Dual diagnosis

A dual diagnosis is an addiction and a mental health condition that influence one another. The meaning of a dual diagnosis is not only clinical: it describes two problems that hold each other in place, which is why they are treated together rather than one after the other.

A dual diagnosis is an addiction and a mental health condition that influence one another. When you use, the symptoms of the condition often seem to ease. You might drink to quieten a restlessness, use drugs to blunt a pain you cannot place, or gamble to fill an emptiness. The relief tends to be short-lived, and the same substance can make those symptoms sharper. What starts as self-medication can develop into an addiction.

According to the Trimbos Institute, the Dutch centre of expertise on addiction, between 20 and 80% of people with a mental health condition also have an addiction. A range that wide says something in itself. A dual diagnosis is common, and it frequently goes unrecognised. It is why integrated treatment matters so much to us at Connection SGGZ, aimed at breaking the pattern for the long term.

Your mental health and your drinking, drug use or gambling are bound up in each other. Each can keep the other going, and each can make the other worse. If only the addiction is treated, or only the mental strain, the chance of relapsing later is greater.

Conditions that can be part of a dual diagnosis:

• personality disorders such as borderline personality disorder
• autism
• ADHD
• mood disorders such as depression
• anxiety disorders
• trauma and post-traumatic stress disorder (PTSD)

The symptoms these conditions bring can be closely tied to what you use. Your head never quite switches off, and you can never settle on one thing at a time. Social situations leave you overloaded. Or drugs make fears you know are out of proportion feel more manageable. There are many other routes into this kind of unintended self-medication.

In the short term it works. Over time, substances tend to leave you more anxious, lower or more impulsive, and that feeds the urge to use again.

An addiction often runs alongside something underneath it. Mental health symptoms can make using more tempting, which makes stopping harder. And using can make those symptoms worse in return.

Breaking that circle on your own can be hard, particularly if you have had treatment before that only addressed one half of it. You do not have to work it out alone. Our multidisciplinary team treats both sides, and works with you towards a life without addiction.

Some patterns stand out:

• you have had addiction treatment before, but the mental health symptoms stayed;
• you have been treated within the Dutch mental health system (GGZ), and the drinking, drug use or gambling came back each time;
• you need something to quieten your head or to feel like yourself;
• the people close to you are worried, and you no longer know where to begin.

If any of that feels familiar, rehab for a dual diagnosis may be closer to what you need. Treating the addiction alone, or the mental health condition alone, tends to leave more room for relapse.

Connection SGGZ specialises in treating addiction alongside an underlying condition. Together, that is what we call a dual diagnosis.

Rehab for a dual diagnosis starts with an addiction assessment. It is a conversation rather than a checklist. We get to know you, and you have room to talk openly about what you use and about how you have been feeling. From there we can see which rehabilitation centre and which form of treatment fit your situation, and we build your treatment plan around that. As a dual diagnosis addiction treatment centre, that is what we mean by care built around you, your circumstances and your recovery.

Our dual diagnosis treatment centres offer two broad forms of treatment, and the difference between them matters.

Outpatient treatment or day treatment means you follow the programme during the day and go home afterwards. You can put what you learn straight into practice in your own life, which works best when your home situation is stable and you have people around you.

Inpatient treatment or residential treatment means staying with us for a number of weeks. You step out of your old surroundings altogether, away from the triggers of an ordinary day, with nothing else competing for your attention.

Looking for dual diagnosis rehab near you? Our dual diagnosis rehab centres are in Eindhoven, Meerlo and Utrecht, and we have a dual diagnosis rehab facility in South Africa. Whichever form fits, the principle holds: we treat the addiction and the mental health condition in relation to each other. Alcohol rehab with a dual diagnosis works the same way as treatment for drug addiction, prescription drug addiction or gambling addiction.

With a dual diagnosis you receive integrated treatment. We look past the using or the behaviour and how to stop it, to what keeps setting it off.

When we understand what else is going on, and which condition may be driving it, we can look for an answer together. From there you can learn other, healthier ways of handling those symptoms. That applies whether you come to us for alcohol rehab with a dual diagnosis, a drug or medication addiction, or a behavioural addiction such as gambling.

Dual diagnosis treatment here is thorough and personal, with both group therapy and individual sessions. Depending on what you need, EMDR, cognitive behavioural therapy and relapse prevention form part of it. Our team is with you from the first contact through to aftercare, which gives you a better chance of success.

Dual diagnosis treatment centres can end up working on symptoms alone. When we treat the mental health side of a dual diagnosis, we look beyond the symptoms to the layer underneath. Where does the restlessness come from? Which experiences or patterns hold the using in place? Giving that room means you are working on lasting recovery, not only on abstinence.

We involve family and the people close to you where that is welcome and appropriate, including through a family meeting.

Connection SGGZ is a member of the LEDD, the Dutch national centre of expertise and implementation for dual diagnosis. It exists to make collaboration around dual diagnosis run smoothly between professionals from different fields.

We are proud to be part of it. Alongside other organisations we share what we know through dual diagnosis training, teaching and advice, which raises the standard of integrated treatment. Dual diagnosis training is one of the ways that knowledge travels between organisations rather than staying inside one of them.

The two terms are often used interchangeably. Comorbidity is the broader one and covers any combination of illnesses or conditions occurring together. That could be diabetes alongside an addiction, or two conditions, mental or physical, with no bearing on addiction at all.

Dual diagnosis is narrower. It describes an addiction together with a psychiatric disorder. That is where the meaning of dual diagnosis parts company with comorbidity. Both are complex, and both call for intensive treatment that fits the situation.

If you live in the Netherlands, treatment for a dual diagnosis at Connection SGGZ is covered by your basic health insurance (basisverzekering) in most cases. Your own risk excess (eigen risico) is applied first, as it is for any specialist care here.

Some expats are insured through an employer scheme or an international policy instead. Cover then works differently, so it is worth checking what your policy says about specialist mental health care and addiction treatment in the Netherlands. We can go through this with you at the addiction assessment.

If you would rather keep everything outside your health insurer, that is possible too. We also offer private health care through our dual diagnosis addiction treatment centre in South Africa.

Want to know more? See treatment costs, or contact us without obligation.

Every situation is different. That is why we offer both residential admission and day treatment when an addiction sits alongside an underlying condition. What fits you is something we work out together, and it is what gives lasting recovery from a dual diagnosis the best chance.

Ready to take a first step? Use the contact form or call 040-303 5023. If you are not sure whether a dual diagnosis is what you are dealing with, we are glad to think it through with you.