Understanding Dual Pathology and its effects

Dual pathology is a term we use in the field of psychology to describe the condition of an individual who simultaneously suffers from a substance use disorder (alcohol, benzodiazepines, cocaine or methamphetamines, among others) and another psychiatric disorder (anxiety, mood, psychotic, personality or neurodevelopmental disorders, For example).

This term acknowledges the additional complexity in symptoms and treatment that can arise when a person has these two conditions together. In many cases, it implies an interrelation and a mutual influence in such a way that the symptoms of one can aggravate those of the other, creating a cycle of deterioration that can be difficult to break without appropriate intervention and complicate both diagnosis and management. treatment.

Its importance lies in recognizing the need for an integrated treatment approach that addresses both disorders.

The keys to understanding dual pathology

The disorders can be of different types and degrees, including, but not limited to, the

schizophrenia, he Bipolar disorder, depression and anxiety disorders. That is why it is an important public health problem due to its high prevalence and complications. that it can cause in the life of an individual and its management requires an integrated approach that addresses both the disorder mental as the addiction problem.

We cannot determine a single cause that explains the appearance of dual pathologies due to its complex and multifactorial condition. Its manifestation, on the other hand, will depend on a combination of genetic, biological, psychological and environmental factors:

1. Genetic and biological factors

Some studies indicate that certain genes can make a person more prone to developing mental disorders and addictions.

2. Psychological factors

Mental health problems can make a person more vulnerable to the use of substances such as a form of self-medication. For example, a person with depression may turn to alcohol to relieve depression symptoms, which in turn can lead to the development of a substance use disorder.

3. Environmental factors

The environment and factors such as stress, trauma, peer pressure, substance availability, and lack of social support can increase the risk of developing mental disorders and addictions.

What comes first: addiction or mental disorders?

Determining what comes before is a challenging procedure since the interaction between both terms is bidirectional and complex. On the one hand, the use of substances can exacerbate the symptoms of a mental disorder, cause a new one or worsen the course of a pre-existing one; however, on the other hand as well, mental disorders can increase vulnerability to substance use and make recovery from a substance use disorder more difficult.

In addition, we must take into account that They can present you with various components that can make diagnosis difficult:

• Symptom overlap. Many of the symptoms are shared between both diagnoses, so they can overlap and you don't know exactly why they are caused.
• Influence of substance use on symptoms. In these cases, it will be necessary to wait until the person has stopped using substances to be able to make an accurate diagnosis.
• Denial or minimization of substance use.
• Stigma and fear. The stigma attached to mental disorders and addictions can make some people afraid to seek help or to be honest about their symptoms and their use.

Therefore, the important thing is to carry out a thorough evaluation and a team approach that includes professionals with experience in treating mental disorders and substance use disorders.

The evaluation needs to include a detailed clinical interview and review of the individual's medical and psychiatric history, where the mental health professional can ask about symptoms, substance use, family history of mental disorders or addictions, and recent stressors or changes in the patient's life individual. Also of special relevance is the application of psychological tests that can help to evaluate the symptoms and identify any underlying mental disorder, as well as tests medical tests, such as blood and urine tests, that can help identify substance use and rule out other medical conditions that may be causing or contributing to the symptoms.

How can we intervene in dual pathology?

Treatment of dual pathology must be comprehensive and individualized, taking into account both the mental disorder and the substance use disorder. The main goal is to help the person manage both disorders, reducing symptoms and improving quality of life.

One of the most common forms of psychotherapy used in the treatment of dual pathology is cognitive behavioral therapy (CBT), in addition to others such as acceptance and commitment therapy, motivation therapy or the medication itself. CBT helps people recognize and change negative or destructive patterns of thinking and behavior, so it can help people people manage the symptoms of their mental disorders, resist cravings to use substances, and develop coping skills healthy. If we add group interventions to these therapies, we will provide a social support network that will encourage learning from the experiences of others with similar problems. In which areas did we manage to have an impact?:

• Physical health, reducing the probability of triggering liver, cardiovascular, respiratory and/or neurological diseases.
• Mental health, being able to reduce, for example, the risk of suicide.
• Interpersonal and family relationships, avoiding behaviors such as social isolation, family conflicts or the breakdown of relationships.
• Education and employment, trying to minimize the impact on academic/labor performance and, in turn, on unemployment rates and economic problems.
• Legal and social, facing a smaller number of legal problems such as arrests or imprisonment.

With the help of these treatments and interventions, we will be able to minimize the negative consequences that the diagnosis of a dual pathology, as they can be devastating not only for the patient himself but also for his around.

Family and friends often face great stress and may feel powerless to help their loved one, for it is essential to provide them with guidance and support to learn how to handle the situation in the best possible way; To do this, helping to understand and raise awareness about dual pathology will also be key to reducing stigma and empathizing with affected people and their families.

Conclusion

We can therefore conclude that the diagnosis of dual pathology poses unique challenges in terms of diagnosis and treatment., due to the complexity of the symptoms and the overlapping challenges associated with each disorder. Despite the difficulties, early detection and diagnosis is essential for effective management. Treatment should be comprehensive and individualized, addressing both the mental disorder and the substance use disorder. Psychotherapeutic therapies play a key role, and in many cases, medication can be a valuable tool, as are social support and group therapies.

Society in general, and especially health professionals, must be well informed about dual pathology. Understanding and awareness can help prevent the occurrence of dual pathology, promote early detection and treatment, and reduce the stigma associated with these disorders. A call to action is needed to raise awareness and improve diagnosis, treatment and support for people with dual disorders. Only through these measures can we work together to improve the lives of people affected by dual pathology and foster a healthier and more caring society.