Dual Diagnosis & Alcohol Rehabilitation Treatment options

What Is Dual Diagnosis?

Dual diagnosis is a term used to refer to the situation when you suffer from two disorders simultaneously. The most common cases of dual diagnosis are when you have a mental health disorder and a substance use disorder. For example, you may be addicted to alcohol and also suffer from bipolar disorder and will then receive a dual diagnosis.

If you have a mental health disorder, you are statistically more likely to develop an alcohol use disorder. In addition, research demonstrates that alcohol can worsen the symptoms of mental health disorders, leading to co-occurring disorders.

If you need alcohol rehabilitation for an alcohol use disorder, and have a separate mental disorder, then your co-occurring disorders will need to be treated individually during rehab. Recent advancements in psychology, neuroscience and medicine mean that it is now more possible to understand and treat you if you have a complex addiction.

Some of the mental disorders that are generally associated with alcohol use disorder are:

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Anxiety

Anxiety is a normal part of life. You may feel anxious when you are faced with a problem, find yourself in a new situation, or before you have to make an important decision. However, when anxiety starts to affect your life to a debilitating level, this may be a sign of anxiety disorder. Anxiety disorder is a mental health condition characterised by disproportionate feelings of fear and worry that affect your daily activities.

There are many scenarios in which, to relieve your symptoms of anxiety, you may have started using or abusing alcohol as a self-medicating mechanism. This can spiral to alcoholism.

Doctors may recommend anti anxiety medication to you if you are suffering from a disorder, and it’s important to recognise that you may be at risk of developing a co-occurring disorder if you choose to self-medicate. If you feel you have developed an alcohol use disorder alongside anxiety disorder, it’s important to seek help and treat the anxiety disorder as well as tackling your alcohol problem through a comprehensive alcohol rehabilitation process.

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Depression

Depression is a mental health condition where you may have feelings of sadness and loss of interest in formerly pleasurable activities. Depression can severely affect how you think, act and feel, and can have serious effects on your relationships, work life and ability to function in daily life.

Many people who suffer from depression self-medicate with alcohol in order to suppress their symptoms, and if you’ve been doing so, you’ve probably experienced significant consequences to your emotional and physical well-being.

If you suffer from depression you may need professional help. There are specific alcohol rehabilitation programmes that are designed to tackle a dual diagnosis of depression and alcohol use disorder.

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Bipolar

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Bipolar disorder is a mental health condition where you may have long periods of depression followed by long periods of abnormally high energy and positive mood state. With bipolar disorder, you may have weeks or months of either high or low, before you reverse.

Research suggests that there is a strong connection between bipolar disorder and alcohol use disorder, with an estimate that over 40% of people who suffer from bipolar are also struggling with alcoholism.

If you suffer from bipolar disorder you know that it is a challenging condition to handle, and that it is even more difficult when you combine uncontrolled alcohol use with it.

Alcohol may act as an avoidance mechanism and stop you acknowledging the feelings that you are experiencing. If you are going to work through your alcohol problem, you need to be able to also understand and manage your experience of bipolar disorder.

Medical experts may have recommended that you take antidepressants to combat your depression, but if you have a dual diagnosis of bipolar and alcoholism, you will likely need specialist help and inpatient rehabilitation.

Schizophrenia

Schizophrenia is a mental health condition where you may have cognitive dysfunction, including trouble concentrating, learning difficulties and impairment to your executive function that makes it difficult for you to process information rationally and make good decisions.

Research demonstrates that around 50% of patients with schizophrenia also struggle with alcohol abuse and other substance addictions. Schizophrenia and alcohol use disorder require a dual diagnosis, specialised rehabilitation treatment, considering all aspects of your addiction and other disorders.

The combination of alcohol abuse and schizophrenia can significantly affect your brain function. Alcohol can also reduce the efficacy of schizophrenia medication. When you get help for a dual diagnosis in a rehabilitation facility, all aspects of your situation will be assessed and understood so that you get personalised treatment.

