s stay she receives treatment for chemical dependency as well as treatment for emotional or psychiatric problems. This involves individual as well as group counseling and therapy for the specific issues – such as PTSD, OCD, anxiety, or depression.
If required for the woman’s personalized treatment plan, clinicians on staff help her with trauma resolution or PTSD. Highly-skilled counselors manage each female client’s case, monitor her progress, and act as the one-on-one between the client and her family.
Staff at the treatment facility for dual diagnosis clients meets frequently to discuss the individual cases. The multi-disciplinary team approach to treatment has been found to be the most effective in treating dual diagnosis addiction. Through such careful coordination and communication, if any other disorder is discovered that requires treatment, the client is then referred to the appropriate counselor or group for therapy for that issue. In the event that an issue is beyond the scope of the treatment facility, the client will be referred to the specialist or facility that can address the issue.
The following is a list of some of the various treatment methods used to treat dual diagnosis. This is not an all-inclusive list, but is meant to be representative of dual diagnosis treatment. Different treatment facilities may utilize other methods in addition to or in place of these:
• Individual counseling
• Group therapy
• Cognitive Behavioral Therapy (CBT)
• Rational Emotive Behavioral Therapy (REBT)
• Experiential therapy
• Eye Movement Desensitization and Reprocessing Therapy (EMDR)
• Various individualized 12-step support groups (Alcoholics Anonymous, Cocaine Anonymous, Narcotics Anonymous, etc.)
• Family treatment program
Healing Body, Mind and Spirit
In a nurturing, calming and comfortable treatment environment, the woman with dual diagnosis addiction is better able to heal. In the best treatment facilities, the process works seamlessly to heal the client’s body, mind and spirit by concentrating on the physical, emotional and spiritual aspects of her life.
If the treatment facility is not able to or does not address the client’s issues while she is in treatment for dual diagnosis, the potential for relapse is significant.
Importance of Family Treatment
The woman who is under the care of the treatment facility for dual diagnosis must eventually return to her family (assuming she has one). If nothing has changed in their attitudes or beliefs or if they haven’t learned how to be supportive of her recovery, the possibility of relapse increases.
To combat this, effective treatment for dual diagnosis addiction incorporates family members into a family treatment program. In some cases, this may be a once per week meeting, whereas other treatment facilities offer an intensive 3-day family treatment program. Whatever the duration and frequency, the important point is that family members learn about the addiction and disorder that the client has, and how they can be supportive and change certain behaviors and beliefs they may hold in order to more enhance the probability of the client’s lasting recovery.
Extended Care and Aftercare
Following treatment for dual diagnosis addiction, the client is encouraged as part of her long-term recovery to attend 12-step meetings and to participate in continuing therapy and workshops. For some clients, transition to a sober-living extended care home or facility is required before they can fully integrate back into society. At the sober living facility, they continue to receive individual counseling and attend group therapy sessions, go to 12-step recovery meetings, and attend addiction workshops, recovery lectures and family groups.
Not every woman who is admitted for dual diagnosis addiction will need to go to a sober living facility upon completion of the treatment program. But for those who do need it, the support and resources are invaluable in their recovery.
Women should, however, continue to attend 12-step recovery meetings and be in contact with their therapist or counselor as needed. Whenever a life stress or problem emerges that she feels she cannot handle, these allies and professionals serve as an always-available helpline.
Recovery is possible from dual diagnosis addiction. It takes time to go through the treatment program, however, and neither the client nor her family should get into the mindset that there’s a quick and easy cure. Once in recovery, the client will always be in recovery for addiction. But recovery should be looked on as an exciting opportunity for a full and rewarding life. For the woman who has suffered with dual diagnosis addiction, such a future of promise, while perhaps beyond the scope of her dreams to begin with, is a very real goal to strive for.