Dual Diagnosis or
Co-occurring Disorders

An excerpt from the forward to At Wit's End, the new book by Jeff Jay and Jerry Boriskin, Ph.D.:

"When mental health issues and addiction become enmeshed, we refer to them as co-occurring disorders. Examples include anxiety and alcoholism or depression and addiction to narcotic pain medication. Co-occurring disorders present a greater level of complexity in diagnosis and treatment than addiction or mental health issues alone. If we treat the alcoholism without addressing the anxiety disorder, for instance, the individual may not be able to participate meaningfully in therapy or Twelve Step groups."

Learn more about At Wit's End by clicking HERE.

We are experts in dealing with co-occurring conditions and in crafting individualized interventions that meet the challenges of complex cases. We have experience dealing with bi-polar disorder, trauma (PTSD), depression, anxiety, panic, personality disorders and many other issues. We also have experience in dealing with other isses, like gambling addiction, eating disorders, sex addiction, online addiction, and more.

Her is another excerpt from At Wit's End:

"There continues to be controversy in the treatment of co-occurring disorders, even among clinicians at the same treatment center. Some argue for the primacy of mental health issues over everything else, where others claim that mental illness will almost always subside once the addict achieves sobriety. One of our goals in this book is to bring clarity to this controversy, based on the latest research and decades of first-hand clinical experience.

"Part of the dilemma that clinicians face is that there is a wide spectrum to the normal human condition, from great joy and exuberance to great pain and sorrow. But we don’t need to put a label of sickness on the extremes of this spectrum unless they are debilitating and ongoing. Some experts have a tendency to label and medicate every psychological ailment, but this is not necessarily helpful. For example, with many forms of depression, especially those with obvious causes, like the death of a parent, there are few prescriptions better than daily walks, sound nutrition, adequate sleep, and time spent talking with family and friends. Such depressions, as agonizing as they are, will normally pass.

"Of course, there are times that psychiatric medication is needed immediately. Active hallucinations, ongoing panic attacks, and crippling depression may all call for medical help. But this should be measured and must be reevaluated as treatment progresses. It is often necessary to medicate patients for anxiety in order for them to participate on any level in group therapy. However, after a period of time, they may need very little medication or none at all.

"What all this means is that there are no simple answers for complex problems. Indeed, the answers to a particular dilemma may change over time. But this is not so unusual, if we look at the analogy of a badly broken leg. At first, surgery may be required, followed by a very restrictive cast and crutches. But these interventions are not required forever. Before too long, the leg will heal and rejuvenate with the help of a less restrictive brace and physical therapy.

"In the same way, patients with co-occurring disorders may need intensive help early on, including medication. But they won’t always be in need of stabilization. With the help of ongoing therapy and a gradually less restrictive treatment environment they can regain their health and normal functioning.

"Co-occurring disorders are also referred to as dual diagnosis and co-occurring conditions, and some people use a more casual and less clinical name: double trouble. Regardless of what term is used, friends and family members of the dually diagnosed are often at wit’s end when trying to fathom the situation, much less know what steps to take to lend some normalcy to everyday life.  Addicts and the mentally ill can wreak havoc on the lives of friends and family members. When a person suffers from both, loved ones are often doubly confused and frustrated.

"Many patients suffer from apathy, cynicism and hopelessness. These maladies will never be cured by a pill, and they can’t be turned around overnight. It is necessary that patients come to believe that they can get better, that their symptoms can be put into remission, and that they can develop a new vision of their lives. This new vision–a reason to move forward—is as necessary to successful treatment as any diagnosis. It is also one of the great facts of the human condition. Once a person has a powerful reason to live, whether for love, faith, friendship, or goals, the obstacles become challenges and stubbornness turns into determination.

"Treating addiction coupled with mental illness is especially difficult because, at some point, patients must become active participants in the process. They must literally become their own treatment managers and primary care givers. Unlike an acute illness such as appendicitis, which might be treated with an operation, chronic illnesses such as addiction and mental health problems require ongoing help and support. And because patients cannot be in treatment forever, they must learn to manage their own recovery. Part of the goal of treatment is to help inspire a great awakening of a patient’s mind and spirit that will allow this miracle to take place. No one, whether patient, professional, or family member, can command this awakening to take place. But we can help bring all the elements together, along with a pinch of hope, faith, and determination."

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Jeff Jay is a nationally-recognized specialist for dual diagnosis interventions. To schedule a consultation with Jeff Jay, call 888-220-4400.

To read more excerpts from At Wit's End, visit the official website: http://dualdiagnosis.info/