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Post-Traumatic Stress Disorder [PTSD]

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Post-Traumatic stress disorder is a mental health condition where you may experience acute stress and anxiety in response to a traumatic event. Any physical or emotional trauma that leaves you feeling out of control and powerless has the potential to escalate into PTSD.

Many people with PTSD turn to alcohol and drugs to control their feelings of helplessness and gain some measure of control over their lives. However, alcohol often increases the severity of the symptoms that you experience, and you may suffer from co-occurring disorders which feed each other.

Treatment for PTSD focuses on confronting the underlying causes of your condition, but if you are also suffering from alcoholism, you will need extra, specialist, treatment, so that both conditions are treated during your rehabilitation process.

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Obsessive-Compulsive Disorder [OCD]

Obsessive-compulsive disorder is a mental health disorder where you may have obsessive fears, which may manifest with you displaying compulsive behaviours that affect your daily life. The most common example of OCD is when you wash your hands obsessively due to a fear of germs.

OCD is often associated with alcohol use disorder, as you may turn to alcohol to escape from your compulsive behaviour. Alcohol use often ends up worsening the condition.

In any rehabilitation process, professionals will seek to understand the underlying cause of your fear and obsessive behaviour, and both your alcohol use and your disorder will be treated in an appropriate way, factoring in all aspects of the dual diagnosis.

Any rehabilitation process for a dual diagnosis situation will mean that you have both conditions treated so that the root causes of addiction can be understood and you can begin a journey to a healthier life over which you have more control.

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Benzodiazepines & Mental Disorders

Mental health wellbeing is important in living a good and healthy life. According to WHO a half of the world’s population is affected by mental illness, making mental health disorders a common illness. Mental health illness affect people’s ability to function properly in a relationship, as well as in the society. Benzodiazepine may be used as medications for mental health disorders, including the following:

Anxiety disorder

Generalized Anxiety Disorder (GAD) is the most common anxiety disorder. Common symptoms of GAD include, muscle tension, fatigue, restlessness, insomnia and excessive anxiety, which may occur for a minimum of 6 months, due to the presence of other mental conditions or substance abuse. Antidepressants (SSRIs/SNRIs) are the leading medications, used for the treatments of GAD. However, when benzodiazepines are administered as an additional treatment for GAD, benzodiazepine address acute symptoms, while antidepressants take effect.

The Process of Rehabilitation

Alcohol use disorder is normally handled through inpatient or outpatient rehabilitation; with specific steps along the way. You may be worried about the rehab process, but it’s important to understand that it is an effective solution that can give you the opportunity to live a sober life in society.

This is what to expect when you seek alcohol use disorder rehabilitation:

Assessment for Alcohol Rehab

The first step in the process of your alcohol rehabilitation will be an assessment. This is where medical specialists assess your health condition to determine the level of alcohol abuse and how much damage has been caused to your health.

During this assessment, specialists will look through your medical history and mental health history. These findings will help determine the treatment programme that you will undergo. Regardless of the nature of your issues, and whether you have a dual diagnosis, your rehabilitation treatment process will follow a general framework.

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Admission to Rehab

After the assessment process, you move to the next step by gaining admission to the rehabilitation centre. This stage includes you signing paperwork and entering the care of the alcohol treatment centre for the duration of the programme. There are many different rehabilitation treatment programme options, including inpatient rehab and outpatient rehab, but every programme will have the same goal of helping you learn how to live a sober life and resist the urge to consume alcohol.

Medical Detox from Alcoholism

About 95% of alcoholics experience mild withdrawal symptoms when trying to quit. When this is the case, it may be possible to continue your rehabilitation programme on an outpatient basis. Around 5% of people with alcohol use disorder will have severe symptoms of withdrawal, which should be treated in-house with a detoxification process.

Detox from alcohol is the process of treating alcohol use disorder in a controlled environment. This will usually be in a professional treatment centre where you can be closely monitored for signs of severe symptoms. In some cases, detoxification will include the administration of medications to help reduce the symptoms associated with alcohol withdrawal. Detoxification tends to take between three and 10 days, after which your addiction should be more psychological than chemical.

