In my many years of service as a Psychiatrist, I have seen “n” number of patients with dual diagnosis. Dual diagnosis means when one patient has a mental health disorder along with substance use disorder or alcohol use disorder. Since many of the cases go undiagnosed over the years as the symptoms of both may overlap each other, the treatment becomes quite difficult but more requisite. It is very important for the patient that his signs and symptoms are correctly diagnosed as the line of treatment depends on it and so does his chances of recovery.

Often when families bring their loved ones to me for the treatment of addiction, they are not able to differentiate between their loved one and his disease. They want a “quick fix” for his “bad habit” of drinking day and night or consuming harmful drugs. They are not able to comprehend the mental health concerns that demand immediate attention and the need for constant care and vigilance side by side to the treatment of addiction. Therefore it is of utmost value to understand that treating addiction itself will not treat the patient if issues concerning his mental health are neglected.

Substance use disorder or alcohol use disorder over power any other alarming signs of the patient that may generally catch attention. These symptoms may look like;

1. Overspending
2. Indulging in risky behaviours
3. High on energy
4. Inability to sleep or over-sleeping
5. Inability to eat or over-eating
6. Decreased ability to concentrate
7. Rapid or frenzied speaking
8. Loss of interest
9. Euphoria
10. Hyperactivity or impulsivity
11. Aggression
12. Restlessness
13. Loss of interest
14. Agitation/Irritability
15. False belief of superiority

The above-mentioned signs or symptoms may not all be present in the patient but it requires immediate psychiatric attention.

Mental health is the core of overall well-being and rehabilitation of the patient requires not only treating the addictive behaviour patterns but addressing the concerns that have never gotten a chance to be addressed.

Whenever I receive any patient, my concern is not the dosage of his substance use or how much amount of alcohol he is taking, my primary and sole focus is on the psychological pain that no one around him can understand and that no one has aimed to resort. My patients may seem aggressive on the outside but deep inside they are broken and want someone to lend a hand and to look through the rough exterior they have forged.

Having a healthy mind is a right for all, and patients of substance use disorder are in so much shadow of their illness that they are never even allowed a glimpse of it. They carry the shame and drown their pain in their bottles.

We can not distinguish between the patients based on their ailments. Addiction is a deadly disorder that not only affects patients physically but psychologically as well and healing of mental pain is not only a need but rather should be a priority. Till the time substance use disorder and mental health issues are not addressed together, the treatment shall remain incomplete.

Hence, we need to look above and beyond the problems addiction is causing and dive right into the heart of it. The pain of addiction may seem uncontrollable but the mental misery the patient is in is unbearable and needs utmost empathy and care.