Question

Discuss whether more than just three major mental illnesses should be used to define dual diagnosis.

Answer 1

Dual diagnosis is a term used to describe a person who is diagnosed with a mental disorder and a substance abuse at the same time. Among people who are diagnosed with a serious mental illness such as schizophrenia, bipolar, anxiety,etc., also have the chances of some substance abuse such as drugs, alcohol, etc. This complex disturbance in the individual's life may complicate the recovery process.

Sometimes these are the substance that may cause the mental disturbance. For example, when a alcoholic person don't get the alcohol, he get anxious and depressed. Often the effect of particular substance serve to counter the symptoms of the corresponding mental disturbance. For example, relaxing drugs are more used by people who have anxiety related disorders.

It is very common that a particular disorder is comorbid with other disorders and sometimes with substance abuse. Schizophrenia and anti social personality disorder have high comorbidity with sbustance abuse. Schizophrenic people are more likely to use stimulants such as cocaine, marijuana, etc. Depressed and anxious people usually have alcohol abusive habits.

It is not just three or four mental disorders that are defined by dual diagnosis. Dual diagnosis is a very common diagnosis. In most of the cases the comorbidity is recorded. As discussed earlier, the treatment of such patients is very difficult. Most of the substance abuse centers do not accept peole with some mental illness as well as may psychiatric centers do not have expertise in substance abuse. There are many other challenges that comes to treat the dual diagnosis patient, as,

• Comorbid disorder is more severe than that of substance abuse
• Substance abuse is more severe than the mental disorder
• Medication sometimes decrease the severity of one disoder but can increase the other's
• Exposure to the extenal environment may be a risk factor

The treatment of such disorders may be done by different procedures. There are two ways of treating people with dual diagnosis:

1. Sequentially: The treatment should go on sequentially. It means first treat the addiction and then treat the underline mental disorder OR first treat the mental disorder and then the addiction.
2. Separately: The treatment should be done simultaneously. Means that the treatment of the problem of addiction and the mental illness should be done at the same time but by different doctors.