Ongoing Rehabilitation

Alcohol rehabilitation is a process that is ongoing. The formal rehabilitation programme will persist until you are sober and can control your urges to consume alcohol. This may take weeks or months, depending on the severity of your addiction and history of alcohol use. As a patient entering rehabilitation, you shouldn’t expect to leave the facility immediately after detoxification.

Successful treatments for alcoholism, especially alongside other co-occurring mental disorders, are a result of professional help alongside your motivation to get better. The ongoing rehabilitation process may include counselling sessions, physical therapy, classes, group sessions and sessions with family and friends. Without all the essential elements of rehabilitation, it is difficult for you to progress to a stage where you can control your triggers, understand your co-occurring disorders, and choose a path that will lead to sobriety.

A typical in-house alcohol rehabilitation programme lasts at least 28 days, during which you will remain in a controlled environment where alcohol and other substances are not available.

Graduation from Alcohol Rehab

At the end of your successful rehabilitation process, you may leave the treatment facility. You will be provided with backup assistance in the form of ongoing recovery or aftercare programmes. Rehabilitation is just the first step in regaining control of your life and alcoholism. As you leave the centre, you should have the skills and mental makeup to move forward towards a productive life of sobriety. Then your recovery is up to you.

Aftercare and Ongoing Recovery

Overcoming alcohol use disorder does not stop with leaving the rehabilitation centre. There is always the possibility that you may relapse, and so you need to have a plan following rehab.

During your aftercare programme, you may have outpatient care, residence in a halfway house so that you can slowly integrate back into society, regular sessions with the facility counsellor, and regular participation in twelve-step programme meetings and group sessions. All of the activities are targeted towards helping you avoid and successfully integrate back into society

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Different Types of Treatment

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There are many different treatment options for alcohol use disorder rehabilitation. Hundreds of rehabilitation treatment centres in the UK provide expert alcohol rehab programmes ranging from short-term and quasi-residential to long-term inpatient and outpatient therapy and counselling.

Your choice of treatment will depend on a lot of factors, such as your daily schedule, proximity to rehabilitation treatment centres, the severity of your alcohol use disorder, your co-occurring disorders and dual/multiple diagnosis, and your finances. If you or someone you know needs rehab for alcohol use disorder, you may want to explore options with a treatment expert who can help you choose the best course of action for your specific situation.

Quasi-Residential

Quasi-residential rehab is an alcohol use disorder treatment designed to provide an option for those not looking for full inpatient rehabilitation. In quasi-residential rehabilitation, you will live in sober housing away from the actual treatment centre, and every day you will go to the rehab facility for treatment. Quasi-residential alcohol rehab is usually managed by a trained treatment supervisor and you will remain in support groups throughout the entire duration of your treatment. This system tends to be less expensive than inpatient programmes and provides you with the opportunity to attend other self-help programmes in the evenings, as well as learn to live a new lifestyle in a residential environment whilst you receive treatment.

Outpatient Treatment

An outpatient rehab programme is ideal if you who have mild alcohol use disorder. If you are willing to get sober and your addiction hasn’t progressed to a level where it is dangerous to your health, this may be the right solution; so that you can live your daily life alongside rehab to help you quit alcohol. Outpatient rehab comes in a lot of forms, but it tends to involve counselling, therapy and flexible programmes to fit around your life.

Inpatient Rehab

Getting sober on your own is less likely to work, especially if you have had a developing alcohol addiction for a long time. Once you have made the important decision to get and stay sober, you need to look for an alcohol treatment programme that will work for you.

Inpatient rehab involves you signing up for alcohol rehab and moving into a treatment facility where you will remain throughout the course of your rehabilitation treatment. Even though all treatment options can provide successful results, inpatient rehab has the highest level of success.

Inpatient rehab offers special treatment options, such as medically supervised detoxification and around-the-clock care from rehabilitation experts.

What Does Alcohol Addiction Treatment Involve?

Your alcohol addiction treatment will involve a number of processes, which may include medication, therapy, detox, education and support. Making the decision to seek treatment for alcohol addiction is one of the most important and life-changing decisions you will ever make. If you have made the choice to seek professional help here are some of the things you can expect through the process.

