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Dr. Steve Frisch, Psy.D. is a clinical psychologist in private practice in
Chicago, Illinois and Northfield, Illinois.

You can contact Dr. Frisch, Psy.D. at
(847) 498-5611.

Recover from chemical dependency and its toxic impact on family members. Raise your children to choose to be alcohol and other drugs free. Learn how to in Dr. Frisch’s, Psy.D. Recovery book series.


What Does Dual Diagnosis Mean?

Dear Dr. Steve:

I’m concerned about my daughter. She came home from the hospital almost six months to the day that I’m writing you yet she doesn’t seem to be getting any better. Don’t get me wrong, I’m grateful for the fact that she is no longer drinking, but she seems so down, almost depressed. She sleeps more than I’ve ever seen her sleep before. There are days that she can’t get out of bed to go to work. She appears sullen more often than not. I have done everything I can to help her feel good about herself but she’s more negative than ever. When she was in her drug program at the hospital, we were given reason to believe that it was normal to be depressed or anxious, but I thought for sure that this would have cleared up by now. What’s got me especially concerned is that I overheard her talking to a friend and I thought I heard her say that there are days where she just wishes that she were dead. I feel like I almost lost her once to alcohol and drugs. Now that we have her back, I don’t want to take a chance of losing her again. What do I need to do to get my daughter the help she needs?

Although what you’re daughter is going through is by no means unusual, you have good reason to be concerned. Oftentimes, an individual who is chemically dependent may be suffering from a co-existing emotional disorder(s) as well. We often use the phrase dual diagnosis to describe a condition where an individual may be diagnosed as chemically dependent as well as suffering from a co-existing emotional disorder. Some examples of co-existing emotional disorders follow.

Alcohol and Depressive Disorders

It’s not uncommon for alcoholic men and women to complain about feeling depressed.  Many symptoms of alcoholism mimic the symptoms of depression. Insomnia, appetite reduction, hopelessness, feelings of worthlessness, and reduced energy are symptoms of both alcoholism and depression. As a result, nearly a third of alcoholic men and women meet the diagnostic criteria for major depressive disorder.

Because alcohol is a depressant, many people who drink experience the depressive effects of alcohol on their mood. It has been found that after two or three weeks of good nutrition, proper rest, and abstinence, the temporary depressive effects of alcohol subside and the individual’s underlying mood begins to clear up. Sadly for many others, depression and bipolar depression are more chronic diagnosable conditions that do not clear up with abstinence and proper nutrition. For those individuals, treatment by a qualified doctor or psychiatrist is critical to an individual’s long-term well-being. If the depression is not treated both timely and properly, the newly abstinent individual is much more vulnerable to relapse.

Alcohol and Anxiety Disorders

Alcohol works in a similar fashion to a group of medications called benzodiazepines. Benzondiazepines are tranquilizers that are often used as anti-anxiety agents. As such, many people who abuse and are dependent on alcohol have learned to medicate their anxiety by drinking. For those individuals who may have a diagnosable anxiety disorder such as generalized anxiety disorder, social phobia, or panic disorder, alcohol may be what they have used to provide temporary relief from their anxious feelings. Tragically, in so doing, they have developed a dependency on alcohol as well as continue to struggle with their co-existing anxiety disorder.  For these individuals, their anxiety disorder must be treated by a qualified doctor or psychiatrist with appropriate medications and/or behavioral therapy.

Alcohol and Suicide

Among people who attempt suicide, alcoholism is a common diagnosis. For those people who commit suicide, major depression and alcoholism are the most commonly diagnosed psychiatric disorders. Alcoholism and drug addiction are the second most important risk factors in people who commit suicide.

Alcoholics are vulnerable to committing suicide because the depressive effects of alcohol can exaggerate a co-existing depression disorder and thus increase the likelihood of an impulsive act like suicide. For those individuals who are at risk for suicide, they need to be treated by a qualified psychiatrist and/or psychologist.

Alcohol and Dependence on Other Drugs

Alcohol abuse and dependence often times co-occur with the abuse of and dependence on other mood altering substances such as marijuana, cocaine, heroin, hallucinogens, and/or a wide range of prescription medications. Because of this, the newly abstinent individual should be abstinent from all mood-altering substances.

Your daughter should be seen by a psychiatrist who specializes in the treatment of alcoholism and drug addiction. It’s critical that the treating psychiatrist understand the potential difficulties with prescribing certain medications to an individual who has a co-existing addiction and emotional disorder. The psychiatrist will do an evaluation of your daughter’s presenting problems, assess the seriousness of her suicidal ideation, and make the appropriate treatment recommendations based on the findings of your daughter’s evaluation.


Recover from chemical dependency and its toxic impact on family members. Raise your children to choose to be alcohol and other drugs free. Learn how to in Dr. Frisch’s, Psy.D. Recovery book series—From Insanity to Serenity.

Pathfinder’s Checklist
1.) Often times a chemically dependent individual suffers from a co-existing emotional disorder as well.
2.) If you suspect that either you or a loved one is suffering from a co-existing emotional disorder, you or your loved one should see a qualified psychiatrist who is an expert in addictions to evaluate and treat the co-existing mood disorder.
3.) If you suspect that either you or a loved one is at risk for committing suicide, you or your loved one should see a qualified psychologist or psychiatrist for an evaluation.
4.) Co-existing emotional disorders can be successfully treated along with successfully treating one’s chemical dependency.
 

G.B.U.

Steve



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