Some addicts who may have a dual diagnosis might be misdiagnosed and suffer extreme side effects from medications intended to be used for other mental illnesses. This is due to symptoms they present while still under the influence of their substances of abuse. Few doctors can determine which came first, the substance abuse or the mental illness, and proper diagnosis in these cases can be tricky.
In cases of personality disorders and anxiety disorders, some of which are manifested from trauma, the substances may be what kept the individual alive until they were able to seek help for their trauma. This is most often the case with children who are sexually and physically abused. While not all children with these experiences will develop trauma-induced personality disorders or post-traumatic stress disorder (PTSD), those who do may not have resources for dealing with the situation until much later in life.
All dual diagnoses are difficult to treat because the symptoms overlap and underlie each other. Like dismantling a complex puzzle, the human psyche may present certain symptoms that seem to be one thing; and, as they are identified during treatment, manifest themselves in other areas of concern for the mental health provider. Teasing out underlying symptoms from addiction symptoms can be challenging.
Many patients have intense shame and embarrassment about their mental illness, along with social stigma they have experienced in living with their condition. Distrust of the services of those most likely to help them is another issue. Gaining the trust of someone who is mentally ill can be difficult, because they may be paranoid and suspicious by virtue of their ongoing condition. It is entirely possible they have been poorly treated by those in positions of authority or by those who were supposed to provide help to them in the past. This is often the case if they have had interactions with police and emergency medical professionals who have had to subdue and/or sedate them.
Less severe mental health disorders can respond well to treatment, once the patients have established a strong desire to maintain abstinence from substance use. This is the tricky part for mental health workers. Sometimes the substance the patient has been using has made their mental illness feel better for them. Their initial denial of their addiction will include the belief that the substance is helping them to cope with the symptoms of their mental illness.
Balancing recovery and abstinence with providing the best care for treating a patient's mental illness can seem like a three-ring circus initially. Many will relapse, due to inability to maintain use of necessary medications for treating mental illness. Given a choice, they are often more comfortable with their symptoms than they are with the unfamiliar and unknown side effects of medications that may or may not relieve their condition. Again, it is in finding the right medication to treat the individual that makes this work.
All in all, there is strong possibility for recovery for dual diagnosis clients. Many have and do recover and lead productive and happy, abstinent lives. The battle is worth the end result for everyone.