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Dual diagnoses

Dual diagnoses in the field of psychiatry and addiction are quite common: against the background of long-term use of psychoactive substances, patients develop depression, anxiety disorders, phobias, panic attacks, affective disorders, and psychoses. Treatment of such patients should be carried out comprehensively, considering the characteristics and development of psychiatric practice.

 

According to various statistics, the number of people suffering from addiction and mental illness at the same time is 10-15% of the total number of addicts. Such patients exhibit typical signs and symptoms that characterize a patient with alcoholism or drug addiction - increased aggressiveness, inability to adapt, an antisocial lifestyle, manipulative behavior, and at the same time there is a non-standard clinical picture, altered by a physiological disease.

The problem is that not all narcologists recognize psychiatric pathology by recording symptoms of addiction. However, if the mental disorder is left unattended, the patient’s condition will worsen. There is a close relationship between mental disorder and mental disorder, so if only one diagnosis is treated, the second can lead to significant deterioration and disability for the patient.

In the case of dual diagnoses, the patient must be under the supervision of a narcologist and a psychiatrist: the treatment program must be selected only taking into account all aspects of the patient’s condition. During therapy, adjustments to the treatment plan may be necessary, so it is very important not to lose sight of changes in the patient’s well-being.

 

Dependence in mental illness

The opposite clinical picture is also possible: the patient may become addicted to psychoactive substances due to one or another psychiatric nature. For example, a person with clinical depression begins to abuse alcohol, or a person with bipolar disorder uses cannabinoids or synthetic drugs in large quantities. With systematic use of alcohol or drugs, the symptoms of the underlying disease progress, and ultimately the person may end up in a psychiatric hospital. During hospitalization, the patient may experience withdrawal syndrome (or withdrawal syndrome), which gives a blurred clinical picture and makes diagnosis difficult. In turn, an incorrect diagnosis and incorrectly prescribed treatment led to a deterioration in the patient’s condition.

It is critical for recovery to consider all the consequences of the disease, therefore in Israel a number of specialists are involved in making an accurate diagnosis: narcologist, psychiatrist, healthy psychologist, neurologist, 12-step program instructors, psychotherapist, social worker. Only a correct diagnosis and understanding of the cause of the patient’s condition can develop a treatment program.

 

What treatment can occur for alcohol, nicotine and drug use?

Below is a table with the most common diseases associated with regular use of various psychoactive substances and nicotine.

 

Alcohol

Depressive disorders, anxiety disorders, affective disorders, delusional disorder, psychosis, hallucinosis, panic disorder, schizophrenia, suicidal tendencies, neurological organic disorders with psychiatric symptoms, personality disorder

Cannabis

Anxiety disorders, delusional disorder, panic disorder, psychosis, psychomotor disorders, exacerbation of chronic mental illnesses, schizophrenia, schizoaffective disorder, suicidal tendencies

Opiates

Depressive disorders, panic disorders, anxiety disorders, schizophrenia, mood disorders, psychosis, personality disorder

Cocaine

Manias, panic attacks, paranoid behavior, affective disorder, panic disorder, personality disorder, schizophrenia, phobias

Psychostimulants

Mania, paranoia, insomnia, psychosis, hallucinosis, affective disorders, schizophrenia, personality disorder

Inhalants

Personality disorder, anxiety disorders, delusional disorder, hallucinosis, psychosis, schizophrenia, affective disorders

Nicotine

Depression, phobias, anxiety disorders

 

1. Depressive disorder. The disease manifests itself in inhibited reactions, apathy, drowsiness or, on the contrary, insomnia, tearfulness, lack of motivation, fading interests, lack of emotional reactions, lack of will, and suicidal tendencies.

 

2. Phobias. The condition manifests itself in attacks of unreasonable fear; it significantly worsens the patient’s quality of life. He begins to avoid repeating situations in which phobias and fears were observed, withdraw into himself, and withdraw from communication. Complete desocialization is possible.

 

3. Personality disorder. A severe psychiatric illness manifests itself in changes in character, will, mental reactions, suspiciousness, antisocial behavior, isolation, quarrelsomeness, the desire to close oneself from society are observed, and the ability to adapt is lost.

 

4. Anxiety disorder. It manifests itself in causeless anxiety, fears, worries and worries. The patient begins to live in a state of constant tension, in anticipation of trouble. Panic attacks develop against the background of an anxiety disorder.

 

5. Mania. Manifests itself in high spirits, euphoria, insomnia, feelings of omnipotence and confidence in the presence of superpowers, there is no criticism in judgments. Performance may improve. The condition is temporary, as a rule, mania is followed by depression.

 

6. Paranoia. Classic signs of paranoia are delusional thoughts and ideas, illogical judgments. The patient may seriously mention all sorts of conspiracy theories; he may be sure that they want to frame him, kill him, or cause bodily harm.

 

7. Panic attacks. They occur suddenly and panic attacks last from 2 to 30 minutes. They manifest themselves as increased heart rate, pain in the chest, attacks of suffocation, sweating, and unreasonable fear of death.

 

8. Schizophrenia. Characterized by personality disintegration, impairment of cognitive functions and emotional sphere.

 

Treatment of patients with dual diagnoses

Unfortunately, not all specialists are able to recognize and treat double diagnoses. In the practice of IsraClinic, there are many examples of patients with dual diagnoses who came for treatment from America, European countries, and the post-Soviet space after several years of unsuccessful treatment. In the case of pathologies such as schizophrenia, schizoaffective disorder or paranoid disorder, time plays a key role: if the correct treatment is not started in time, the patient’s personality will become more and more degraded. Therefore, before recommending treatment to a patient in a rehabilitation center, a thorough examination is always carried out.

 

After a psychiatric examination, doctors prescribe a therapy program. Depending on the identified pathology, therapy can be carried out on an outpatient or inpatient basis. The treatment program may include both group and individual therapy, medication, additional psychotherapeutic techniques, and the 12-step program. The entire therapeutic process is under the supervision of a psychiatrist and a narcologist. If necessary, before starting treatment, the patient may be prescribed a detox - a course of medications and restoratives to relieve physical dependence.

 

Recommendations for outpatient or inpatient treatment are given by a psychiatrist, who determines the most effective method of treating the patient. The duration of therapy is also determined - it can last from 1 month to six months.

 

If a psychiatrist gives recommendations for inpatient treatment, then the therapy is carried out within the framework of a rehabilitation center, where specialists can provide emergency psychological assistance and give medicine to relieve acute conditions. The IsraClinic rehabilitation center has all the conditions for a comfortable stay and receiving expert professional help.

Psychotherapists, psychiatrists, narcologists, rehabilitation specialists, social workers, and sports therapy instructors work with patients. Drug therapy involves the use of the most modern drugs with a minimum number of side effects.

 

Comprehensive treatment combined with an individual approach gives very good results for patients with dual diagnoses. Doctors and specialists at IsraClinic have extensive positive experience in treating dual diagnoses; we will help you and your loved ones.