Group Therapy

One of the most effective treatments for alcohol addiction is group therapy, which is why groups like Alcoholics Anonymous have had high success rates and gained widespread support.

Group therapy is where a community of men and women share the desire to get sober and meet on a regular basis to discuss experiences, hopes, successes and failures in their efforts to get free from addiction.

When you sign up for alcohol addiction rehab, you will be strongly advised to participate in group therapy sessions. You may feel reluctant to join group sessions, but studies have shown that these support groups, in combination with other rehab treatments, are more effective when treating alcohol addiction than just the treatments themselves.

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Personal Therapy

The role of personal therapy in alcohol addiction rehab cannot be overemphasised. Personal therapy, or individual therapy, is an effective form of treatment based on one-to-one conversations between you and a trained therapist.

During this type of treatment, the therapist will explore your past experiences, personality, behaviours, and any co-occurring disorders, and will feed into the overall treatment plan to help you on your journey through the first stages of your recovery process. This personal therapy process will help you to understand the underlying causes of your alcoholism, to help you manage cravings, and the rapport and trust you experience with the therapist will go a long way to helping you in developing the confidence to rebuild other relationships in your life.

Medication

If you need medication to support your alcohol rehabilitation, then you will be provided drugs to help you cope with withdrawal symptoms. The drugs used to help with alcohol rehabilitation will be administered by professionals and prescribed by doctors. Every aspect of the detoxification process will be controlled to make it as comfortable as possible for you.

Twelve-Step Work

Your twelve-step work, or participation in a 12-step programme, is a useful part of the alcohol rehabilitation process. The 12 steps were originally proposed by alcoholics anonymous and are the foundation of many programmes the world over. The philosophy behind twelve-step programmes is that they help you to take responsibility for your past and build new guiding principles for your future. When you join an alcohol rehabilitation programme, you may like to follow the 12 steps to provide you with an additional framework to help you move forward in a sober, alcohol-free manner.

Cognitive Behavioural Therapy [CBT]

Cognitive behavioural therapy is the cornerstone of many addiction rehab treatment programmes. Research has shown that CBT is highly effective in treating addiction, helping you develop the skills that remain valuable long after the end of the formal rehab programme.

CBT is based on the premise that behaviours and feelings are largely controlled by your thoughts. The implication is that while you may not be up to change what happens around you and your environment, you can change the way you think about it.

Cognitive behavioural therapy will help you to change the way you think about yourself and your circumstances so that you can make choices other than consuming alcohol, even when life is difficult.

The goals of CBT are:

  • To help you recognise the situations that can lead to you consuming alcohol
  • To teach you to avoid the situations and triggers that lead to alcohol consumption
  • To help you cope with problems and life situations that may lead to alcohol abuse
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What Happens after Rehab?

Going through alcohol rehabilitation is a very important step in you achieving your goal of living a sober life, but staying sober is an ongoing process- a journey. After completing the detoxification and rehabilitation treatment plan that you are provided with, you are able to return to normal life, which often means going back to the same setting in which your alcohol use disorder developed.

Research suggests that relapse usually happens within the first six months following rehab. By understanding your triggers and what causes your craving for alcohol, and by securing the support of friends and family, you can buffer yourself against the dangers of relapse.

Support for Families

Friends and family are the strongest support system a recovering addict can get, but this kind of support is only possible when the family knows how to provide it.

Addiction treatment centres will give the option for family members to receive training, including sensitisation and tools to help you recover and cope with ongoing temptations. In some cases, your family and friends may attend therapy sessions during rehabilitation. This is an important way for them to learn how to handle potential relapse situations.

Recovering from alcohol addiction may be one of the most difficult challenges of your life, but committing to a sober, healthy future, free from any alcohol, will be the best decision you ever make.

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FAQ

Is alcohol rehab free?

The NHS, community organisations, and private rehab centres offer rehab treatment to anyone suffering from alcohol use disorders. Most people can start with a free service offered by the NHS. You can also find of low-cost alcohol rehabilitation treatment programmes in the UK if you are unable to afford the more expensive packages. You may want to check your health insurance provider to see if your plan supports addiction rehab, or some of the rehab process. If you have a complex addiction, and co-occurring mental disorders, you should look for an alcohol real rehab programme that is able to cater to your special requirements.

