Defining Dual Diagnosis

What do mental health professionals mean by "dual diagnosis?"

Mike Matoney, Executive Director: A "dual diagnosis" describes when any substance abuse issues and mental health issues are occurring at the same time - someone could have substance abuse issues with marijuana and alcohol and at the same time have depression, conduct disorders, or bipolar disorders. "Co-occuring" is the more new millennium way to describe these types of disorders.

Does one cause the other?

Mike Matoney: We would say that these issues need to be treated concurrently - one is not a result of the other.

At New Directions you treat adolescents. Do these types of disorders appear more often in young men or young women?

Carrie Moore, Development Associate: Females are more apt to be described as depressed, males are more likely to be described oppositional or defiant. Also, girls are more likely to come to treatment at an older age because they don't seek it out. And when they do come to treatment they're better at hiding their disease - they're better at maneuvering.

Mike Matoney: Female young adults in our society tend to be just below the radar screen of identification of these issues - males are more prone to act out and be more seen in community - for this reason females with these problems are not really noticed by teachers, principals, or juvenile courts.

What signs should parents and teachers look for in adolescents that could indicate a co-occurring disorder?

Mike Matoney: Obvious signs are clear indicators that they're using - the smell of alcohol or marijuana a change of friends, being withdrawn, estrangement from family. A lack of interest in activities that were once important, such as music, dance, choir or singing.

Are mental health professionals developing more awareness of co-occurring disorders?

Mike Matoney: The state of art is moving forward in the way that we provide therapy and treatment. We're taking a look at the whole person, which includes mental health as well as drug and alcohol issues. Although treatment still isn't provided in tandem as often as it should be. A substance abuse issue is often the missing piece when therapy and medication for mental illness aren't as effective as expected. It's only been seriously looked at in the last 4 to 5 years. Those of us who were in the trenches realized it - clients weren't getting well and they weren't responding to treatment - we asked - what's getting in the way here?

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