A person with substance abuse or substance dependence does fall under axis I criteria (I'M PRETTY SURE; check this out). There are separate criteria for both substance abuse and substance dependence as separate disorders. If your friend is being given a different diagnosis, it's possibly for insurance purposes, as the ones I mentioned might not be parity.
As for the abuse, it would probably fall under Axis I if there was Post-Traumatic Stress Disorder and Axis IV if it was causing significant trauma at present and had led to a dearth of healthy relationships.
So yes, it's easily possible -- but the DSM is a limited tool. It doesn't tell stories, or make extensive notes about history. These would be in medical documents and/or disclosed during therapy.
Hope this helps! I'm confusing myself...
Best of luck.Is it possible to not have a separate mental health diagnosis?Yes it is possible. The reason is many of the symptoms associated with substance use, and the long term usage of it can relate to other mental health issues. The line that distinguishes this is actually the presence of substance abuse. Meaning, until that is resolved and some of the issues related to it are taken care of a second diagnosis is generally avoided. This is due to medication control. It is not good to over medicate, also additional problems come from using multiple medications as they often conflict and the side effects can be more detrimental to the individual than positive. To show you the other side, if a person had the same issues as the one you are inquiring about but did not have substance abuse presently or a long term history of it, the diagnosis would be much different. Take a look on the Internet at mental health issues associated with addicts you will get a large scope of information detailing behaviors and disorders and will see clearly what I mean.Is it possible to not have a separate mental health diagnosis?I'm from the UK and studying occupational therapy and have been on community mental health placements where there have been some people who have been there under substance misuse and in my experience they do a full history check with that person. So their past is taken into account but if that person doesnt reveal their past traumas then it fully upto the person as to whether they want to share that information and talk and work on ways on how to move on from that. I dont think that the person will be given a second/separate diagnosis because it's only really doctors that give out diagnosis's and they do that so the person can get the right medical/medication for their current mental state.Is it possible to not have a separate mental health diagnosis?
I'm not sure if I understand your question, but I try to answer.
If someone has a mental illness, a history of abuse, and a substance abuse problem; it does not always mean either the substance abuse or the abuse caused the mental illness.
I know of people who have diagnoses of schizophrenia or bipolar disorder who also abuse illegal drugs and have a history of being sexually abused. The main mental illness diagnosis doesn't seem to have any direct connection to the other problems.
A lot of mentally ill people come from families where there was abuse. Some of them will be diagnosed with post traumatic stress disorder or a dissociative disorder than is considered a result of the abuse. Some others will be diagnosed with bipolar, schizophrenia, etc., which are not thought to be directedly related to trauma. Maybe other family members were also mentally ill and the disorder might have to do with genetics.
A lof of mentally ill people use alcohol or illegal drugs to "self-medicate." Sometimes it's hard to tell if the problem started with the drug abuse or if the person has a mental illness whether or not they use drugs.
It's not unsusual for the diagnosis to change. I have seen people get admitted to the state hospital for bipolar disorder and later the diagnosis gets changed to "substance induced mood disorder." Still later, the diagnosis is changed back to bipolar disorder or to something else.
A friend of mine was abusing drugs a lot and was acting pretty strange. He went to the state hospital and got diagnoses of "Bipolar Disorder with Psychotic Features" and "Opiate Abuse." The psychiatrist did not think the drugs were the underlying cause of his behavior.
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