What is alcohol rehab like?

Rehabilitation begins the moment you sign up for treatment at a rehab centre. You are entering a new journey, towards a new life, and must be willing to change. You will face certain examinations and interviews to understand your medical history and experience of alcohol use. As you quit alcohol, you may experience withdrawal symptoms, and the rehab facility will help you manage the symptoms, potentially using medications to make it easier.

Alcohol rehab involves a series of programmes and activities in order to reduce your craving for alcohol and provide you with the tools and mental outlook to live a sober life in the future. Living an alcohol-free life is a journey not a destination, and it is the job of alcohol rehab practitioners to get you ready for that new path.

How long do I need to stay in rehab?

The length of your rehab stay will depend on several factors, such as the type of treatment you opt for, the duration of your alcohol use disorder, and whether there are co-occurring mental disorders in the picture. Generally, alcohol rehabilitation takes between 30 and 90 days.

Can I rehab at home?

It is possible to rehab at home but it’s not always advisable.

Alcohol rehabilitation usually results in alcohol withdrawal symptoms, which for some can be strong. Additionally, home-based rehabilitation tends to be less effective because you are embedded in the environment in which you developed your alcohol use disorder.

If your work schedule or daily routine does not allow you to go for full inpatient treatment rehab, you may want to consider outpatient rehab, or quasi-residential rehab.

During outpatient rehab, you can live at home, but you will follow a treatment path prescribed by an addiction treatment specialist. In quasi-residential treatment, you will live in a sober living house.

Can you leave alcohol rehab?

Just as it is your choice to seek alcohol rehab, leaving rehab before completing the addiction treatment programme or staying until the end is up to you. If you are, however, in the middle of the treatment process and decide to leave, it is important that you understand that you are riskinglosing the progress you’ve made. You need to have the motivation to go through the change process of recovery. There will be hurdles along the way, and your treatment professionals will help instil in you the persistence and belief that you can continue on the journey.

Can you drink after alcohol rehab?

Experts recommend total abstinence and an alcohol-free life after rehab. Instead of giving into temptation, explore options that can help you stay away from alcohol, such as participating in support groups.

How does rehab work?

Rehab works by providing you with a better understanding of yourself and your addiction, and new ways of thinking and tools so that you can make better choices based on solid foundations after you leave the rehab programme. Rehab provides you with what you need to live your life in recovery and helps you to choose to avoid trigger situations that could cause you to relapse in the future.

How effective is alcohol rehabilitation?

Alcohol rehab is about teaching you to manage the underlying causes of your addiction and to control your thoughts, avoid trigger situations and remain strong amidst the temptation to consume alcohol. Rehabilitation is just the first step on the journey, and, after rehab,you live your life in recovery. Most alcohol rehab treatment programmes are excellent at providing you with the tools that you need to live a sober life.

What to bring to alcohol rehab

Every treatment rehab centre has a strict policy regarding what you can bring and what you cannot bring into the treatment rehab centre. Common items you can bring include:

  • Contacts of family members, sponsors and other people that the facility can reach on your behalf
  • Any medication you currently take. The practitioners at the facility will want to know any regular medication you take.
  • Clothes
  • No rehab centre will allow you to bring in drugs, alcohol or any illegal substances.

When does alcohol rehab work?

The key to getting results from alcohol rehabilitation is to have a strong will. With determination and persistence, a willingness to change and put in the effort, your participation in the activities of rehab will have the best possible chance of affecting lasting change.

Why alcohol rehab doesn’t always work

Alcohol rehab is the start of the process of living a life in recovery. After rehab, you will go back to society and the many temptations that it harbours. It is then up to you to manage your thoughts and behaviours, avoid trigger situations and understand your feelings in order to stay away from alcohol. Those that relapse may become overwhelmed with life or cannot control their urges. During rehab, it is important to identify, analyse and talk through your specific triggers and history of addiction to give you the best possible chance of living a life in recovery.

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