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The Dual Diagnosis Dilemma: Have You Tried DRA?

If you’re suffering from a dual diagnosis—experiencing both chemical dependency as well as mental health issues—you might be interested to learn that there is an organization called Dual Recovery Anonymous.  With a set of 12 steps and 12 traditions adapted from Alcoholics Anonymous, this is a group meant to help the person who is dealing with the stigma of both types of problems.

Dual Recovery Anonymous (DRA) is no longer a new organization; it’s actually been around since 1989. The website for those interested is www.draonline.org.  DRA cites statistics by the National Institute on Mental Health (NIMH) that 41 to 65.5 percent of those with a substance abuse problem experience a concomitant psychiatric disorder, also called a co-occurring disorder. That breaks down to 10 million people affected by co-occurring diagnoses each year. There are 3 million people who have 3 mental health diagnoses, and another million who have 4 diagnoses.

Why is there such a high incidence of these addiction and psychiatric disorders co-occurring? Many people who suffer from illnesses such as depression, anxiety, mood disorders, attention deficit disorder, and other issues begin drinking or taking drugs in order to self-medicate the symptoms that bother them. Other people may have a latent potential to develop a mental health problem, whether it’s genetic or environmental, and when they abuse drugs this propensity is triggered and rises to the surface.

DRA describes these illnesses as no-fault illnesses because nobody asks for or deserves them. The chemical imbalance in the brain that makes you susceptible to addiction is no more your fault than the biochemical imbalance in the pancreas that causes someone to develop diabetes.

The NIMH website tells us that many people are experiencing problems from major depressive disorder, seasonal affective disorder, psychotic depression, or other forms of depression as well as bipolar disorder. Today’s sophisticated imaging technology such as magnetic resonance imaging (MRI) demonstrates that the brains of those who are depressed differ from the brains of people without a depression diagnosis.  It is not possible, however, for those scans to tell why someone develops those illnesses.

Typical indications of depressions include a blue mood that you just can’t shake, sleeping problems, an increase or a decrease in your appetite, difficulty in maintaining focus or concentration, and thoughts of suicide.

Newer medications enhance the levels of serotonin and norepinephrine, two helpful neurotransmitters found in the brain. Some of them help the brain to produce more of those natural biochemicals, and others help the brain to utilize serotonin for a longer period of time before this biochemical is reabsorbed. The most serious side effects reported by people who take these categories of medications include decreased sex drive, weight gain, and some insomnia. If you are taking one of them, your pharmacist will make you aware of all possible side effects.

Tricyclic antidepressants (TCAs) and monoamine oxidase inhibitors (MAOIs) have the same side effects as above, but more pronounced. Also, TCAs are not always a good choice for people with heart problems, and MAOIs interact poorly with some foods.

The side effects of antidepressant medications can be compounded when a person drinks with his medication. Alcohol is a natural depressant, and drinking along with a prescribed medication is always dangerous. If the patient is using street drugs or illegally obtained prescription medication along with his prescribed antidepressants, his symptoms will worsen and he will be unable to make good choices and recognize the realities of his life.

That’s why it’s important to combine pharmacological treatment for your depression with psychotherapy. Dual Recovery Anonymous seeks to help people deal with the fear and shame of suffering from dual diagnosis. Some substance abuse treatment counselors are trained in helping such patients so that they can make progress in treating both their addiction and their mental health diagnosis. If you or someone you know suffers from the dual dilemma of addiction and mental illness, help them to get help now.

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