Dual Diagnosis Alcohol and Depression

Dual Diagnosis Alcohol and Depression

A dual diagnosis occurs when an individual is struggling with both a substance use disorder and a coexisting mental health disorder. Dual diagnosis is a complex and prevalent condition that impacts about 25% of those with a drug or alcohol addiction, according to the Substance Abuse and Mental Health Services Administration. Of those, the most common is the dual diagnosis alcohol and depression combination.

There are two ways the dual diagnosis alcohol and depression can develop. In some cases, the individual is experience a major depressive episode and may turn to alcohol as a means of self-medicating their emotional pain away. Over time, the tolerance to alcohol increases, resulting in more excessive drinking and potentially alcohol addiction. This is a situation where depression was a precursor to alcoholism. In others, the individual develops alcoholism first. As the consequences that result from the alcohol addiction mount, depression can set in, indicating that alcoholism can trigger a depressive disorder. In both scenarios, the dual diagnosis alcohol and depression is the outcome.

This particular dual diagnosis is a particularly dangerous one. Because alcohol is a depressant, and can cause major devastation in all aspects of one’s life, when co-occurring with depression there is a higher risk of suicide. In fact, suicide rates among alcoholics are exorbitantly high. According to a study published in the International Journal of Environmental Research and Public Health, among alcoholics, the lifetime risk of suicide is 10%-15%, and that, in fact, depression and alcoholism were comorbid in 85% of 100 cases of completed suicide.

Treatment for individuals who present with this dual diagnosis of alcohol and depression will need to be provided through a specialized dual diagnosis provider where both disorders will be treated simultaneously for the best recovery outcome. These programs include psychiatric expertise on staff that are trained to respond to the issues that may emerge during detoxification and rehab.

Signs of the Dual Diagnosis Alcohol and Depression Co-Occurrence

The symptoms of both disorders, depressive disorder and alcohol dependency, will be evident in individuals who have developed this dual diagnosis. These symptoms include:

Depression

  • Sadness, despair, hopelessness
  • Fatigue
  • Loss of desire to participate in usual activities
  • Weight loss or gain
  • Insomnia or hypersomnia
  • Slowed motor and cognitive functioning
  • Inappropriate feelings of shame or guilt
  • Trouble concentrating or making decisions
  • Suicidal thoughts

Alcoholism

  • Tolerance increases causing increased alcohol consumption
  • Experiences blackouts
  • Increasing time spent thinking about, obtaining alcohol, and recovering from drinking
  • Continue to drink despite negative consequences
  • Secretive behavior, hiding alcohol, lying about how much is being consumed
  • Efforts to quit or cut back are ineffective
  • Physical signs include bloating, glassy eyes, ruddy complexion
  • Withdrawal signs commence when alcohol is not available

Characteristics of Alcoholism and Coexisting Depression

The fallout for this dual diagnosis can be exceptional. Struggling with both depression and alcohol dependency can result in a slew of negative consequences. This can be due to the increased impulsivity of the alcoholic, an increase in risk-taking behaviors, and neglecting obligations, among other causes.

Consequences of the dual diagnosis of alcoholism and depression might include:

  • Loss of job
  • Divorce or interpersonal relationship issues
  • Loss of custody
  • Financial consequences due to job loss
  • Legal problems, such as getting a DUI
  • Health problems, such as pancreatitis, liver disease, heart disease, cancer
  • Accidents that result in injury to self or others, or damaged property

Individuals with a dual diagnosis of alcoholism and depression should not ignore the need for professional help. Loved ones who recognize these signs and symptoms are encouraged to seek out treatment for the individual.

Suicide Prevention

One of the more devastating consequences of alcoholism/depression co-occurring disorders is the dramatically increased risk of suicide. Primary care providers are being trained to assess for risk of suicide among patients who are alcohol dependent, hopefully increasing referrals to addiction treatment programs. These patients should be questioned about possible presence of depression symptoms as a way of identifying suicide risk in this group.

Suicide awareness includes recognizing symptoms such as:

  • Prolonged and persistent sadness, signs of hopelessness
  • The individual conveys the opinion that his or her loved ones are better off without them
  • Isolating behaviors
  • Loneliness
  • Successive setbacks that occur, such as relationship problems, loss of employment, financial difficulties
  • Appear to be giving away prized possessions
  • Making end of life arrangements
  • Saying goodbye to loved ones and friends
  • Acquiring the means to commit suicide, such as a firearm, rope, pills

If there is a present danger of suicide, immediately contact the National Suicide Prevention Lifeline at (800) 273-8255.

Comprehensive Treatment for Dual Diagnosis

Treatment for the dual diagnosis will involve a full spectrum of therapeutic interventions that work together in an integrated approach to recovery. These treatment elements include:

Medically supervised detox and withdrawal: Alcohol detox should always be medically supervised, as potentially dangerous withdrawal symptoms can suddenly emerge. Detoxification is treated using benzodiazepines and other medications to ease symptoms.

Individual psychotherapy: Therapy is an essential core element for treating both disorders. The therapist will guide the individual to examine sources of emotional pain and help them resolve these. In addition, cognitive behavioral therapy helps shift addiction responses toward positive, productive behavioral responses, as well as teaching coping skills.

