Dual Diagnosis and Recovery

What is dual diagnosis?
Dual diagnosis is the term used when a person has a mood disorder such as depression or bipolar disorder (also known as manic depression) and a problem with alcohol or drugs. A person who has a dual diagnosis has two separate illnesses, and each illness needs its own treatment plan.

There is help and hope.
Mood disorders and alcohol/drug problems are both treatable illnesses. They are not moral weaknesses or character flaws. They can affect anyone, regardless of age, ethnicity or economic background. Studies have shown that more than half of the people who have depression or bipolar disorder also use alcohol and/or drugs.

What is self-medication?
Sometimes people may use alcohol or drugs to help cover up or mask symptoms of a mood disorder. For example, if a person's mind is racing because of mania, a drink of alcohol may slow it down. If a person has intense sadness or hopelessness because of depression, a drug may help him or her feel happy or hopeful for a period of time.

This "self-medication" may appear to help, but it actually makes things worse. After the temporary effects of the alcohol or drugs wear off, a person's symptoms are often worse than ever. Self-medication can cause a person's mood disorder to stay undiagnosed for a long time.

What are the symptoms of mood disorders?
Knowing the symptoms of mood disorders can help you decide to seek help. You can't diagnose yourself.

Only a health care professional can diagnose and treat a mood disorder.

Symptoms of Depression
When a person has five or more of the following symptoms, including feelings of sadness or loss of interest or pleasure, or if these symptoms interfere with a person's life, s/he may have major (clinical) depression and should see a health care professional.

• Feeling sad, crying a lot
• Major changes in appetite and sleep patterns
• Irritability, anger
• Worry, anxiety
• Pessimism, indifference, feeling like nothing will ever go right
• Loss of energy, constant exhaustion
• Unexplained aches and pains
• Feelings of guilt, worthlessness and/or hopelessness
• Not able to concentrate or make decisions
• Not able to enjoy things once enjoyed, not wanting to socialize
• Recurring thoughts of death or suicide

When a person's mood switches between depression and mania, it is called bipolar disorder (also known as manic depression).

Symptoms of Mania
When a person has three or more of the following symptoms, including an unusually excited, irritable or energized mood for a week or more, or if these symptoms interfere with a person's life, s/he may be having a manic episode and should see a health care professional.

• Increased physical and mental activity and energy
• Extreme optimism and self-confidence
• Grandiose thoughts, increased sense of selfimportance
• Irritability
• Aggressive behavior
• Decreased need for sleep without feeling tired
• Racing speech, racing thoughts
• Impulsiveness, poor judgment
• Reckless behavior such as spending sprees, major business decisions, careless driving and sexual promiscuity
• In severe cases, delusions (thinking things that aren't true) and hallucinations (seeing or hearing things that don't exist)