Group counseling. Group therapy supports peer interaction and is a source for sharing and accountability.

Medication management. Medications for the mental health disorder and/or the alcoholism may include antidepressants and naltrexone.

Relapse Prevention: Individuals create a detailed relapse prevention strategy by identifying specific triggers or situations that could lead to relapse, and response strategies as well.

Continuing care services: Following completion of the program, sober living housing, 12-step group participation, and outpatient counseling are strongly encouraged.

Ken Seeley Communities Provides Expert Dual Diagnosis Treatment

Ken Seeley Communities is a Palm Springs-based addiction and dual diagnosis recovery program. The expert dual diagnosis clinical staff is trained to treat both disorders, alcoholism and depression, concurrently, providing detox, rehab, and sober living transitional housing. Ken Seeley Communities features a unique approach to guiding individuals into recovery, including intervention services and a subsequent continuum of care throughout the recovery process. For more detail about the program, please contact Ken Seeley Communities today at (877) 744-0502.

 

10 relapse triggers

10 Relapse Triggers

Like the drip, drip, drip of a leaky pipe before it blows, the onset of a relapse begins with small, nearly undetectable, signs. As anyone in recovery will tell you, the threat of relapse is ever present as the “monster” just lies in wait. As it is often referred to, addiction is a wily foe. It is stealthy and omnipresent, and seeks opportunities should you let your guard down.

While in treatment there is an important emphasis on relapse prevention planning. Clients are encouraged to give this assignment careful attention, and to do a thorough and introspective review of potential triggers. Many triggers are obvious, such as hanging out with people who use or drink or becoming over confident to the point of deluding yourself. But with so many possible triggers that can trip up the newly sober individual it bears reviewing here the most common 10 relapse triggers.

That Are the Most Common 10 Relapse Triggers?

Early recovery requires constant vigilance on behalf of the newly sober individual. The addict brain is cunning and will continue to try to convince you to return to using. Being aware of the traps is intrinsic to overcoming the lure when the wrong path beckons. The 10 relapse triggers that most often befall the recovering addict or alcoholic include the following:

  1. Boredom. Too much down time can allow the mind to conjure up ideas and thoughts about using drugs or alcohol in order to relieve boredom. Just being still and alone with oneself if sometimes very difficult in early recovery, tempting some to return to the substance.
  2. Loneliness. Cutting old friends loose in recovery can result in feelings of loneliness. Loneliness is a very powerful emotion that can quickly lead to romancing the substance again, using it as substitution for a human relationship.
  3. Stress. In many cases, abusing drugs or alcohol was initially used as a coping tool for managing stress, so navigating stress in recovery without the crutch can be challenging. Work and family stress can overpower someone in recovery, leading to a relapse.
  4. Mental health disorder. An untreated or undiagnosed mental health condition, such as depression or anxiety, can be very triggering. Many with a mood disorder or anxiety used alcohol or drugs to self-medicate, or mask the difficult symptoms.
  5. Glamorizing addiction. After a certain period of sobriety it is common for those in recovery to begin playing head games with themselves, romancing their time as an addict and pining away for those freewheeling days.
  6. Social connections. Continuing to hang out with friends or acquaintances that party and do not support your recovery will eventually trigger a relapse.
  7. Dating. A.A. recommends that someone in early recovery wait a year before initiating a new relationship. Romantic strife or a breakup can trigger deep emotions that may trigger a relapse.
  8. Overconfidence. Many a recovering addict has fallen victim to overconfidence. After a year or so it may seem entirely reasonable that you can handle having just one drink at an event, resulting in a weeklong bender that ends with a readmit to rehab.
  9. Stop working the program. Recovery is hard work. It requires your constant attention and a lot of self-discipline. Some may grow weary from this and begin to skip meetings or continue nurturing sober friendships and connections, and that can leave the person vulnerable to relapse.
  10. Guilt and shame. In recovery, many may feel the full effect of the damage done and harm caused while in active addiction. The feelings of guilt and low self-esteem around these realizations can lead the person to believe there is no point in remaining sober.

Addiction is a complex disease. The triggers that could send one person careening toward relapse may not affect another at all. Knowing your own particular weaknesses and vulnerabilities and humbly seeking support when it becomes clear that the “pipe is springing leaks” and is about to burst. Call someone. Go to a meeting. Distract yourself with a project. Do not let the wily one win.

Ken Seeley Communities is a Full Service Addiction Program in Palm Springs

Ken Seeley Communities provides a wide range of addiction treatment services, including intervention services, medical detox, outpatient programming, residential rehab, and sober living housing. Our continuing care services can help the newly sober client confront the 10 relapse triggers mentioned above and reinforce relapse prevention. Ken Seeley has a long career in the field of addiction recovery, and is well known for his appearances on A&E’s Intervention series.

Nestled in a beautiful and serene desert setting in Palm Springs, California, Ken Seeley Communities offers an effective blend of evidence-based psychotherapies, complimentary holistic therapies, and a sense of community that helps foster a new healthy life in recovery. For more information about our spectrum of services, please reach out to Ken Seeley Communities today at (877) 744-0502.